In patients with psoriasis, retrospective data revealed that compared with phototherapy, a significantly lower incidence of psoriatic arthritis (PsA) was observed when treated with biologics. This was confirmed by a difference of -25.5 cases of PsA in the biologics group.

Kathleen Miao, PhD, and colleagues conducted retrospective cohort study aimed at exploring whether treatment with biologics would impact the incidence of PsA in patients with moderate-to-severe psoriasis compared with those receiving phototherapy1. They analyzed data from 4,695 patients with psoriasis from Optum’s de-identified Clinformatics® Data Mart Database and their findings were presented at the 2023 American Academy of Dermatology annual meeting.

All patients in the study cohort received phototherapy as index treatment for psoriasis; 461 patients later switched to biologics. The occurrence of PsA after 10 years was defined as an outcome measure.

At diagnosis, patients switching to biologics were younger (median age 44.9) compared with the phototherapy patients (median age 53.8); more than half of the cohort were women. PsA occurred at an incidence of 46.2 per 1,000 person-years in the entire group. Differentiated by treatment, this incidence changed to 24.6 per 1,000 person-years in the biologics arm and 50.0 per 1,000 person-years in the phototherapy arm. With a difference of -25.48 cases of PsA per 1,000 person-years, this corresponded to a significantly lower incidence in the biologics group (P=0.0011).

The HR of biologic versus phototherapy was 0.476 (P=0.005), identified by a Cox regression that adjusted for sex, age, and time on oral systemics.

Dr. Miao and colleagues concurred that that biologic use may reduce the development of PsA among psoriasis patients.

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