Effect of Biological Therapy for Psoriasis on the Development of Psoriatic Arthritis: A Population-Based Cohort Study
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View abstract on PubMed
Summary
This summary is machine-generated.Interleukin (IL) inhibitors, especially IL-23 inhibitors, significantly reduce the risk of developing psoriatic arthritis (PsA) in psoriasis patients compared to tumor necrosis factor (TNF) inhibitors.
Area Of Science
- Dermatology
- Rheumatology
- Immunology
Background
- Psoriasis is a chronic inflammatory condition with a significant risk of progressing to psoriatic arthritis (PsA).
- Limited evidence exists comparing the efficacy of different biologic therapies in preventing PsA development.
- Tumor necrosis factor (TNF) inhibitors are a common treatment, but newer interleukin (IL) inhibitors offer alternative mechanisms of action.
Purpose Of The Study
- To compare the risk of developing psoriatic arthritis (PsA) in patients with psoriasis treated with different classes of biologic agents.
- Specifically, to evaluate the association between IL-23 inhibitors, IL-17 inhibitors, and IL-12/23 inhibitors versus TNF inhibitors in preventing PsA onset.
Main Methods
- A population-based cohort study utilizing South Korean nationwide claims data from 2007-2023.
- Newly diagnosed psoriasis patients without pre-existing PsA or other inflammatory arthritis were categorized by their initial biologic treatment (IL or TNF inhibitors).
- Multinomial overlap weights and Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) for incident PsA.
Main Results
- The study included 9499 psoriasis patients, with 41.2% receiving IL-23 inhibitors, 22.4% IL-17 inhibitors, 28.8% IL-12/23 inhibitors, and 7.7% TNF inhibitors.
- PsA developed in 3.0% of patients over 23,275 person-years.
- Any IL inhibitor use was associated with a significantly lower risk of PsA (HR 0.40; 95% CI 0.25-0.62), with IL-23 inhibitors showing the greatest risk reduction (HR 0.22; 95% CI 0.13-0.37).
Conclusions
- Interleukin (IL) inhibitors, particularly IL-23 inhibitors, are associated with a reduced risk of developing psoriatic arthritis (PsA) compared to TNF inhibitors in patients with psoriasis.
- These findings suggest a potential benefit of IL-targeting therapies in preventing the progression from psoriasis to PsA.
- Further research may elucidate optimal biologic strategies for managing psoriasis and preventing joint involvement.
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