Increased risk of psoriatic arthritis in patients with familial Mediterranean fever: a population-based cohort study

Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disease, associated with various inflammatory conditions. IL-1 is involved in the underlying pathogenesis of both FMF and psoriatic arthritis (PsA). However, data on the association of FMF with PsA are scarce. We aimed to assess this association using data from a large population database.

This was a retrospective cohort study based on data from a large healthcare provider in the Mediterranean that includes ∼4.9 million members conducted between January 2010 and December 2023. We identified all adults aged ≥18 ever diagnosed with FMF treated with colchicine without history of PsA. Identified patients were frequency matched by age and sex to 10 controls without FMF. Both groups were followed until the occurrence of PsA, death or end of follow-up. Cox proportional hazard regression analysis was used to assess the association between FMF and PsA adjusted for demographic factors and comorbidities.

The FMF study group included 9736 subjects, of whom 51.2% were females, with a mean age of 32.0 (19.7) years, matched by age and sex to 97 360 controls. During the follow-up period, 43 patients in the FMF group developed PsA compared with 119 in the controls, resulting in a hazard ratio of 3.52 (95% CI: 2.48, 5.0) adjusted to demographics and clinical characteristics.

FMF is associated with increased risk of developing PsA, highlighting the need for increased clinical awareness of PsA risk in FMF patients.