Related Experiment Video
Updated: Jul 3, 2026
Measuring Psoriasis Severity at Home
Published on: March 1, 2024
Do Patients Diagnosed with Psoriatic Arthritis Before or Concurrently With Psoriasis Have Different Disease
Matthew Anacleto-Dabarno1, Fadi Kharouf2, Virginia Carrizo Abarza3
1M. Anacleto-Dabarno, MDCM, Gladman Krembil Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Schroeder Arthritis Institute, University Health Network, and Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, and Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Objective:
This study aimed to investigate whether patients who present with psoriatic arthritis (PsA) before or concurrently with psoriasis exhibit different baseline characteristics and disease outcomes compared with patients with classical PsA, in whom psoriasis precedes PsA. We also characterized factors contributing to the onset of psoriasis in these patients.
Methods:
We included patients with PsA from an observational cohort and classified them into 3 groups: classical PsA (psoriasis diagnosed before PsA), concurrent disease (psoriasis and PsA diagnosed within 1 year), and antecedent PsA (PsA diagnosed > 1 year before psoriasis). We assessed the association between these groups and 2 outcomes: mean disease activity and the course of radiographic damage. We used multivariable linear regression to estimate the adjusted 5-year mean swollen joint count (SJC) and Cox proportional hazards regression to evaluate time to radiographic progression. Cox regression was also used to identify factors associated with psoriasis onset in the antecedent PsA group.
Results:
Of the 1702 patients studied, 1138 (66.86%) were classified as having classical PsA, 444 (26.09%) as having concurrent PsA, and 120 (7.05%) as having antecedent PsA. These groups differed in baseline demographic and PsA-related characteristics. Compared with patients with classical PsA, those with concurrent or antecedent PsA showed no significant differences in time-averaged disease activity or time to radiographic progression. Biologic disease-modifying antirheumatic drug (bDMARD) use was associated with a reduced risk of developing psoriasis in the group with antecedent PsA.
Conclusion:
The relative order of psoriasis and PsA diagnosis does not significantly affect disease activity or radiographic progression. bDMARDs may influence the onset of psoriasis in patients with antecedent PsA.