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Updated: Aug 13, 2026
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Measuring Psoriasis Severity at Home
Published on: March 1, 2024
Biologic DMARD class influences progression from psoriasis to PsA: A real-world cohort study
Nikolaos Kougkas1, Eleni Sotiriou2, Dimitrios Deligeorgakis1
1Fourth Department of Internal Medicine, Aristotle University of Thessaloniki, School of Medicine, Hippokration University Hospital, Thessaloniki, Greece.
Rheumatology (Oxford, England)
|August 12, 2026
Summary
Biologic disease-modifying antirheumatic drugs (bDMARDs) for psoriasis impact psoriatic arthritis (PsA) risk. Non-tumor necrosis factor inhibitors (non-TNFi) like IL-17 and IL-23 agents show lower PsA incidence compared to TNFi.
Area of Science:
- Dermatology
- Rheumatology
- Immunology
Background:
- Psoriasis is a chronic inflammatory condition.
- Psoriatic arthritis (PsA) is a common complication of psoriasis.
- Biologic disease-modifying antirheumatic drugs (bDMARDs) are used to treat psoriasis.
Purpose of the Study:
- To investigate if bDMARD class influences the risk of developing PsA in psoriasis patients.
- To compare PsA incidence across different bDMARD classes in a real-world setting.
Main Methods:
- Retrospective study in two university centers.
- Included adult psoriasis patients receiving bDMARDs for at least six months.
- Primary outcome was the incidence of PsA.
Main Results:
- 86 out of 393 patients (22%) developed PsA.
- Non-TNFi bDMARDs (IL-17, IL-23) were associated with significantly lower odds and hazards of PsA compared to TNFi.
- No difference in PsA risk was observed when analyzing by the first bDMARD received.
Conclusions:
- Non-TNFi bDMARDs, especially IL-17 and IL-23 inhibitors, are linked to a reduced risk of PsA development in psoriasis patients compared to TNFi.
- These findings suggest potential for PsA interception through strategic biologic selection.
- Further prospective studies are warranted to confirm these observations.
