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. 2025 Mar 1;64(3):1131-1137.
doi: 10.1093/rheumatology/keae257.

Treatment of psoriasis with different classes of biologics reduces the likelihood of peripheral and axial psoriatic arthritis development

Alberto Floris  1   2 , Cristina Mugheddu  1   3 , Leonardo Sichi  1   2 , Jasmine Anedda  1   3 , Alessia Frau  1   3 , Jessica Sorgia  1   2 , Laura Li Volsi  1   2 , Maria Teresa Paladino  1   2 , Mattia Congia  1   2 , Elisabetta Chessa  1   2 , Maria Maddalena Angioni  1   2 , Micaela Naitza  1   2 , Caterina Ferreli  1   3 , Matteo Piga  1   2 , Laura Atzori  1   3 , Alberto Cauli  1   2
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Treatment of psoriasis with different classes of biologics reduces the likelihood of peripheral and axial psoriatic arthritis development

Alberto Floris et al. Rheumatology (Oxford). .

Abstract

Objective: To assess the potential role of biologic treatment for psoriasis (PsO) in reducing the likelihood of psoriatic arthritis (PsA) development, through a detailed analysis that considered the different historical phases in PsA management, the different biologic classes and the different patterns of articular involvement.

Methods: A monocentric cohort of 1023 PsO patients underwent a rheumatological assessment in which clinical and therapeutic data were recorded. A chi-squared test and multivariate logistic regression analysis (adjusted for the main PsA risk factors) were performed to compare the likelihood of PsA development in different treatment groups.

Results: The PsA prevalence in PsO patients treated at least once with biologics was significantly lower than in patients never treated with biologics (8.9% vs 26.1%, P < 0.001). In multivariate analysis, a significantly (P < 0.01) lower likelihood of PsA development in biologic-treated patients was confirmed in the whole cohort (adjusted odds ratio [adjOR] 0.228), as well as in the subgroups of patients with PsO onset after 2005 (adjOR 0.264) and after 2014 (adjOR 0.179). Separately analysing the different biologic classes, the TNF (adjOR 0.206), IL-17 (adjOR 0.051) and IL-23 or 12/23 (adjOR 0.167) inhibitors were significantly (P < 0.01) associated with a lower likelihood of PsA development. Finally, patients treated with biologics had a significantly (P < 0.04) lower prevalence of both pure peripheral PsA (adjOR 0.182) and peripheral PsA with axial involvement (adjOR 0.115).

Conclusions: This study provides meaningful and concordant evidence supporting the significant role of different classes of biologics in reducing the likelihood of peripheral and axial PsA development.

Keywords: biologic; interception; psoriasis; psoriatic arthritis; treatment.

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