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. 2024 Dec;91(6):1143-1149.
doi: 10.1016/j.jaad.2024.06.106. Epub 2024 Aug 27.

Risk of developing inflammatory arthritis in patients with psoriasis initiating treatment with biologics: A population-based analysis

Bruce Strober  1 , Ahmed M Soliman  2 , Chao Li  2 , Manish Patel  2 , Ikenna Unigwe  2 , Paolo Gisondi  3
Affiliations
Free article

Risk of developing inflammatory arthritis in patients with psoriasis initiating treatment with biologics: A population-based analysis

Bruce Strober et al. J Am Acad Dermatol. 2024 Dec.
Free article

Abstract

Background: The relationship between biologic treatments for psoriasis (PsO) and the development of inflammatory arthritis in patients is not fully understood.

Objective: The objective of this study was to analyze the effects of biologic treatment on the development of inflammatory arthritis in patients with PsO.

Methods: This retrospective study assessed patients with PsO identified in the Optum Clinformatics Data Mart database from Jan 2007 to Mar 2023 with no baseline diagnosis of inflammatory arthritis. Patients were stratified based on the class of initial biologic treatment (interleukin [IL] 23, IL-12/23, IL-17, or tumor necrosis factor [TNF] inhibitor) and followed for up to 3 years or development of inflammatory arthritis. Risk of developing inflammatory arthritis was assessed using a multivariate Cox proportional hazard model using IL-23 inhibitors as reference.

Results: Incidence rates of developing inflammatory arthritis expressed as events/100 person-years were 4.99, 7.29, 6.06, and 9.39 for IL-23, IL-17, IL-12/23, and TNF inhibitors, respectively. Adjusted hazard ratios were significantly higher for patients receiving IL-17 (1.44; P = .0294) and TNF (1.90; P < .0001) inhibitors when compared with patients receiving IL-23 inhibitors.

Limitations: Limitations include those associated with medical coding errors and the potential for protopathic bias.

Conclusion: Patients receiving IL-23 inhibitors are at lower risk of developing inflammatory arthritis or psoriatic arthritis than those receiving IL-17 and TNF inhibitors.

Keywords: IL-23 inhibitor; biologic; psoriasis; psoriatic arthritis.

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Conflict of interest statement

Conflicts of interest Dr Strober has served as a consultant for AbbVie, Acelyrin, Alamar, Alumis, Almirall, Amgen, Arcutis, Arena, Aristea, Asana, Boehringer Ingelheim, Kangpu Pharmaceuticals, Bristol Myers Squibb, Capital One, Celltrion, CorEvitas, Dermavant, Imagenebio, Janssen, Leo, Eli Lilly, Maruho, Meiji Seika Pharma, Protagonist, Monte Carlo, Takeda, Novartis, Pfizer, UCB Pharma, Sun Pharma, Rapt, Regeneron, Sanofi-Genzyme, SG Cowen, Union Therapeutics, Ventyxbio, and vTv Therapeutics; has stock options from Connect Biopharma and Mindera Health; has served as a speaker for AbbVie, Arcutis, Dermavant, Eli Lilly, Incyte, Janssen, Regeneron, and Sanofi-Genzyme‘ is a Scientific Co-Director and investigator for the CorEvitas Psoriasis Registry; and is Editor-in-Chief of the Journal of Psoriasis and Psoriatic Arthritis. Drs Soliman, Li, and Patel are full-time salaried employees of AbbVie and may own stock/options and/or patents. Dr Unigwe was a part time employee of AbbVie and received hourly compensation. Dr Gisondi has been a consultant for AbbVie, Almirall, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, LEO pharma, Eli Lilly, Pfizer, Sanofi, and UCB.

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