This study set out to determine whether biologic therapy for psoriasis is associated with a reduced incidence of psoriatic arthritis.

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Background:
Psoriasis is a chronic inflammatory skin disorder that often precedes psoriatic arthritis. Conflicting evidence exists regarding whether biologic therapies for psoriasis can prevent or delay psoriatic arthritis onset.

Objectives:
To determine whether biologic therapy for psoriasis is associated with a reduced incidence of psoriatic arthritis.

Methods:
A retrospective cohort study was performed utilizing Optum's de-identified Clinformatics® Data Mart Database, from January 1, 2007, to February 29, 2024. Patients with moderate-to-severe psoriasis were identified by phototherapy use. Among these, some continued on phototherapy, and others switched to a biologic. Individuals with a psoriatic arthritis diagnosis or history of biologic therapy prior to phototherapy initiation were excluded. Cases of psoriatic arthritis developing within 1 year after biologic initiation were also excluded to minimize protopathic bias. Outcomes included the incidence of psoriatic arthritis, measured as incident cases per 1000 person-years. Hazard ratios (HRs) for psoriatic arthritis development were calculated using a multivariable Cox proportional hazards model.

Results:
Of 36,508 patients who received phototherapy for psoriasis, 26,470 met eligibility criteria. Among these, 2611 patients switched to biologics, while 23,859 patients did not. The overall PsA incidence rate was 7.85 per 1000 person-years. Patients continuing phototherapy alone had an incidence rate of 8.06 per 1000 person-years, compared with 6.75 in the biologic cohort. After multivariable adjustment for demographics, comorbidities, insurance type and oral systemic therapy, biologic use was associated with a lower likelihood of psoriatic arthritis development compared with phototherapy (adjusted HR, 0.66; 95% CI, 0.53–0.83; p < 0.05).

Conclusions:
In this study of moderate-to-severe psoriasis patients, those who initiated biologic therapy demonstrated a lower incidence of psoriatic arthritis than those continuing on phototherapy alone. This suggests that biologic treatments may delay or prevent psoriatic arthritis in psoriasis patients.

Source: onlinelibrary.wiley.com

*Funding: Early view funding unknown

Keep digging Watson.

(Tue-11-11-2025, 03:22 AM)mataribot Wrote: Keep digging Watson.

Well… why am I not surprised.

For me this is more or less obvious, as most biologics, they don’t say which one they used by the way, also are being used as therapies for Psoriatic Arthritis. That makes it more or less logical that the development of Psoriatic Arthritis is slowed down or even completely prevented.
As phototherapy is only aimed at the skin, though the effect of vit D might also help, it will help less in this prevention.

e.g. that also holds for my treatment DMF, that also works for both, so may prevent the development of PsA.
I still remember a question of Jim, he was developing PsA, and I advised him to slightly increase his medication, which helped, the symptoms stopped.

It is nice that there is now scientific evidence, but lets not forget that simple logic thinking also can provide solutions without necessary proof.

(Tue-11-11-2025, 20:21 PM)Caroline Wrote: It is nice that there is now scientific evidence, but lets not forget that simple logic thinking also can provide solutions without necessary proof.