PsA Risk Highest in Patients With Severe Psoriasis

A recent study published in Journal of the American Academy of Dermatology concluded that the risk of psoriatic arthritis (PsA) increases with psoriasis severity, with patients with severe psoriasis having the highest risk of PsA.

Merola et al sought to assess the incidence, prevalence, and predictors of PsA among patients with psoriasis, stratifying psoriasis severity using treatment type. Data from the Optum electronic health records database included incidence of PsA per 100 patient-years (PY) and prevalence of PsA. They assessed incidence from psoriasis diagnosis and 1-year postdiagnosis overall, then further stratified by severity.

Overall, the authors found that the incidence of PsA was 2.9 events per 100 PY. Patients with mild psoriasis has a incidence of 2.1 events per 100 PY, whereas as patients with moderate or severe psoriasis had 9.9 and 17.6 events per 100 PY, respectively, as determined by treatments of nonsystemics, nonbiologic systemic therapy, and biologics. The overall incidence of PsA was lower when patients who were diagnosed with PsA 1 year following their psoriasis diagnosis, with similar outcomes for the different treatment classifications.

Therefore, concluded the study authors, “the risk of developing PsA increased with disease severity and was highest in patients with the most severe psoriasis.”

Reference
Merola JF, Tian H, Patil D, et al. Incidence and prevalence of psoriatic arthritis in patients with psoriasis stratified by psoriasis disease severity: retrospective analysis of a US electronic health records database. J Am Acad Dermatol. Published online September 18, 2021. doi:10.1016/j.jaad.2021.09.019