Spondyloarthritis & psoriatic arthritis
Association between biological immunotherapy for psoriasis and time to incident inflammatory arthritis: a retrospective cohort study
Authors' conclusion
In this large cohort study of patients with psoriasis, treatment with IL-12/23 inhibitors or IL-23 inhibitors was associated with reduced risk of progression to inflammatory arthritis compared with TNF inhibitors.
Study context
- Population
- Adults (≥18 years) with psoriasis (two ICD codes >30 days apart) newly prescribed a biologic, TriNetX network, USA, Jan 1, 2014–June 1, 2022mean age 50.2 years
- Participants
- 15,501 adults
- Exposure
- IL-12/23, IL-23 or IL-17 inhibitors vs TNF inhibitors in psoriasis
- Outcome
- Time to incident inflammatory arthritis (first diagnostic code for PsA or other inflammatory arthritis after biologic initiation)
Methodological detailsweighted Cox proportional hazards regression, adjusted for demographic and clinical covariables, national EHR database (TriNetX)
- Weighted Cox proportional hazards regression
- Adjusted for demographic and clinical covariables
- National EHR database (TriNetX)
Main finding
As reported in the abstract
Incident inflammatory arthritis
Each group vs TNF inhibitorsAdjusted hazard ratio (95% CI)
IL-12/23 inhibitors
0.58(0.43–0.76)
IL-23 inhibitors
0.41(0.17–0.95)
IL-17 inhibitors
0.86(0.54–1.38)
- Developed inflammatory arthritis, whole cohort
- 976 (6.3%)
- Cumulative incidence, whole cohort
- 2.6 cases per 100 person-years
Observational data: associations, not effects.
Further findings
- IL-23 inhibitors: results persisted in three of six sensitivity analyses
- 3 of 6
- IL-12/23 inhibitors: results persisted in all sensitivity analyses
Original publication
Association between biological immunotherapy for psoriasis and time to incident inflammatory arthritis: a retrospective cohort study. Lancet Rheumatol. Published 6 March 2023. doi:10.
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