Spondyloarthritis & psoriatic arthritis

Association between biological immunotherapy for psoriasis and time to incident inflammatory arthritis: limitations and opportunities

RMD OpenPublished Commentary on a population-based retrospective cohort study

Authors' conclusion

Although the analysis was based on a large set of clinical data and the findings were rigorously evaluated, there are some limitations in interpretation due to the study design.

Study context

Population
Psoriasis patients in a US electronic health records database
Participants
15,501 patients
Exposure
IL-12/23 or IL-23 inhibitors, and IL-17 inhibitors, vs tumour necrosis factor (TNF) inhibitors in psoriasis
Outcome
Time to incident inflammatory arthritis
Methodological detailsUS electronic health records database, multivariable regression analysis, Limitations in interpretation due to the study design; prospective clinical trials are missing
  • US electronic health records database
  • Multivariable regression analysis
  • Limitations in interpretation due to the study design; prospective clinical trials are missing

Main finding

As reported in the abstract

Risk of developing inflammatory arthritis
  • Significantly lower risk with IL-12/23 or IL-23 inhibitors vs TNF inhibitors
  • No significant difference in risk with IL-17 vs TNF inhibitors
  • Multivariable regression analysis

Observational data: associations, not effects.

Further findings

Cumulative incidence of psoriatic arthritis (PsA)

PsA cases per 100 person-years
2.6

Original publication

Association between biological immunotherapy for psoriasis and time to incident inflammatory arthritis: limitations and opportunities. RMD Open. Published 21 September 2023. doi:10.1136/rmdopen-2023-003166

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