Biologics May Reduce Psoriatic Arthritis Development in Patients With Psoriasis

Switching from phototherapy to biologics may decrease the incidence of psoriatic arthritis among patients with psoriasis.

The use of biologics may be associated with decreased psoriatic arthritis (PsA) incidence among patients with psoriasis, according to study results presented at the American Academy of Dermatology (AAD) 2023 conference, held from March 17 to 21, 2023, in New Orleans, Louisiana.

This retrospective cohort study used data obtained between 2007 and 2021 from the Optum Clinformatics Data Mart. Researchers sought to determine the incidence of PsA among patients with moderate to severe psoriasis receiving phototherapy. The incidence of PsA was compared between patients who switched to biologics and those who continued phototherapy. The primary outcome was incident PsA within a follow-up period of 10 years.

Among 4695 patients included in the analysis, 4234 continued phototherapy and 461 were switched to biologics. Mean ages at psoriasis diagnosis of patients in the phototherapy and biologics groups were 53.81 and 44.88 years, 56.02% and 50.98% were women, and mean ages at phototherapy initiation were 54.92 and 46.00 years, respectively.

In the phototherapy group, 196 patients (4.63%) developed PsA compared with 17 (3.69%) in the biologics group (P =.356). The overall incidence of PsA per 1000 person-years (py) was 46.21 (95% CI, 40.40-52.85). Stratified by therapy, the incidence of PsA per 1000 py was 50.00 (95% CI, 43.50-57.55) in patients who continued phototherapy and 24.55 (95% CI, 15.26-39.49) among those who switched to biologics.

This study suggests that biologic use may reduce the development of psoriatic arthritis among psoriasis patients.

Cox proportional hazards models were used for further analyses. In age- and sex-adjusted models, the hazard ratio [HR) for incident PsA was 0.464 (95% CI, 0.275-0.784; P =.004) for biologics vs phototherapy. Similar results were observed in models adjusted for duration of oral systemic agent use (HR, 0.476; 95% CI, 0.282-0.803; P =.005).

Among patients (n=557) who used oral systemic agents, an HR of 0.245 (95% CI, 0.088-0.68; P =.007) was observed in those who switched to biologics vs continued phototherapy.

“This study suggests that biologic use may reduce the development of psoriatic arthritis among psoriasis patients,” the researchers concluded.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Miao KL, Huang MY, Xepoleas M, et al. Do biologics for psoriasis prevent the development of psoriatic arthritis? A population-based study. Presented at: AAD 2023; March 17-21, 2023; New Orleans, LA. Poster 42744.