A recent retrospective analysis has uncovered a potential relationship between psoriatic arthritis (PsA) and concomitant atopic dermatitis, shedding light on how this connection could influence treatment effectiveness and aid in selecting the most appropriate biologic agent. The findings were published in the Journal of Personalized Medicine.
Researchers from Romania highlighted the importance of considering comorbidities and associated conditions in the management of PsA patients, as these factors can influence the choice of biologic therapy. They noted that the coexistence of psoriasis, psoriatic arthritis, and atopic dermatitis presents unique challenges and may require tailored treatment approaches.
Psoriasis and atopic dermatitis are among the most prevalent inflammatory skin diseases, affecting approximately 3-10% of the population. However, the simultaneous occurrence of both conditions is less common, estimated at around 1.3%. Atopic dermatitis, characterized by chronic inflammatory and itchy skin lesions, is more prevalent in younger individuals globally but tends to stabilize in adulthood. When psoriasis and atopic dermatitis coincide, they pose therapeutic challenges due to their distinct immunological mechanisms.
The retrospective analysis followed 64 PsA patients treated with various biologic agents, such as tumor necrosis factor (TNF) and interleukin (IL)-17 inhibitors, over a period of up to 10 years in an academic outpatient rheumatology department. All patients met the Classification Criteria for Psoriatic ARthritis (CASPAR) and underwent regular follow-up visits between January and December 2023.
Patients were categorized based on the presence or absence of concomitant atopic disorders, including atopic dermatitis, allergic rhinitis, and allergic asthma. They were further subdivided into those with atopic disease other than atopic dermatitis (non-AD PsA) and those with atopic dermatitis and concurrent PsA.
The primary aim was to examine atopic dermatitis in PsA patients undergoing biologic treatment, focusing on its prevalence and potential therapeutic implications.
Key findings revealed that approximately one-third of the patients exhibited atopic diseases, including atopic dermatitis (52.6%), allergic rhinitis (31.6%), and allergic asthma (15.8%). Patients with both PsA and atopic dermatitis tended to experience late-onset skin atopy, resided in urban areas, were younger (mean age 51 years), and required multiple biologic switches to achieve disease control.
The investigators emphasized the need for future studies involving larger patient cohorts to further evaluate therapeutic responses in PsA patients with atopic dermatitis, aiming to refine treatment selection criteria.
“Screening PsA patients for atopic dermatitis could facilitate more tailored treatment approaches and potentially enhance disease control and treatment outcomes,” the researchers concluded. More extensive research is warranted to better understand and address the interplay between these conditions in clinical practice.
