New research presented at the 2024 EULAR congress suggests a promising approach in the prevention of psoriatic arthritis (PsA) among individuals with psoriasis. PsA, a chronic inflammatory arthritis affecting approximately one-third of psoriasis patients, may potentially be intercepted through effective treatment of the skin condition.
Psoriasis often precedes PsA, offering a window for preventive interventions. Researchers hypothesize shared pathways in their pathogenesis, proposing that rigorous management of moderate-to-severe psoriasis could hinder progression to PsA. While biologic therapies effectively control psoriasis symptoms, their preventive efficacy against PsA remains inconclusive.
A retrospective study leveraging extensive electronic health records from a global database of over 1 million psoriasis patients examined the incidence of PsA in those treated with first- or second-line biologics. This encompassed tumor necrosis factor inhibitors (TNFi) and biologics targeting interleukins (IL-12i, IL-23i, IL-17i, and IL-12/23i). Over a 5-year period, the study compared PsA incidence across different treatment cohorts, using first-line TNFi users as a reference.
Findings indicated a significant risk reduction in PsA development among patients receiving IL-12/23i and IL-23i therapies compared to TNFi. Specifically, IL-12/23i showed a 37% lower risk during first-line treatment and 32% lower during second-line treatment, while IL-23i demonstrated a 39% and 31% lower risk, respectively. Notably, IL-23i exhibited a 47% lower probability of PsA compared to IL-17i at 3 and 5 years.
The study underscores the utility of Big Data analytics in evaluating real-world drug effectiveness. By conducting matched cohort analyses with a 5-year follow-up, researchers gleaned insights into the preventive potential of IL-12/23i and IL-23i in PsA onset, both in treatment-naïve and bio-experienced patients. This data prompts further exploration into interceptive strategies for PsA, offering hope for early intervention before clinical manifestations emerge.
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