Treating the skin with biologics in patients with psoriasis decreases the incidence of psoriatic arthritis.

Autor:	Acosta Felquer ML; Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires and Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., LoGiudice L; Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires and Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Galimberti ML; Dermatology Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Rosa J; Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires and Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Mazzuoccolo L; Dermatology Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Soriano ER; Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires and Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina enrique.soriano@hospitalitaliano.org.ar.
Jazyk:	angličtina
Zdroj:	Annals of the rheumatic diseases [Ann Rheum Dis] 2022 Jan; Vol. 81 (1), pp. 74-79. Date of Electronic Publication: 2021 Jul 19.
DOI:	10.1136/annrheumdis-2021-220865
Abstrakt:	Objectives: To compare the incidence of psoriatic arthritis (PsA) in patients with psoriasis (PsO) according to different treatments for their skin: topics/no treatment, conventional disease-modifying antirheumatic drugs (DMARDs) (cDMARDs) or biological DMARDs (bDMARDs). Methods: Patients with PsO without PsA followed at a university hospital were included in this retrospective cohort study. Patients were classified according to their treatment in topics (topics, phototherapy or no treatment), cDMARDs (methotrexate and cyclosporine) and bDMARDs (tumour necrosis factor inhibitors (TNFi), interleukin 17 inhibitors (IL-17i) and IL-12-23i ((interleukin (IL) 12/IL-23 inhibitor))) groups. Incident cases of PsA were attributed to one treatment if developed during the administration of that treatment. A Cox proportional hazards model was used to evaluate the adjusted risk of PsA development by treatment group. Results: 1719 patients with PsO contributed a total of 14 721 patient/years (py). 1387 (81%) patients were in the topics, 229 (13%) in cDMARDs and 103 (6%) in the bDMARDs group. During follow-up, 239 patients (14%) developed PsA (231 under topics, six under cDMARDs and two under bDMARDs). Global incidence was 1.6 per 100 py. The risk of developing PsA in patients with PsO treated with bDMARDs was significantly lower (incidence rate ratio (IRR)=0.26; 95% CI 0.03 to 0.94; p=0.0111), compared with topics, but not compared with cDMARDs (IRR=0.35; 95% CI 0.035 to 1.96; p=0.1007). Adjusted Cox proportional hazards regression analysis showed that male sex, nail involvement and higher body max index were associated with increased risk of developing PsA, while biologics use was protective (HR: 0.19; 95% CI 0.05 to 0.81). Conclusion: Treatment with biologics in patients with PsO reduced the risk of PsA development. Competing Interests: Competing interests: ERS received grants from AbbVie, Janssen, Novartis, Pfizer and Roche, outside the submitted work, and consulting/speaker’s fee from AbbVie, Amgen, BMS, Janssen, Novartis, Lilly, Pfizer, Roche, Sandoz and UCB outside the submitted work. MLAF received consulting/speaker’s fee from AbbVie, Janssen, Novartis, Lilly and Pfizer outside the submitted work. JR received consulting/speaker’s fee from AbbVie, Amgen, Janssen, Novartis, Lilly and Pfizer outside the submitted work. LM received consulting/speaker’s fee from AbbVie, Janssen, Novartis and Lilly outside the submitted work. (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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