The impact of biologics on the risk of progression from PsO to PsA

Results from a systematic review and meta-analysis evaluating the association between biologic therapy and the risk of incident psoriatic arthritis (PsA) in 124,138 adults with psoriasis (PsO) across 15 cohort studies were published in the American Journal of Clinical Dermatology, by Xie et al.  

Key data: Biologic use was associated with a 46% lower PsA risk vs non-biologic therapy (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.43−0.68). Stratified analyses by comparator type showed consistent associations vs non-systemic therapies (HR, 0.57; 95% CI, 0.33−0.97) and methotrexate (HR, 0.48; 95% CI, 0.45−0.51). In head-to-head comparisons between biologic classes, interleukin (IL)-17 inhibitor use was associated with a 35% lower risk of PsA vs tumor necrosis factor (TNF) inhibitors (HR, 0.65; 95% CI 0.49−0.87), while IL-12/23 or IL-23 inhibitor use was associated with a 54% lower risk vs TNF inhibitors (HR, 0.46; 95% CI, 0.36−0.60). 

Key learning: Biologic therapy, particularly agents targeting the IL-17/IL-23 pathway, was associated with a reduced risk of incident PsA in adults with PsO, warranting future prospective validation studies.