A recent retrospective cohort study investigated the effectiveness of various treatments in preventing psoriatic arthritis (PsA) in patients with psoriasis (PsO). The study analyzed data from 58,671 patients in the Israeli Meuhedet Health Services Organization database, categorizing them based on their treatment type: topical therapy, phototherapy, conventional disease-modifying antirheumatic drugs (cDMARDs) like methotrexate, and biologic DMARDs. The study aimed to clarify previous inconsistent findings, particularly regarding the effectiveness of IL-23 blockers compared to TNF blockers in reducing PsA risk and the impact of higher Psoriasis Area and Severity Index scores on PsA development.

The results showed that biologic agents were more effective than methotrexate in reducing the incidence of PsA, with the biologic group having a significantly lower hazard ratio (0.46) compared to the methotrexate group. While the incidence rates varied among different biologic treatments, there were no significant differences in PsA prevention across biologic classes. The phototherapy group had a higher rate of PsA development compared to the topical therapy group, suggesting that psoriasis severity is a key risk factor for PsA. Overall, the study highlights the superior efficacy of biologics over methotrexate in preventing PsA in patients with psoriasis.

Reference: Watad A, Zabotti A, Patt YS, et al. From Psoriasis to Psoriatic Arthritis: Decoding the Impact of Treatment Modalities on the Prevention of Psoriatic Arthritis. Rheumatol Ther. 2024;11(4):963-976. doi: 10.1007/s40744-024-00680-3.