Ann Rheum Dis

Psoriasis: Which biologic most effectively reduces psoriatic arthritis risk?

February 27, 2025

IL-23 inhibitors may offer a slightly lower risk of developing psoriatic arthritis (PsA) compared with tumour necrosis factor [TNF] inhibitors in patients with chronic placque psoriasis, according to this Italian retrospective observational study. However, prospective studies are warranted before basing choice of biologic on PsA risk.

Study design: This retrospective observational study analyzed 622 biologic-naïve patients with plaque psoriasis initiating treatment with TNF, IL-17, or IL-23 inhibitors. The study utilized inverse probability of treatment weighting (IPTW) to balance pretreatment covariates across cohorts and employed an IPTW Cox regression model to estimate hazard ratios (HRs) for PsA development.

Results: Over a mean follow-up of 4.1 years, 60 patients (10%) developed PsA. Incidence of PsA was highest in the TNF inhibitor group (14.2%), followed by the IL-17 (5.5%), and IL-23 (4.3%) inhibitor groups. After IPTW adjustment, the HRs for developing PsA were 0.63 (95% confidence interval [CI], 0.38-1.05) for IL-17 inhibitors and 0.57 (95% CI, 0.34-0.96) for IL-23 inhibitors compared with TNF inhibitors.

Source:

Gisondi P, et al. (2025, February 6). Ann Rheum Dis. Risk of developing psoriatic arthritis in patients with psoriasis initiating treatment with different classes of biologics. https://pubmed.ncbi.nlm.nih.gov/39919973/