What Clinical Factors Affect Length of Transition to Psoriatic Arthritis in Patients with Psoriasis?

Objective

We aimed to identify clinical and demographic features associated with the interval between the appearance of psoriasis and the onset of psoriatic arthritis (PsA).

Methods

We identified patients with psoriasis and PsA diagnoses from our tertiary care psoriatic disease biorepository: a longitudinal, real-world database including clinical information and patient-reported outcomes. We used a multivariable, zero-inflated negative binomial model to evaluate several clinical and demographic features that may be associated with the time between psoriasis and PsA onset.

Results

A total of 384 patients were included, of whom 52.2% were women. The mean age of psoriasis onset was 31.5 years. Advanced age at psoriasis onset was associated with a shorter interval between psoriasis and PsA. Based on our model, patients with psoriasis onset at age 42.6 years (upper end of the interquartile range [IQR]) had a 62% shorter expected interval than patients with psoriasis onset at age 18.9 years (lower end of IQR) (P<0.001) and were more likely to have concurrent (onset within six months) diagnoses (odds ratio 4.56; 95% confidence interval 2.9–7.17). Patients with a body mass index (BMI) of 34 compared with a BMI of 26 had a 10% shorter interval between psoriasis and PsA, which trended toward statistical significance (P=0.053).

Conclusion

Our study demonstrated that patients with a diagnosis of psoriasis at an older age have a shorter interval between psoriasis and PsA diagnoses and are more likely to have concurrent diagnoses than patients with an onset of psoriasis at a younger age. These results suggest that patients with a later onset of psoriasis may benefit from earlier PsA screening.

Shashank Cheemalavagu, MD,¹ Yuxuan Jin, MS,¹ and M. Elaine Husni, MD, MPH¹

1. Cleveland Clinic, Cleveland, Ohio.

Disclosures: Shashank Cheemalavagu: None;Yuxuan Jin: None; M. Elaine Husni: supported in part by the National Institutes of Health grant R01AR075777, BMS, Janssen, Novartis, Lilly, UCB, Pfizer, National Psoriasis Foundation, unpaid, Rheumatology Research Foundation, unpaid.

Citation

Cheemalavagu S, Jin Y, Husni ME. What clinical factors affect length of transition to psoriatic arthritis in patients with psoriasis? [abstract]. ACR Open Rheumatol. 2024 Sep;6(9):553–560.