PO:03:036 | Psoriatic arthritis: does pre-existing treatment with cs/bDMARDs for psoriasis influence the characteristics and outcomes of joint disease?

Ilenia Marchesini¹, Alberto Floris¹, Cristina Mugheddu², Laura Li Volsi¹, Maria Teresa Paladino¹, Roberta Origa¹, Jessica Sorgia¹, Mattia Congia¹, Elisabetta Chessa¹, Matteo Piga¹, Caterina Ferreli², Laura Atzori², Alberto Cauli¹ | ¹Unità di Reumatologia, AOU e Università di Cagliari-Monserrato; ²Unità di Dermatologia, AOU e Università di Cagliari, Italy

Background. Several studies have shown that treatment of psoriasis with cs/bDMARDs reduces the risk of developing psoriatic arthritis. The aim of this study is to investigate and compare the characteristics of patients who developed psoriatic arthritis without having ever received any systemic therapy (cs/bDMARD-naïve) with those who developed it despite ongoing treatment with cs/bDMARDs (cs/bDMARD-experienced), in order to understand whether treatment differences influence the characteristics and outcomes of joint disease.

Materials and Methods. This analysis represents a preliminary phase of a retrospective study conducted on a cohort of patients with psoriatic arthritis, divided into two groups based on whether or not they were receiving cs/bDMARD therapy at the onset of joint disease. For all patients, demographic (age at disease onset and at diagnosis, sex, smoking status), clinical (fibromyalgia, BMI, oligoarticular/polyarticular onset, axial involvement, dactylitis), clinimetric (DAPSA, physician VAS, patient VAS, SPARS, HAQ), and therapeutic data (use of cs/bDMARDs at disease onset, multidrug resistance) were collected and compared.

Results. A total of 224 consecutive patients with psoriatic arthritis were enrolled, of whom 45 (20%) developed the disease despite ongoing cs/bDMARD therapy, while the remaining 179 (80%) developed psoriatic arthritis without having received any systemic treatment. No significant differences were observed between the two groups in terms of M/F ratio (p=0.567), age at arthritis onset (p=0.180), age at diagnosis (p=0.776), oligoarticular/polyarticular pattern (p=0.349), prevalence of axial involvement (p=0.197), radiographic damage (p=0.491), physician VAS (p=0.851) and patient VAS (p=0.340), DAPSA (p=0.585), HAQ (p=0.609), or multidrug resistance (p=0.308) (Table 1, Figure 1). A trend toward a higher prevalence of dactylitis was observed among DMARD-naïve patients compared with those receiving cs/bDMARD therapy at disease onset (38.2% vs. 25.0%, p=0.101), although this did not reach statistical significance (Table 1, Figure 1).

Conclusions. Although previous studies have reported that the use of cs/bDMARDs for psoriasis may be associated with a reduced risk of developing psoriatic arthritis, among patients who develop the arthropathy despite ongoing systemic treatment, the disease pattern and outcomes do not appear to differ significantly from those of patients who have never received systemic therapy. An expansion of the present study to a larger cohort is needed to confirm these findings.