Time to transition from psoriasis to psoriatic arthritis: A population-based study

• Published in: Seminars in arthritis and rheumatism 2022-02, Vol.52, p.151949-151949, Article 151949
• Main Authors: Karmacharya, Paras, Wright, Kerry, Achenbach, Sara J., Crowson, Cynthia S., Ogdie, Alexis, Bekele, Delamo, Duarte-García, Alí, Ernste, Floranne C., Tollefson, Megha M., Davis III, John M.
• Format: Article
• Language: English
• Subjects: Adult; Arthritis, Psoriatic - complications; Arthritis, Psoriatic - epidemiology; Cohort Studies; Female; Humans; Male; Middle Aged; Minnesota - epidemiology; Psoriasis - complications; Psoriasis - epidemiology; Psoriatic arthritis; Retrospective Studies; Spondyloarthritis; Transition
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1016/j.semarthrit.2021.12.013

To identify demographic and clinical characteristics associated with time between psoriasis and psoriatic arthritis (PsA). A retrospective, population-based cohort of incident PsA patients ≥18 years (2000–17) from Olmsted County, MN was identified. PsA patients were divided into two groups: patients with concurrent psoriasis and PsA (within 1 year), and patients with psoriasis before PsA (>1 year). Patients with PsA prior to psoriasis were excluded. Age- and sex-adjusted logistic regression models were used to examine factors associated with the time between psoriasis and PsA diagnosis. Among 164 patients with incident PsA, 158 had a current or personal history of psoriasis. The mean (SD) age at PsA diagnosis was 46.3 (12.0) years, and 46% were females. The median (interquartile range) time from psoriasis to PsA was 35.5 (0.8–153.4) months. 64 patients (41%) patients had concurrent psoriasis and PsA while 94 (59%) had onset of psoriasis before PsA. The estimated age at onset of psoriasis symptom (OR per 10-year decrease = 1.63, 95% CI: 1.26–2.11) and psoriasis severity (OR = 3.65, 95% CI: 1.18–11.32 for severe vs. mild) were associated with having a psoriasis diagnosis more than one year prior to incident PsA. In this population-based study, approximately 60% of the patients had psoriasis before PsA, and the rest had concurrent psoriasis and PsA. Patients with lower age at psoriasis onset or severe psoriasis were more likely to have a longer time to transition from psoriasis to PsA.