Megna Matteo, Ocampo-Garza Sonia Sofia, Potestio Luca, Fontanella Giuseppina, Gallo Lucia, Cacciapuoti Sara, Ruggiero Angelo, Fabbrocini Gabriella
Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy.
Dermatology Department, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico.
Biomedicines. 2021 Oct 15;9(10):1482. doi: 10.3390/biomedicines9101482.
Psoriasis and psoriatic arthritis (PsA) development is sustained by tumor necrosis factor (TNF)α, interleukin (IL)17, and IL23; hence, biologics targeting those cytokines represent useful therapeutic weapons for both conditions. Nevertheless, biologics strongly reduce PsA risk; several studies reported the possibility of new-onset PsA during biologic therapy for psoriasis. The aim of this 1-year prospective study is to evaluate the prevalence of paradoxical PsA in psoriasis patients under biologic therapy and review the existing literature. For each patient, age, sex, psoriasis duration, psoriasis severity, comorbidities, and previous and current psoriasis treatments were collected, and each subject was screened for PsA using the Early ARthritis for Psoriatic patient (EARP) questionnaire every 3 months for 1 year. New-onset PsA was diagnosed in 10 (8.5%) out of 118 patients (three male, 30.0%; mean age 44.5 years) involving every different biologic class (anti-TNF, anti-IL12/23, anti-IL17, and anti-IL23). No significant risk factor for new-onset PsA was identified; no significant difference was found comparing patients who developed PsA and subjects who did not develop PsA regarding psoriasis severity, past/current therapies, and comorbidities. Clinicians must keep in mind the possibility of PsA onset also in patients undergoing biologics so that PsA screening should be strongly recommended at each follow-up.
银屑病和银屑病关节炎（PsA）的发展由肿瘤坏死因子（TNF）α、白细胞介素（IL）17和IL23维持；因此，针对这些细胞因子的生物制剂是治疗这两种疾病的有效武器。然而，生物制剂能大幅降低PsA风险；多项研究报告了银屑病生物治疗期间新发PsA的可能性。这项为期1年的前瞻性研究旨在评估接受生物治疗的银屑病患者中矛盾性PsA的患病率，并回顾现有文献。收集每位患者的年龄、性别、银屑病病程、银屑病严重程度、合并症以及既往和当前的银屑病治疗情况，每位受试者在1年时间里每3个月使用银屑病患者早期关节炎（EARP）问卷进行一次PsA筛查。118例患者中有10例（8.5%）诊断为新发PsA（3例男性，占30.0%；平均年龄44.5岁），涉及每种不同的生物制剂类别（抗TNF、抗IL12/23、抗IL17和抗IL23）。未发现新发PsA的显著危险因素；在银屑病严重程度、既往/当前治疗及合并症方面，比较发生PsA的患者和未发生PsA的患者未发现显著差异。临床医生必须牢记接受生物制剂治疗的患者也有发生PsA的可能性，因此强烈建议在每次随访时进行PsA筛查。
