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Article

New-Onset Psoriatic Arthritis under Biologics in Psoriasis Patients: An Increasing Challenge?

by
Matteo Megna
1,
Sonia Sofia Ocampo-Garza
1,2,
Luca Potestio
1,
Giuseppina Fontanella
1,
Lucia Gallo
1,
Sara Cacciapuoti
1,
Angelo Ruggiero
1 and
Gabriella Fabbrocini
1,*
1
Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
2
Dermatology Department, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico
*
Author to whom correspondence should be addressed.
Biomedicines 2021, 9(10), 1482; https://doi.org/10.3390/biomedicines9101482
Submission received: 1 September 2021 / Revised: 6 October 2021 / Accepted: 8 October 2021 / Published: 15 October 2021
(This article belongs to the Special Issue Immune-Mediated Skin Diseases: From Pathophysiology to Novel Therapeutic Approaches)
Versions Notes

Abstract

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.
Keywords: psoriasis; psoriatic arthritis; biologic therapies; paradoxical reaction; anti-TNF; anti-IL12/23; anti-IL17; anti-IL23 psoriasis; psoriatic arthritis; biologic therapies; paradoxical reaction; anti-TNF; anti-IL12/23; anti-IL17; anti-IL23

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MDPI and ACS Style

Megna, M.; Ocampo-Garza, S.S.; Potestio, L.; Fontanella, G.; Gallo, L.; Cacciapuoti, S.; Ruggiero, A.; Fabbrocini, G. New-Onset Psoriatic Arthritis under Biologics in Psoriasis Patients: An Increasing Challenge? Biomedicines 2021, 9, 1482. https://doi.org/10.3390/biomedicines9101482

AMA Style

Megna M, Ocampo-Garza SS, Potestio L, Fontanella G, Gallo L, Cacciapuoti S, Ruggiero A, Fabbrocini G. New-Onset Psoriatic Arthritis under Biologics in Psoriasis Patients: An Increasing Challenge? Biomedicines. 2021; 9(10):1482. https://doi.org/10.3390/biomedicines9101482

Chicago/Turabian Style

Megna, Matteo, Sonia Sofia Ocampo-Garza, Luca Potestio, Giuseppina Fontanella, Lucia Gallo, Sara Cacciapuoti, Angelo Ruggiero, and Gabriella Fabbrocini. 2021. "New-Onset Psoriatic Arthritis under Biologics in Psoriasis Patients: An Increasing Challenge?" Biomedicines 9, no. 10: 1482. https://doi.org/10.3390/biomedicines9101482

APA Style

Megna, M., Ocampo-Garza, S. S., Potestio, L., Fontanella, G., Gallo, L., Cacciapuoti, S., Ruggiero, A., & Fabbrocini, G. (2021). New-Onset Psoriatic Arthritis under Biologics in Psoriasis Patients: An Increasing Challenge? Biomedicines, 9(10), 1482. https://doi.org/10.3390/biomedicines9101482

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