Early Diagnosis and Comprehensive Treatment Are Key to Adequate Care in Psoriatic Arthritis

Hand psoriatic arthritis
Hand psoriatic arthritis
The aim of the study was to evaluate the epidemiology, comorbidities, and risk factors for psoriatic arthritis, using a health insurance claims database.

Early diagnosis and comprehensive treatment are key to adequate care among patients with psoriatic arthritis (PsA), given the high disease burden and socioeconomic impact associated with PsA symptoms and the increased frequency of related cardiovascular and psychiatric comorbidities. Results of the analysis were published in Acta Dermato-Venereologica.

Psoriatic arthritis is a common manifestation of psoriasis (PsO) and has a significant impact on physical function, work ability, and quality of life.

A retrospective, epidemiologic, health care research study was conducted that evaluated data from a German public health insurance company. The researchers sought to determine the epidemiology, comorbidities, and risk factors for PsA in Germany, based on data collected between 2010 and 2015 among a large cohort of insured individuals.

A total of 2,319,584 individuals were insured throughout the DAK-Gesnudheit sample in 2010. Overall, 2.78% (n=55,734/2,006,003) of insured adults and 0.32% (n=1003/313,581) of insured children were diagnosed with PsO in 2010. After adjustments for sex and age, the rates were 2.63% in adults and 0.30% in children. The adjusted prevalence of PsO increased with age and peaked in the 50- to 59-year-old group at 3.38%. Regarding PsA, the prevalence was 0.31% in adults and 0.01% in children, peaking in the 50- to 59-year-old age-group as well, at 0.50%.

According to Cox regression modeling for risk factors, depression (hazard ratio [HR], 1.38; 95% CI, 1.92=1.87; P =.0351) and neurosis/stress (HR, 1.46; 95% CI, 1.03-2.05;

P =.0322) were both positively and significantly associated with concomitant PsA. Ischemic heart disease (IHD) was significantly negatively associated with concomitant PsA (HR, 0.49; 95% CI, 0.27-0.98; P =.0164), implying that IHD has a protective effect against the development of concomitant PsA. Further, older age at PsO onset was associated with a significantly decreased risk for the development of PsA during the consecutive 5-year observation period (HR, 0.98; 95% CI, 0.98-0.99; P =.0001).

The percentage of adult patients with incident PsO who developed comorbid PsA within 5 years (mean, 2.3 years) following their PsO diagnosis was 2.6%. Cardiovascular diseases have been shown to be the most common comorbidity among individuals with PsO with or without concomitant PsA. Other indicators for the development of PsA included neurosis/stress disorder and depression.

The results from the analysis provide important data for epidemiologic research, particularly among the European population.

The researchers concluded that the findings from this study highlight the fact that early detection of PsA should continue to be a priority in an effort to prevent nonreversible joint damage among these individuals. They also emphasized that cross-disciplinary collaborations should be strengthened.

Disclosure: Multiple study authors have declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures. 


Maximilian R, Garbe C, Petersen J, et al. Epidemiology, comorbidity and risk factors for psoriatic arthritis: a health insurance claims database analysis. Acta Derm Venereol. Published online October 11, 2021. doi:10.2340/00015555-3879