Effects of Family History on Psoriasis, Psoriatic Arthritis Disease Outcomes

A family history of psoriasis or psoriatic arthritis (PsA) affects disease severity, musculoskeletal features, and skin phenotypes, according to a study published in Arthritis Care & Research.

The study was designed to assess the effects of having a family history of psoriasis or PsA on disease phenotypes by analyzing data from 1393 participants in the longitudinal multicenter Psoriatic Arthritis-International Database. Logistic regression was used to investigate the effects of psoriasis or PsA family history on disease characteristics.

Of the total 1393 participants, 31.9% (n=444) had a family history of psoriasis or PsA. These patients were also more frequently women, had an earlier disease onset, attained minimal disease activity less frequently, and had more frequent deformities, enthesitis, and nail disease. Out of the 444 patients with family history of disease, 335 patients had only psoriasis in the family, 74 had PsA, and 35 were unspecific and were therefore excluded from further analysis.

Multivariate analysis determined that a family history of psoriasis was associated with earlier psoriasis onset (odds ratio [OR], 0.976) and enthesitis (OR, 1.931), and family history of PsA was associated with lower plaque psoriasis risk (OR, 0.417) and higher deformity risk (OR, 2.557). Family history of PsA compared with a family history of psoriasis increased the deformity risk (OR, 2.143) and lowered the plaque psoriasis risk (OR, 0.324).

Limitations included a potential for lack of knowledge of all family history, observation-based data, and potential variations in data collection.

Despite the fact that this data is observational and lacking in genetic analyses, study investigators conclude that “the family history of psoriasis and PsA has impacts on skin phenotypes, musculoskeletal features and the disease severity. The link between family history of psoriasis/PsA and pustular/plaque phenotypes may point out to a different genetic background and pathogenic mechanisms in these subsets.”

Reference

Solmaz D, Bakirci S, Kimyon G, et al. The impact of having family history of psoriasis or psoriatic arthritis on psoriatic disease [published online January 25, 2019]. Arthritis Care Res. doi: 10.1002/acr.23836