The role of phototherapy in reducing the risk of psoriatic arthritis among psoriasis patients in the era of biologics
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND OBJECTIVES: Biologic therapies for psoriasis have shown promise in reducing the risk of Psoriatic Arthritis (PsA) by targeting inflammatory pathways. Emerging evidence suggests that phototherapy may also exert systemic anti-inflammatory effects. This study examines the impact of phototherapy on the progression to PsA. PATIENTS AND METHODS: This exploratory, hypothesis generating retrospective cohort study comprised 667 psoriatic patients, subclassified based on therapeutic interventions administered during longitudinal follow-up: phototherapy alone; phototherapy combined with systemic therapy [either conventional agents (e.g., methotrexate, acitretin, cyclosporine) or biologics (e.g., TNF inhibitors, anti-IL-12/23, anti-IL-17A, anti-IL-23A); topical therapy alone; and systemic monotherapy. PsA diagnoses were established in accordance with the Classification Criteria for Psoriatic Arthritis. RESULTS: Patients receiving standalone phototherapy exhibited a reduced PsA incidence compared to those on topical agents (4.09 vs 5.30 events per 100 person-years; HR = 0.73; 95 % CI: 0.53-0.99; p = 0.047). Combining phototherapy with systemic therapy further reduced PsA risk compared to systemic monotherapy (2.26 vs 3.74 events per 100 person-years; HR = 0.56; 95 % CI: 0.38-0.82; p = 0.003). The lowest incidence was observed in patients treated with both phototherapy and biologics, outperforming biologics alone (HR = 0.43; 95 % CI: 0.19-0.93; p = 0.03). CONCLUSIONS: Phototherapy, especially in combination with systemic treatments, demonstrates synergistic potential in mitigating PsA risk.
DOI: 10.1111/ddg.15956
Institutions: Tel Aviv University, Sheba Medical Center
Language: German
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4417292096