Long-Term Outcomes of Patients with Biologically Treated Psoriatic Arthritis and Atopic Dermatitis—A Single-Center Experience

TL;DR

This study examines patients with psoriatic arthritis and atopic dermatitis, finding that they often require multiple biologic treatments for disease control.

Contribution

The study provides new insights into the coexistence of psoriatic arthritis and atopic dermatitis and their treatment challenges.

Findings

Atopic dermatitis was more common than other atopic diseases in patients with psoriatic arthritis.

Patients with both conditions required more biologic switches to achieve disease control.

Three distinct morphological patterns of atopic dermatitis were identified in these patients.

Abstract

(1) Background: Although the association between psoriasis and atopic dermatitis (AD) is reported in the literature, scarce data are known about the efficacy of biologic therapy (including TNF and IL-17 inhibitors) in patients with psoriatic arthritis (PsA) and concomitant AD. (2) Objective: We aimed to explore AD in patients with PsA undergoing biologics for their active disease, focusing on prevalence and clinical and potential therapeutic implications. (3) Material and methods: We performed a retrospective analysis of 64 patients with PsA receiving various biological agents, followed-up in an academic outpatient rheumatology department up to 10 years. (4) Results: Atopic diseases were reported in about one third of cases, with a higher incidence of AD (10 cases; 52.6%) vs. atopic rhinitis (6 cases; 31.6%) and allergic asthma (3 cases; 15.8%). Three morphological patterns of AD were recognized including chronic prurigo (3 cases), a chronic lichen simplex (1 case), and eczemas (6 cases). All PsA with concomitant AD displayed a late onset of skin atopy (in their adult life) and demonstrated a specific profile (younger), from urban settings, equally distributed among genders, and requiring switching to a higher number of biologics to achieve disease control. (5) Conclusion: PsA and AD may coexist, requiring special attention when selecting the optimal biologic agent.

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