Background/Purpose: Psoriatic arthritis (PsA) is a debilitating disease that occurs in up to one-third of patients with psoriasis (Pso), generally manifesting after the onset of Pso. Numerous studies have analyzed the risk factors for the development of PsA in patients with Pso, highlighting family history. However, there is little evidence about what determines the latency period between the onset of Pso and the development of arthritis.Therefore, the following objectives have been established for this study:a) To analyze the clinical phenotype of PsA based on the presence or absense of a family history of Pso or PsA (FH Pso/PsA)b) To determine which factors (including FH Pso/PsA) influence the speed of onset of arthritis after the initial presentation of Pso

Methods: We conducted a retrospective analytical study including 359 patients diagnosed with PsA according to the “Classification Criteria for Psoriatic Arthritis” (CASPAR). These patients were divided based on the presence or absence of a family history of Pso/PsA (FH Pso/PsA). We collected clinical, radiographic, and treatment variables for each patient, as well as the dates of onset of Pso and arthritis. For the comparison of variables, Student’s t-test (for quantitative variables) and Chi-square test (for qualitative variables) were used. We designed a survival analysis with Cox multiple regression to determine which factors influence the speed of onset of arthritis after the initial presentation of Pso.

Results: Of the 359 patients included, 37.5% had a family history of Pso/PsA (FH Pso/PsA). Patients with FH showed cutaneous-onset forms of PsA more frequently than those without FH (86.4% vs. 70%; p< 0.001), as well as a younger age at disease onset (Table 1). The latency period between the onset of Pso and the development of arthritis was longer in patients with FH (median time: 9.6 vs. 4.3 years; log-rank: p< 0.001; Figure 1). In the multivariable analysis, FH Pso/PsA (HR 0.88 (95% CI 0.78–0.99)) and a younger age at Pso onset (HR 1.03 (95% CI 1.02–1.04)) were associated with a delay in the onset of arthritis relative to Pso (Omnibus test: p< 0.001).

Conclusion: Family history of Pso/PsA in patients with Pso is associated with a longer time until the onset of arthritis. Therefore, patients with FH not only require a higher index of suspicion for PsA but also need longer follow-up periods to detect it. Collaboration between Dermatology and Rheumatology will be essential for early diagnosis and optimal management.

Table 1. Descriptive summary of the most relevant collected variables

Figure 1. Longer latency to arthritis. Median time: 10 years vs. 4 years (p < 0.001)

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/transition-from-psoriasis-to-psoriatic-arthritis-does-family-history-influence-the-time-to-onset-of-arthritis-in-psoriasis-patients/