ArticleRheumatology (Oxford, England)2025
TNF-alpha inhibitors reduce the incidence of PsA in patients with psoriasis: a propensity score-matched cohort study.
Article in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of Biologic Therapies on the Risk of Progression from Psoriasis to Psoriatic Arthritis: A Systematic Review and Meta-Analysis of Cohort Studies.American journal of clinical dermatology · 2026Pooled it
- Understanding the transition from psoriasis to psoriatic arthritis: the role of targeted therapy.EULAR rheumatology open · 2026Review
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesConflicting data exist on TNF inhibitors' (TNFi) role in preventing PsA in psoriasis. Using propensity score matching, we compared PsA incidence in severe psoriasis patients treated with TNFi vs narrow-band ultraviolet B (nbUVB) phototherapy over a decade of follow-up.
methodsConsecutive adults with severe psoriasis prescribed TNFi or nbUVB phototherapy between September 2005 and September 2010 were enrolled. Of 946 patients, 497 received TNFi (median follow-up 9.6 ± 2.6 years) and 449 underwent nbUVB (9.4 ± 5.9 years). All had rheumatologist assessment before therapy and for PsA diagnosis. PS matching was adjusted for factors linked to PsA, including arthralgia, family history, BMI, PASI and psoriasis distribution, including nails.
resultsAfter propensity score matching, the TNFi cohort contributed 2705.5 person-years of follow-up (mean 9.1 ± 2.9 years), and the nbUVB cohort contributed 2654.1 person-years (mean 8.9 ± 5.4 years). The PsA incidence rate per 100 patients was 1.18 (0.84-1.52) in the TNFi group and 2.48 (2.24-2.72) in the nbUVB group, yielding an incidence rate ratio of 2.1 (1.37-2.98, P = 0.0002). A time-dependent Cox model confirmed that TNFi treatment was associated with a significantly lower risk of PsA (HR = 0.32, P < 0.0001). Arthralgia (HR = 7.68, P < 0.0001), nail psoriasis (HR = 1.93, P = 0.0004) and higher PASI score (HR = 1.03 per point, P = 0.0096) were independent predictors of PsA.
conclusionThis PS-matched study shows a clear benefit of TNFi vs nbUVB in PsA reduction in severe psoriasis patients over nearly a decade of therapy.
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