Psoriatic Arthritis: Who’s Most at Risk?

Psoriatic arthritis (PsA) is a type of arthritis where not only is there joint pain, joint swelling, and joint stiffness, but there are also psoriasis—or red, thick, scaly skin patches on the skin.

While psoriasis is a fairly well-known condition, awareness of PsA is not as common. In fact, while up to 7.5 million people in the US have psoriasis, only about a third of those develop PsA. Still, a better understanding of PsA is key to improving outcomes for people with the disease.^1,2

The importance of psoriatic research

One way to increase understanding is through research. One key thing to research in PsA is the risk of developing the condition. It is important to be aware of risk factors for psoriatic arthritis so that researchers can continue to develop treatments that work to relieve symptoms.

Better knowledge about patient risk may even provide critical information that could help prevent PsA.^1,2

Risk factors for psoriatic arthritis

While it is not known what causes PsA, there are some known risk factors to watch out for:²

• Family history: Like many other autoimmune diseases, PsA can be inherited. Roughly 40% of people with PsA have a family member who also suffers from the condition, and people with close relatives with PsA are more than half as likely to develop PsA than an unrelated person.
• Genes: Researchers know that certain gene mutations are commonly found in people with PsA. One of the most common of these mutations in the HLA-B gene, which helps instruct proteins that are critical to the body’s immune system.
• Psoriasis: We know that nearly one-third of patients with psoriasis later go on to develop PsA. And while anyone with psoriasis can go on to develop PsA, there are certain psoriasis features that make this more likely, such as psoriasis on the scalp, groin, or nails.
• Obesity: Research has found that being overweight can increase the risk of PsA, and losing weight can alleviate symptoms. This is because of the inflammatory nature of the disease, and obesity can produce inflammatory cells in the body.
• Smoking: Smoking has multiple health risks, and PsA is one of them. In addition, smoking can interfere with the efficacy of medicines prescribed to treat PsA.
• Age: Though PsA can develop at any age, it most often appears between the ages of 30-50, and for most patients, PsA develop symptoms about 5 to 10 years after psoriasis.
• Environment: Certain infections may increase the risk for developing PsA. Researchers have observed a connection between PsA and streptococcal infection, as well as the human immunodeficiency virus (HIV), but the reason is unknown. Other environmental factors that could increase risk include physical trauma, extreme stress, or prior skin infections.

Can PsA be prevented?

It is important to be aware of the risk factors for PsA, because not only can it improve diagnosis, it may lead to prevention. While some risk factors for PsA cannot be prevented, such as family history or genes, certain risk factors can be.

It stands to reason that if certain risk factors, such as obesity, smoking, or certain environmental factors, can be reduced, then perhaps the risk of developing PsA can be, as well.^1,3 In addition, further research connected to patient risk may help with disease prevention.

Since PsA tends to develop about 5-10 years after psoriasis, could there be certain indicators ahead of time that might make patients more at risk for PsA.¹

Summary

Knowing the risk factor for PsA can help increase diagnosis when needed, as well as lead to appropriate treatment intervention.

In addition, this knowledge is helpful in identifying certain lifestyle changes that may be useful in disease prevention. Knowing which patients are at greater risk for PsA even before they develop it may help prevent the onset of disease.