Psoriatic arthritis linked to comorbidity burden and shorter ustekinumab persistence

A recent study published in Rheumatic and Musculoskeletal Diseases Open has noted increased comorbidity burden and shorter ustekinumab (UST) persistence in patients with plaque psoriasis and psoriatic arthritis (PsA) compared to those with plaque psoriasis alone.

The retrospective observational study selected 9057 patients enrolled in the British Association of Dermatologists Biologic and Immunomodulators Register. The researchers have noted significant comorbidity burden, including diabetes, hypertension, obesity, depression, and increased working disability in the PsA cohort when compared to psoriasis patients. Significant association of PsA (HR 1.98), female gender (HR for male sex 0.72), and depression (HR 1.21) with shorter UST persistence was also observed. Depression and PsA negatively impaired the quality of life of affected subjects.

In concurrence with these findings, a systematic review and meta-analysis by Gupta et al. have found that comorbidities in PsA patients were associated with adverse disease features. They have also noted an increased prevalence of comorbidities, especially cardiometabolic disorders in PsA patients.

These findings highlight the need for a patient-centric, multidisciplinary care approach to achieve the best possible outcomes in psoriatic disease. Considering the impact of the disease on quality of life and increasing the likelihood of depression, lifestyle counseling, and psychological support should also be a part of patient care.


  1. Tillett W, Ogdie A, Passey A, Gorecki P. Impact of psoriatic arthritis and comorbidities on ustekinumab outcomes in psoriasis: a retrospective, observational BADBIR cohort study. RMD Open. 2023 Jan;9(1):e002533.
  2. Gupta S, Syrimi Z, Hughes DM, Zhao SS. Comorbidities in psoriatic arthritis: a systematic review and meta-analysis. Rheumatol Int. 2021 Feb;41(2):275-284.