IL-17 Inhibitors vs. methotrexate in preventing new-onset psoriatic arthritis in psoriasis patients: a retrospective population-level analysis

Summary: Abstract Body: Psoriasis increases the risk of psoriatic arthritis (PsA), potentially due to shared inflammatory pathways. This study compares the incidence of new-onset PsA in psoriasis patients treated with IL-17 inhibitors (IL-17i) versus methotrexate (MTX). A TriNetX query identified 1:1 propensity score matched cohorts of 8,531 patients each, controlling for age, race, gender, and comorbidities. Patients treated with IL-17i demonstrated a protective effect against new-onset PsA vs. those on methotrexate. Risk analysis and Kaplan-Meier survival analysis revealed a lower incidence of PsA in the IL-17i group (6.1%) versus the MTX group (7.2%) (p=0.010). Kaplan-Meier analysis showed higher PsA-free survival in the IL-17i group (72.82%) compared to MTX (61.15%) (p=0.003). Hazard ratios confirmed IL-17i's protective effect (HR=1.214, p=0.000). These findings suggest IL-17i as a promising first-line therapy for psoriasis patients at risk of developing PsA. Further longitudinal studies with larger sample sizes and extended follow-up periods are warranted to explore the long-term benefits of IL-17i in PsA prevention. Ryan Chan¹, Rahib Islam², Alexander Maltese³, Kazi Islam⁴, Jashin Wu⁵ 1. New York Medical College, Valhalla, NY, United States. 2. LSU Health New Orleans, New Orleans, LA, United States. 3. University of Louisville School of Medicine, Louisville, KY, United States. 4. Central State University, Wilberforce, OH, United States. 5. University of Miami Miller School of Medicine, Miami, FL, United States. Clinical Research: Epidemiology and Observational Research