Background Psoriasis is a chronic inflammatory skin disorder that frequently precedes psoriatic arthritis onset. Given that biologics can treat both conditions, there is growing interest in whether early biologic intervention can prevent psoriatic arthritis. Objectives This systematic review examines observational studies to determine whether biologic treatment for psoriasis reduces psoriatic arthritis incidence. Methods Following the PRISMA guidelines, we searched PubMed in November 2025 for studies published between 2003 and 2025; 11 articles met eligibility. Results A total of 368,033 psoriasis patients were analyzed, including 27,195 patients receiving biologics. Five clinical studies demonstrated that biologics were associated with a lower risk of psoriatic arthritis. In contrast, 6 claim‐based studies showed conflicting results, often indicating higher psoriatic arthritis incidence among biologic users. Conclusions Current evidence is mixed regarding the ability of biologics to delay psoriatic arthritis onset in psoriasis patients. Prospective studies and rigorously designed retrospective analyses that carefully adjust for biases are needed to determine whether biologic therapy can reduce psoriatic arthritis incidence.
Miao et al. (Thu,) studied this question.