Family History Shapes Psoriatic Disease Onset in PsA

TOPLINE:

Patients with psoriatic arthritis (PsA) who had a family history of psoriatic disease were diagnosed with psoriasis and PsA earlier and showed more entheseal involvement than those without such family history.

METHODOLOGY:

• Researchers enrolled 843 patients with PsA (mean age, 50.8 years; 50.6% men; 76.4% White individuals) from the New York University (NYU) Psoriatic Arthritis Center and associated clinics in an observational, longitudinal registry to study familial aggregation and differences in disease onset and phenotype.
• They collected data on demographics, medical and family history, and psoriatic phenotype and activity.
• Patients were categorized on the basis of family history, with 379 participants having one or more first-degree or second-degree relatives with psoriatic disease (301 had relatives with psoriasis, and 78 had relatives with PsA) and 464 having no history.
• Disease measures included the age at which psoriasis and PsA were diagnosed, types and locations of psoriasis, and areas affected by PsA.

TAKEAWAY:

• Patients with a family history of psoriatic disease were diagnosed with psoriasis and PsA earlier than those without (mean age, 27.6 vs 32.2 years and 37.6 vs 40.3 years, respectively; P < .01 for both).
• Patients with first-degree or second-degree relatives with PsA were diagnosed with psoriasis and PsA earlier than those with relatives with psoriasis alone or no family history (P < .01 and P = .01, respectively).
• Patients with a family history of psoriatic disease were more likely to have a history of enthesitis than those without (36.7% vs 30.0%; P < .05) and active enthesitis at baseline (30.1% vs 21.6%; P < .01).
• The transition time between the diagnosis of psoriasis and PsA was longer among patients with two or more first-degree or second-degree relatives than among those with only one relative or those with no family history (mean time to diagnosis, 14.1 vs 8.0 vs 8.8 years; P < .01).

IN PRACTICE:

“Additional studies integrating molecular and immune features are needed to elucidate how genetic, environmental, and epigenetic elements influence the progression from psoriasis to PsA, as well as PsA’s clinical presentation, severity, and therapeutic response,” the authors of the study wrote.

SOURCE:

The study was led by Catherine Howe, MD, NYU Grossman School of Medicine, New York City. It was published online on July 14, 2025, in Arthritis & Rheumatology.

LIMITATIONS:

The study relied on patient-reported data for age of diagnosis and family history, which may introduce potential recall bias and underdiagnosis of mild cases. Having a family history may not equate to genetic burden. The lack of a uniform baseline visit for all patients with PsA may affect the assessment of disease activity.

DISCLOSURES:

This study was funded by grants to authors from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the NYU Colton Center for Autoimmunity, the Rheumatology Research Foundation, the National Psoriasis Foundation, and other sources. Two authors reported receiving support from an Institutional National Research Service Award and the National Institute of Diabetes and Digestive and Kidney Diseases. Some authors reported receiving consulting fees from or serving on advisory boards for pharmaceutical companies that market drugs for psoriatic disease.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.