OBJECTIVES: Psoriatic arthritis (PsA) is a chronic, progressive inflammatory disease affecting the musculoskeletal system, potentially resulting in severe joint impairment and functional limitations. Understanding the prognostic and risk factors contributing to the onset or progression of PsA in the adults with psoriasis is essential. The systematic literature review (SLR) aimed to explore the prognostic or risk factor of PsA among adult patients with psoriasis in the United States (US).

METHODS: Key biomedical databases (Embase®, Medline®) were searched from January 2012 to January 2024 to identify the recent published evidence in English language which met the prespecified eligibility criteria. The SLR was performed using the standard two review and quality control process.

RESULTS: A total of 10 studies assessing the risk factors of PsA were included (sample size 128 to 85,324). Gender (n=3 studies), comorbidities (n=3 studies), age (n=2 studies), body mass index (BMI) (n=2 studies), psoriasis disease severity (n=2 studies), and smoking (n=2 studies) were the most assessed risk factors across the studies. A statistically significantly higher risk of PsA was reported among patients with BMI ≥35.0 (vs. <25) (RR: 6.60, 95% CI 4.26–10.23), cholecystectomy (RR: 3.45, 2.34-5.08), presence of psoriasis phenotypes such as pustular psoriasis (HR: 3.32, 1.91-5.77), palmoplantar pustular psoriasis (HR: 3.30, 1.57-6.97), generalized pustular psoriasis (HR: 3.12, 1.42-6.85), current smokers (RR: 3.08, 2.06-4.61), history of gallstones (RR: 2.51, 1.69-3.73), hypercholesterolemia (HR: 2.14, p<0.0001), females (OR: 1.30, 0.92-1.84), comorbidities like coronary artery disease (OR: 2.37, 1.08-5.16), diabetes (OR: 2.16, 1.15-4.07), hypertension (OR: 1.78, 1.22-2.58), stroke (OR: 1.64, 0.35-6.53). Further, more severe, and extensive psoriasis, obesity and age were also positively and statistically significantly correlated with onset of PsA (p <0.05).

CONCLUSIONS: The SLR highlights the diverse factors contributing to PsA in the US, with notable associations found in demographics, lifestyle, comorbidities, and phenotypes.