Given the heightened risk for infection in patients with PsA, providers must advocate for vaccinations against influenza, pneumonia, herpes zoster, COVID-19, tetanus, HBV, and hepatitis A.

Mood disorders, especially depression, are more prevalent among patients with PsA and predict reduced joint remission. Providers should refer patients with PsA to a mental health provider to address mood changes, as it may interfere with quality of life and increase likelihood of disability and loss of income.

Patients with PsA have a low risk of developing malignancies, with similar rates of malignancy as that in the general population. However, certain studies reported an increased risk for nonmelanoma skin cancer in patients with PsA receiving immunomodulatory medications.

Fibromyalgia, chronic pain, and/or central sensitization affects between 20% and 30% of patients with PsA vs 6% of the general population. Prompt diagnosis and management of fibromyalgia or central sensitization may improve patient response to therapy and quality of life.

Limitations of the review included the strength of data supporting treatment recommendations, which may have been limited by a small number of study participants, limited follow-up, and lack of clinical trial designs.

“There is much work to do to improve our understanding of how best to screen for, manage, and prevent comorbidities in patients with PsA,” the study authors said. “We hope that the recommendations from the comorbidity working group will assist clinicians in identifying important comorbidities and considering their effects on treatment selection.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

References:

Campanholo CB, Maharaj AB, Corp N, et al. Management of psoriatic arthritis in patients with comorbidities: an updated literature review informing the 2021 GRAPPA treatment recommendations. J Rheumatol. Published online November 1, 2022. doi:10.3899/jrheum.220310