• A new study found that the rates of serious infections in people with psoriatic arthritis (PsA) have dropped despite higher use of immunosuppressive treatments.
• Rates of sepsis, urinary tract infections (UTIs), and other infections decreased from 2012 to 2017, though pneumonia rates remained level.
• The study authors believe controlling inflammation and the disease have helped lower these rates.

Immunosuppressive medications such as biologics can be valuable in treating conditions like psoriatic arthritis. However, they are known to make some people more susceptible to serious infections, including urinary tract infections and pneumonia. A recent study has found that rates for certain infections have dropped significantly — by as much as 57 percent — in people with PsA who take immunosuppressants.

“One of the biggest questions that we have, as treating rheumatologists, is how do drugs that suppress the immune system translate to the real world with regards to risk of infection?” said the study’s lead author, Dr. Vagishwari Murugesan, to Healio News. “This is especially important in the COVID-19 era when we are constantly faced with the challenge of balancing management of our immune-mediated disease patients against the risk of infection.”

Biologics for PsA

More people have begun to use biologic therapies in recent years to treat their PsA. Biologics are human-made proteins used to treat a number of diseases and conditions. Many biologics target specific parts of the immune system to stop inflammation, which makes them successful treatments for autoimmune diseases like PsA. These medications may also make it difficult for the immune system to fight off infections — increasing the risk of sepsis, pneumonia, skin or soft tissue infections (SSTIs), and urinary tract infections.

With this, the authors of this study set out to look at national trends of serious infections in people with PsA who use biologics. Previous studies have looked at the rates of infections in people who use biologics, but they did not separate the risk of minor infections from serious ones.

Read about MyPsoriaisTeam member Katya Melthaus’s experiences with biologics for psoriasis.

Serious Infections Decreased From 2012 to 2017

To see the effects biologics had on the rates of serious infections, the authors searched the National Inpatient Sample database for anyone with PsA who was treated for sepsis, pneumonia, SSTIs, or UTIs between 2012 and 2017. They then ran a series of statistical analyses to ensure accuracy.

Overall, according to study data provided to MyPsoriasisTeam, researchers found that between 2012 and 2017, for people with PsA:

• Instances of SSTIs dropped from 3 percent to 1.3 percent, a 57 percent decrease.
• Instances of sepsis dropped from 3.1 percent to 1.6 percent, a 48 percent reduction.
• Instances of UTIs went from 2 percent to 1.2 percent, a 40 percent decrease.
• Pneumonia rates remained the same.

All in all, among 50,700 people with PsA who were discharged from a U.S. community hospital in 2012, there were 312 cases of SSTIs, 230 cases of sepsis, 174 UTI cases, and 125 cases of pneumonia. The total percent of serious infections among those with PsA was around 1.7 percent.

In 2017, among 179,400 people with PsA, there were 681 cases of skin and soft-tissue infections, 374 cases of sepsis, 348 UTIs, and 344 cases of pneumonia. The total percent of serious infections among those with PsA was around 1 percent.

The researchers told Healio that the decrease in infection rates could be attributed to better disease and inflammation control. However, they noted that more studies are needed to determine the exact risks and reasons for the drop.