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Investigative Report

Epidemiology, Comorbidity and Risk Factors for Psoriatic Arthritis: a Health Insurance Claims Database Analysis

Maximilian Reinhardt, Claudia Garbe, Jana Petersen, Matthias Augustin, Natalia Kirsten, Mona H.C. Biermann, Benjamin Häberle, Kristina Hagenström
DOI: 10.2340/00015555-3879


Psoriatic arthritis is a frequent manifestation of psoriasis, and has a high level of impact on physical functioning, work ability and quality of life. However, there have been few studies of the epidemiology, development of and risk factors for concomitant psoriatic arthritis in patients with psoriasis. This study analysed data from a German public health insurance database of > 2 million individuals. Factors influencing the development of psoriatic arthritis were determined by descriptively analysing comorbidities and Cox regression modelling. The prevalences of psoriasis and psoriatic arthritis were 2.63% and 0.29% in adults (18+ years) and, respectively, 0.30% and 0.01% in children (0–17 years). The proportion of adult patients with incident psoriasis who developed concomitant psoriatic arthritis within five years after diagnosis of psoriasis (mean 2.3 years) was 2.6%. Cardiovascular diseases are the most frequent comorbidity in patients with psoriasis with or without concomitant psoriatic arthritis. Depression and neurosis/stress disorder were identified as indicators for the development of psoriatic arthritis.


Psoriatic arthritis is an inflammatory joint disease that often occurs in connection with psoriasis and impairs physical functioning, work ability and quality of life. This study evaluated the occurrence and possible risk factors for psoriatic arthritis, using data from a German health insurance company from 2010 to 2015. The results show that concomitant psoriatic arthritis can appear even after a short time in patients with psoriasis, and that depression and stress increase the probability of developing psoriatic arthritis. These data emphasize that the early detection of psoriatic arthritis must continue to be a priority goal, in order to avoid non-reversible damage to the joints; hence cross-disciplinary collaborations should be strengthened.

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