How does age of onset affect outcomes for psoriatic arthritis?

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Research from 2020 indicates that up to 41% of people who have psoriasis also develop psoriatic arthritis.

The National Psoriasis Foundation (NPS) notes that while symptoms can develop at any age, they most often appear between the ages of 30 and 50 years.

The NPS also highlights that, in most cases, psoriatic arthritis develops about 10 years after the onset of psoriasis. However, some people develop psoriatic arthritis first. These individuals are likely to be older and have more severe symptoms. They may also respond differently to treatment.

According to an older 2014 review, for many years, researchers have used the age of onset to classify psoriasis into two categories: type 1 and type 2.

Type 1 onset occurs before age 40 and accounts for about 70% of all psoriasis cases. Onset most often occurs when people are between the ages of 16 and 22 years.

Type 2 onset occurs after age 40, and the peak age range of onset is 57–60 years.

Most researchers agree on the age groups for psoriasis. However, there is less agreement on what early or late onset means in relation to psoriatic arthritis.

Understanding the age of onset may help with determining risk factors. In the same study, the researchers found that earlier onset of psoriasis may be linked to a certain gene that is present in people with type 1 psoriasis.

Psoriatic arthritis can cause symptoms such as:

• limited range of motion
• fatigue
• stiffness and tiredness in the morning
• pain or swelling of tendons
• swelling in fingers and toes
• pain, stiffness, or swelling in the joints
• eye pain or redness
• changes to the nails

In a 2017 study, researchers found that later onset of psoriatic arthritis is associated with:

• higher rates of fatigue
• presence of other diseases
• high pain scores
• more effects on the nails
• increased inflammation

In an older 2015 review of studies, researchers looked at the risk factors for developing psoriatic arthritis. They considered various factors, including:

• alcohol consumption
• obesity
• smoking
• nail disease
• severity of psoriasis

The research suggested that the severity of psoriasis plays a role in the development of late onset psoriatic arthritis. Studies on the condition’s links to smoking and alcohol consumption were less conclusive.

The authors of a 2019 review suggest that genes may play less of a role in late onset psoriatic arthritis than in early onset psoriatic arthritis. Other risk factors, such as smoking, may be more significant in the development of late onset psoriatic arthritis.

Psoriatic arthritis has no cure, but treatment can help people manage symptoms such as swelling and pain. Treatment can also help slow or prevent the progression of the disease.

There are several approved treatment methods, including:

• disease-modifying antirheumatic drugs, which help slow down joint damage and disease progression
• newer oral treatments to help suppress swelling
• biologic medications, which may prevent joint pain and slow down disease progression
• over-the-counter or prescription-strength nonsteroidal anti-inflammatory drugs, such as ibuprofen and aspirin, to help reduce pain and swelling
• home remedies, including possible changes to diet and exercise

Early treatment can help prevent the disease from progressing. A person should talk with their doctor if they start developing symptoms of psoriatic arthritis.

In a 2019 study, researchers found that late onset psoriatic arthritis was less responsive to treatment. They suggested that future research should further explore how to effectively treat late onset psoriatic arthritis.

A person should consult a healthcare professional if they experience any symptoms of psoriatic arthritis. Although there is no cure for psoriatic arthritis, earlier treatment can help prevent joint damage and may slow the progression of the disease.

A person who has psoriatic arthritis should talk with their doctor if their symptoms are not improving or are becoming worse despite treatment. A doctor may need to work with the person to find a better course of treatment.

Psoriatic arthritis can begin at nearly any age. A person should consult a healthcare professional if they notice symptoms of psoriatic arthritis.

Psoriatic arthritis is not life threatening, but it can increase a person’s risk of developing other diseases.

Treatments may help reduce symptoms and slow the progression of the disease.