Research indicates a high severity of arthritis symptoms in people with psoriasis

Early results of an international study assessing the risk of arthritis in people with psoriasis showed a high burden of joint symptoms in 712 patients – 25% of all patients examined so far.

The study, led by scientists from the universities of Oxford, University College Dublin and supported by the University of Manchester, has so far recruited almost 3,000 patients.

However, the team is still looking for 2,000 more patients with psoriasis – a disease causing scaly patches of skin covered in white scales that affects around 3% of people in the UK and Europe.

The 25% results confirm existing knowledge that up to one third of people will develop psoriatic arthritis (PsA), which causes inflammation and pain in the joints and tendons.

The project is led by Professor Laura Cotes, Associate Professor at the University of Oxford.

She said: “It is currently impossible to predict which psoriasis patients will develop joint problems.

“This research will assist us develop ways to prevent arthritis in people with psoriasis, offering potential drug treatments or lifestyle changes such as exercise or stress management.”

The online study, called the HIPPOCRATES Prospective Observational Study (HPOS), monitors people with psoriasis over a three-year period to see who will develop PsA.

Participants complete questionnaires online and send petite fingerstick blood samples by pre-paid post.

After launching in the UK in July 2023, the trial opened in Ireland in August 2023, followed by Greece in February 2024 and Portugal in April 2024.

The Oxford research team is working to open HPOS in a further 12 European countries, with the ultimate goal of recruiting 25,000 people with psoriasis.

This week, on June 19 and 20, researchers from across Europe will meet in Manchester to discuss progress in the study so far.

To date, we have baseline data on a total of 2,841 patients, of which 1,761 are from Ireland and 1,067 from the UK.”

Professor Laura Cotes, Associate Professor, University of Oxford

Professor Ann Barton from the University of Manchester will lead the analysis of genetic samples collected as part of the study.

She said: “We know that some patients with psoriasis will develop psoriatic arthritis. If we could determine which patients are at higher risk of developing arthritis, it could mean that these people could receive preventive treatment in the future.

“Manchester is leading work to identify genetic changes that can be used to predict which psoriasis patients may be at increased risk of developing psoriatic arthritis. The HPOS study will enable us to collect samples from psoriasis patients to assist further this work.”

Russ Cowper, who lives in Manchester and has suffered from psoriatic arthritis for many years, said: “Psoriatic arthritis is so tough to diagnose that it can lead to real confusion for patients who know something is wrong but they can’t explain it.

“GPs are not always skilled enough to detect symptoms and they can present themselves in many different ways. Receiving a diagnosis is in many ways a relief, patients can then plan for the future knowing that they do indeed have an ongoing disease

“PsA can be debilitating, and in my case it was also quite random. I may feel quite well for a few days, and then suddenly I can’t get out of bed and my joints are painful.

“The only joints that weren’t affected were my elbows, I had flare-ups everywhere else, even in my jaw.

“It’s a terrible condition and very tiring. The pain can cause lack of sleep, and if you touch your hands, it will be tough to perform daily tasks. If it’s really bad, applying creams to your skin becomes tough and you risk making your psoriasis worse.