Key
Summary
The transition
from psoriasis to psoriatic arthritis (PsA) is driven by several modifiable
risk factors, including obesity, severe skin involvement, and specific lesions
on the scalp and nails. 1-5 Research indicates that early intervention with biologics, particularly IL-17A inhibitors like Copellor (ixekizumab), can significantly lower the risk
of this progression, with studies showing these treatments achieve the lowest
prevalence of PsA compared to other classes. 6-9 Because even a six-month delay in
diagnosis can lead to permanent joint erosion, clinicians are
urged to use screening tools like the PEST to ensure prompt referral and to
adopt a holistic, multidisciplinary
approach that prioritizes high clearance in
both dermatological and joint domains. 6
Optimizing
Psoriatic Arthritis Prevention by Managing Psoriasis Risk Factors
Progression
to PsA is influenced by several identified risk factors. Long-term indicators (typically
appearing 7–12 years before onset) include obesity, genetic history, and specific disease locations such as
the scalp and nails, as well as severe overall skin involvement. 1-4 Short-term warning signs (1–3 years
before onset) often manifest as joint
pain (arthralgia) and subclinical inflammation of the entheses or
synovium. 5 Effective management of these initial PsO symptoms is
considered a vital step in modifying the risk of developing joint disease.
Utilizing
Biological Therapies to Lower the Likelihood of Psoriatic Arthritis Development
Research
indicates that treatment with biologics can successfully delay or reduce the
transition to PsA. 6,7 Real-world data suggest that IL-17A inhibitors are particularly effective
in this regard; patients treated with this class showed a lower risk of
progression compared to those on IL-23 inhibitors. Specifically, one large
study found that patients on IL-17 inhibitors had the lowest prevalence of PsA (1.9%) compared to those on TNF
inhibitors (8.8%) or IL-23/IL-12 inhibitors (6.1%). 7
Core
Insights and Performance Metrics of Copellor (ixekizumab)
Copellor (ixekizumab) addresses the primary risk factors for PsA by
providing high clearance rates in the skin, 8,9 scalp, and nails. 10
Skin Clearance:
Approximately 40% of patients achieve complete skin clearance (PASI 100) by Week 12, a result
that remains stable through one year of treatment (figure 1). 8,9 Figure 1: PASI 100 at Week 12 and Month 12
Scalp and Nail
Efficacy: Copellor (ixekizumab) shows superior results in difficult-to-treat areas, with roughly 70% of patients achieving clearance in
both scalp and nails by Week 12 (figure 2 and 3). 10Figure 2: Complete clearance of scalp PsO at Week 12Figure 3: Complete clearance of Nail PsO at Week 12
Long-term and
Comparative Results:
By Year 5, scalp clearance reaches 87% and nail clearance reaches 77%.
Additionally, network meta-analyses show Copellor (ixekizumab) has the highest probability
of achieving complete nail resolution compared to other biologics like
bimekizumab and guselkumab. 11-13
The
Critical Need for Timely Detection and Specialty Consultation
Early identification is paramount because even a six-month delay in diagnosis can lead
to irreversible joint erosion and impaired physical function. 14-16
Dermatologists are encouraged to use validated screening tools like the PEST;
a score of 3 or higher necessitates an immediate referral to a rheumatologist
to prevent long-term damage. 6
Comprehensive
Management of Both Dermatological and Joint Symptoms
For
patients who have already transitioned to active PsA, a dual-domain treatment
approach is required to improve quality of life. 17 Copellor (ixekizumab) has demonstrated balanced efficacy across
both joints and skin. In head-to-head trials against adalimumab,
significantly more patients on Copellor (ixekizumab) achieved the combined goal of ACR50 (joint improvement) and PASI 100 (skin
clearance) at both 24 and 52 weeks.18 Real-world studies
further support these findings, showing significant improvements in Clinical
Disease Activity Index (cDAPSA) and Body Surface Area (BSA) scores over 12
months (figure 4).Figure 4: Change from Baseline in Joints and Skin
Adopting
an Integrated Strategy for Managing Psoriatic DiseaseThe
complex nature of psoriatic disease requires a multidisciplinary and holistic approach. 2 Treating PsO
effectively before the onset of joint symptoms is a proactive strategy to reduce
progression. 6,7 Clinicians may choose therapies that offer proven
guidance across multiple domains to ensure optimal outcomes for patients at
risk of, or currently living with, active PsA. 6-13
References: 1. Errichetti
E, Zabotti A. Dermatol Ther (Heidelb). 2024;14(1):1–3. 2. Zabotti A, et al. Ann
Rheum Dis. 2023;82(9):1162–1170. 3. Wilson FC, et al. Arthritis Rheum.
2009;61(2):233–239. 4. de Vlam K, et al. Acta Derm Venereol.
2014;94(6):627–634. 5. Zabotti A, et al. RMD Open. 2024;10(2):e004314. 6.
Pinter A, et al. Presented at: European Academy of Dermatology and Venereology
Congress 2025. 17–20 September 2025, Paris, France. 7. Floris A, et al.
Rheumatology (Oxford). 2025;64(3):1131–1137. 8. Pinter A, et al. J Eur Acad
Dermatol Venereol. 2022;36(11):2087–2100 (+suppl). 9. Pinter A, et al. Dermatol
Ther (Heidelb). 2024;14(6):1479–1493 (+suppl). 10. Piaserico S, et al. Front
Med (Lausanne). 2023:10:1185523 (+suppl). 11. Blauvelt A, et al. J Am Acad
Dermatol. 2021;85(2):360–368. 12. Reich K, et al. J Dermatolog Treat.
2017;28(4):282–287. 13. van de Kerkhof P, et al. J Eur Acad Dermatol Venereol.
2017;31(3):477–482. 14. Tillett W, et al. Ann Rheum Dis. 2013;72(8):1358–1361.
15. Ocampo DV, Gladman D. F1000Res. 2019;8. F1000 Faculty Rev-1665. 16. Haroon
M, et al. Ann Rheum Dis. 2015;74(6):1045–1050. 17. Kavanaugh A, et al. Ann
Rheum Dis. 2019;78(9):1215–1219. 18. Reich K, et al. Dermatol Pract Concept.
2022;12(2):e2022104.Disclaimer: Some molecules/drugs may not be approved in India.CMAT-16366 | 03/03/2026Eli Lilly and Company (India) Private Limited
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