{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T18:29:09Z","timestamp":1788805749446,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Janssen Pharmaceuticals","award":["7873-20"],"award-info":[{"award-number":["7873-20"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: To examine the prevalence of fibromyalgia syndrome (FMS) in patients with psoriasis (PsO) and psoriatic arthritis (PsA) and its impact on treatment patterns and biologic therapy adherence. Materials and Methods: This retrospective cohort study utilized electronic health records from the Meuhedet Health Maintenance Organization in Israel between 2000 and 2020. PsO patients were matched 1:4 with controls by age, sex, and ethnicity. We assessed FMS prevalence, comorbidity burden, and treatment patterns. Cox regression and linear models evaluated the association between FMS and biologic switching and duration, adjusting for confounders. Results: Among 61,003 PsO patients and 244,012 controls, FMS prevalence was higher in PsO (3.3% vs. 2.3%, OR = 1.45, 95% CI: 1.38\u20131.53, p &lt; 0.001). Among PsO patients, those with FMS were predominantly female (81.1% vs. 49.8%, p &lt; 0.001) and had a higher prevalence of PsA (33.6% vs. 7.7%, p &lt; 0.001). They received biologics more frequently (10.2% vs. 2.7%, p &lt; 0.001) and were more likely to require multiple biologic lines (4.2% vs. 0.7%, p &lt; 0.001). In PsA patients receiving biologics, FMS was associated with reduced survival on first-line therapy (6.1 vs. 10.1 years), increased switching risk (HR = 1.82, 95% CI: 1.42\u20132.35), and shorter treatment duration (B= \u22120.97 years, p = 0.001). Conclusions: In PsO patients, especially those with psoriatic arthritis, FMS is linked to greater treatment complexity and shorter biologic therapy survival, underscoring the need for tailored management strategies.<\/jats:p>","DOI":"10.3390\/medicina61101809","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T13:19:26Z","timestamp":1760015966000},"page":"1809","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Association Between Psoriasis, Psoriatic Arthritis, and Fibromyalgia Syndrome: Effects on Treatment\u2014A Population-Based Study"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5285-6695","authenticated-orcid":false,"given":"Yoav","family":"Elizur","sequence":"first","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mor","family":"Amital","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel"},{"name":"The Adelson School of Medicine, Ariel University, Ariel 40700, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4721-2003","authenticated-orcid":false,"given":"Niv","family":"Ben-Shabat","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Patt","sequence":"additional","affiliation":[{"name":"The Adelson School of Medicine, Ariel University, Ariel 40700, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0722-7326","authenticated-orcid":false,"given":"Galia","family":"Zacay","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel"},{"name":"Department of Family Medicine, Meuhedet Health Maintenance Organization, Tel Aviv 62038, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Lassman","sequence":"additional","affiliation":[{"name":"St George\u2019s Hospital, University of London, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7715-8226","authenticated-orcid":false,"given":"Dennis","family":"McGonagle","sequence":"additional","affiliation":[{"name":"Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1404-8027","authenticated-orcid":false,"given":"Abdulla","family":"Watad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel"},{"name":"Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Gendelman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5406-7716","authenticated-orcid":false,"given":"Howard","family":"Amital","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat Gan 52621, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1001\/jama.2020.4006","article-title":"Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review","volume":"323","author":"Armstrong","year":"2020","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1080\/00015550252948130","article-title":"Quality of life and prevalence of arthritis reported by 5,795 members of the Nordic Psoriasis Associations. 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