PsA may be linked to jaw limitations

Investigators found associations between joint involvement, skin disease severity, and sleep quality in patients with psoriasis.

By
Andrea Surnit
November 5, 2026
4 min

MDSpire News

Overview

In a prospective, controlled cross-sectional study of 105 patients with psoriasis and 73 matched controls, jaw functional limitation was greater among patients with psoriatic arthritis (PsA) than among those without PsA. Psoriasis severity was independently associated with poorer sleep quality, while biologic treatment status was associated with better sleep quality; the study design does not establish treatment effects.

Background

Psoriasis can coexist with PsA, which involves musculoskeletal disease as well as skin manifestations. The study assessed temporomandibular function and sleep because both may be affected in people with psoriasis. Current PsA guidance uses a domain-based, treat-to-target approach that considers joint and skin involvement when selecting therapy. The study authors identified PsA-associated temporomandibular functional limitation as their principal novel finding.

Data Highlights

Measure or comparison	Findings
Study population	178 participants: 105 patients with psoriasis and 73 age- and sex-matched controls
JFLS-20 by PsA status	Mean score 0.80 with PsA vs. 0.45 without PsA
JFLS-20 by group	Healthy controls, 0.52; no systemic therapy, 0.54; nonbiologic systemic therapy, 0.59; biologics, 0.51
Poor sleep quality (PSQI >5)	No systemic therapy, 60%; nonbiologic systemic therapy, 60%; biologics, 7%; healthy controls, 10%
Mean PSQI score	No systemic therapy, 6.05; nonbiologic systemic therapy, 5.70; biologics, 4.23; healthy controls, 4.05
Mean PASI score	Biologics, 1.57; no systemic therapy, 7.19; nonbiologic systemic therapy, 6.89
PsA subgroup by biologic status	Mean JFLS-20: 0.67 with biologics vs. 0.92 without; mean PSQI: 4.25 vs. 7.00

Key Findings

PsA status was independently associated with greater jaw functional limitation after adjustment for the reported covariates; skin disease severity and biologic treatment status were not independently associated with jaw function.
Jaw limitation was not significantly greater in the overall psoriasis group than in healthy controls, and group mean JFLS-20 scores were similar.
Higher PASI scores remained independently associated with poorer sleep quality, while biologic treatment status was associated with better sleep quality; PsA status was not independently associated with sleep quality.
Among patients with PsA, those receiving biologics had lower mean jaw limitation and PSQI scores than those not receiving biologics, but exploratory comparisons could not determine whether treatment accounted for these differences.
No statistically significant differences in psoriasis severity, jaw function, or sleep quality were observed between the IL-17/IL-17A/F and IL-23 inhibitor groups.
Limitations included the single-center cross-sectional design, small sample, patient-reported measures without objective dental or sleep assessments, unadjusted multiple exploratory comparisons, and exclusion of patients receiving tumor necrosis factor inhibitors.

Clinical Implications

The study findings support attention to jaw functional symptoms in patients with psoriasis and PsA, while they do not establish that biologic therapy improves jaw function or sleep. The authors noted that treatment-related associations are difficult to separate from differences in disease activity and treatment response.

Conclusion

In this study, PsA was independently associated with greater jaw functional limitation, whereas poorer sleep was associated with greater skin disease severity. The cross-sectional findings and study limitations preclude causal conclusions about treatment effects.