scholarly journals AB0743 DISEASE CHARACTERISTICS OF PSORIATIC ARTHRITIS PATIENTS MAY DIFFER ACCORDING TO AGE AT PSORIASIS ONSET: CROSS-SECTIONAL ANALYSIS OF PSORIATIC ARTHRITIS-INTERNATIONAL DATABASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1667.2-1668
Author(s):  
E. Bilgin ◽  
Ö. Bayindir ◽  
E. Kasapoğlu ◽  
S. Bakirci ◽  
D. Solmaz ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Family History ◽  
Disease Duration ◽  
Late Onset ◽  
International Database ◽  
Psoriatic Disease ◽  
Disease Characteristics ◽  
Axial Disease ◽  
Disease Family ◽  
Nail Involvement

Background:Psoriasis and psoriatic arthritis (PsA) are heterogenous diseases with various disease manifestations and phenotypes. Psoriasis has a bimodal age of onset being early (before the age of 40, type 1) and late. The impact of this classification on the PsA features is not well understood.Objectives:To compare the PsA characteristics of patients with early- and late-onset psoriasis in a large, multicenter databaseMethods:PSART-ID (Psoriatic Arthritis-International Database) is a prospective, multicenter web-based registry (www.trials-network.org) of patients with PsA. A detailed data collection was performed including demographics (sex, age, duration of education, smoking status, BMI), skin features (psoriasis onset date, type, initially involved site of skin, nail involvement (ever) and family history) and PsA characteristics (type of articular involvement and presence of axial, dactylitis (ever), enthesitis (ever), family history) and indices for disease activity and function (DAPSA, Leeds enthesitis index, BASDAI, BASFI, patient and physician global assessment, pain, HAQ-DI). We grouped according to the age at psoriasis onset (early onset, psoriasis before the age of 40 (EOPsO); late-onset, psoriasis after the age of 40 (LOPsO)), patient and disease characteristics of the groups were compared (1). Due to the differences among groups, following adjustments weer made: BMI for age, nail involvement for PsO disease duration, axial PsA for PsA disease duration.Results:A total of 1634 (62.8% females; EOPsO, 1108 (67.8%); LOPsO, 526 (32.2%)) patients with PsA was recruited. Rate of over-weight patients was higher in LOPsO group (66.8% vs. 86.8%, p<0.001; adjusted for age - aOR 1.55 (1.11-2.20; % 95 CI)). The EOPsO group had the scalp involvement as the initial site of skin disease more often than the LOPsO group (56.7% vs. 43.0%, p<0.001), whereas extremity involvement was more frequent as the initial finding in the LOPsO group (EOPsO vs. LOPsO 63.8% vs. 74.2%, p<0.001). Nail involvement (ever) was more prominent in EOPsO group, however, the significance was disappeared when adjusted for psoriasis duration. Interaction between gender and both axial disease and psoriatic disease family history were found (axial disease in man; EOPsO vs LOPsO; 38.0% vs. 25.4%; p=0.005; adjusted for PsA duration - aOR 0.56 (0.38-0.84; %95 CI) // psoriatic disease family history in females; EOPsO vs LOPsO; 39.5% vs. 30.1%; p=0.003; OR 0.65 (0.50-0.86; %95 CI)). Duration between PsO and PsA was significantly longer in EOPsO group (148 vs. 24 months, p<0.001). In EOPsO group, more patients had PsO preceeding PsA than LOPsO group (81.8% vs. 60.6%, p<0.001), however, synchronous disease -defined as the diagnosis of PsO and PsA within the same year- was more common in LOPsO group (16.6% vs. 30.3%, p<0.001) (Table 1). Psoriatic disease activity parameters, patient and physician reported outcomes and HAQ-DI scores were similar in both groups.Table 1.Comparison of psoriatic arthritis patients‘ characteristics according to age at psoriasis onsetConclusion:Clinical features of PsA may be affected by the age at the onset of psoriasis. As the genetic background is different in early and late-onset psoriasis, this may suggest a different pathogenetic mechanism based on the psoriasis phenotype, also affecting the PsA features. Further prospective studies are needed to define whether the classification of PsA requires including psoriasis phenotypes as well.References:[1]Henseler T, Christophers E. Psoriasis of early and late onset: characterization of two types of psoriasis vulgaris. J Am Acad Dermatol. 1985;13(3):450-6.Disclosure of Interests:Emre Bilgin: None declared, Özün Bayindir: None declared, esen kasapoğlu: None declared, Sibel Bakirci: None declared, Dilek Solmaz: None declared, Gezmiş Kimyon: None declared, Atalay Doğru: None declared, Ediz Dalkiliç: None declared, Cem Özişler: None declared, Meryem Can: None declared, Servet Akar: None declared, Emine Figen Tarhan: None declared, Şule Yavuz: None declared, Levent Kiliç: None declared, Orhan Küçükşahin: None declared, Ahmet Omma: None declared, Emel Gönüllü: None declared, Fatih Yildiz: None declared, Duygu Ersözlü: None declared, abdurrahman tufan: None declared, Muhammet Çinar: None declared, Abdulsamet Erden: None declared, Sema Yilmaz: None declared, Seval Pehlevan: None declared, Tuncay Duruöz: None declared, Sibel Aydin: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB

scholarly journals POS1083 PSORIATIC DISEASE – A HETEROGENOUS DISEASE WHO NEEDS A MULTIDISCIPLINARY CARE!

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 820.3-821
Author(s):  
B. Santos ◽  
J. Antao ◽  
M. Loureiro ◽  
A. Barcelos
Keyword(s):  
Psoriatic Arthritis ◽  
Family History ◽  
Early Diagnosis ◽  
Disease Activity ◽  
Disease Duration ◽  
Multidisciplinary Care ◽  
Comprehensive Treatment ◽  
Multidisciplinary Management ◽  
Psoriatic Disease ◽  
History Of

Background:Rheumatologists and Dermatologists usually manage Psoriatic Arthritis (PsA) and Psoriasis (PsO) separately, but early diagnosis and integrated management could achieve better outcomes with gains in quality of life of the patients. A multidisciplinary care is essential to achieve these goals.Objectives:The aim of this study is to describe a model of integrated multidisciplinary approach for early diagnosis of PsA and the multidisciplinary management of PsA patients.Methods:A retrospective study including patients that attended the multidisciplinary clinical from January 2019 to December 2020 was performed. Patients with PsO complaining articular symptoms and patients with articular symptoms with cutaneous lesions suspected to be PsO was referred to this clinical. Demographic, clinical data and disease activity measures were collected. Descriptive, Student’s t and Fisher test and Odds Ratio were estimated.Results:A total of 50 patients were referred to multidisciplinary clinical. Of these, 40 patients met criteria for psoriatic arthritis according to CASPAR criteria: 22 (55%) were male and median age was 49.5 ± 11.5 years. Family history of psoriasis was present in 19 (47.5%) and 7 (17.5%) had spondyloarthritis family history. Obesity and overweight were the comorbidities most found, 42.9% and 37.1%, respectively, followed by hypertension 25%, dyslipidaemia and depression 22.5% and metabolic syndrome 15%. Thirty-three patients (84.6%) were under topical treatment, 23 (59%) were under csDMARDs and 13 (32.5%) were under bDMARDs. After multidisciplinary clinical evaluation, treatment change was made - switch to another bDMARDs in 5 patients and bDMARD was started in 7 patients. All patients had a previous evaluation for infection risk assessment and 11 patients performed 9 months isoniazid for latent tuberculosis treatment.Eleven patients (28.9%) presenting moderate to severe PASI. Thirty-one patients presenting prolonged disease duration (> 10 years) with cutaneous (74.2%) and articular (61.3%) involvement. Peripheral disease without axial involvement was present in 28 patients (90%) while the others (10%) had both axial and peripheral involvement. Severe or moderate articular disease activity (DAS28) was present in 52.6% of the patients. The most frequent extra-articular manifestation was dactylitis (23.3%) and enthesitis (19.4%). The average number of multidisciplinary clinical consultations for these patients was 2.There was a statistically significant difference at the mean age, gender and disease duration > 10 years between patients with psoriatic disease with and without arthritis (p= 0.047; p=0.01 and p=0.03, respectively); there was no statistically significant differences in family history of psoriasis (p=0.711) and spondyloarthritis (p=0.174), nutritional status (p=0.732) and comorbidities such as diabetes mellitus (p=0.545), hypertension (p=0.404), dyslipidaemia (p=0.394) and depression (p=0.089).In the remaining 10 patients screened, the osteoarthritis and/or tendonitis were responsible for the articular complaints in 6 patients and scalp seborrhoea and eczema were responsible for the cutaneous complaints in the rest.Conclusion:Despite the small number of patients observed in our multidisciplinary clinical, we found that this kind of clinical care may facilitate the diagnosis of joint disease and offers a more comprehensive treatment approach for patients with both psoriasis and PsA.References:[1]Luchetti MM, Benfaremo D, Campanati A, Molinelli E, Ciferri M, Cataldi S, Capeci W, Di Carlo M, Offidani AM, Salaffi F, Gabrielli A. Clinical outcomes and feasibility of the multidisciplinary management of patients with psoriatic arthritis: two-year clinical experience of a dermo-rheumatologic clinic. Clin Rheumatol. 2018 Oct;37(10):2741-2749. doi: 10.1007/s10067-018-4238-4[2]Theodorakopoulou E, Dalamaga M, Katsimbri P, Boumpas DT, Papadavid E. How does the joint dermatology-rheumatology clinic benefit both patients and dermatologists? Dermatol Ther. 2020 May;33(3):e13283. doi: 10.1111/dth.13283Disclosure of Interests:None declared.

scholarly journals AB0797 ULTRASONOGRAPHIC ASSESSMENT OF ENTHESEAL INVOLVEMENT IN PSORIATIC ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1698.2-1699
Author(s):  
I. Mahmoud ◽  
S. Rahmouni ◽  
A. Ben Tekaya ◽  
S. Bouden ◽  
R. Tekaya ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Achilles Tendon ◽  
Patellar Tendon ◽  
Clinical Examination ◽  
Disease Duration ◽  
Plantar Fascia ◽  
Quadriceps Tendon ◽  
The Mean ◽  
Triceps Tendon ◽  
Nail Involvement

Background:Entheseal involvement is a frequent and distinctive feature of psoriatic arthritis (PsA), often under diagnosed. It is especially associated with nail involvement. Because clinical examination is not sensitive enough for the detection of early signs of this involvement, US may be considered as an alternative imaging technique in the diagnosis of enthesopathy.Objectives:The aim of the present study is to evaluate US entheses abnormalities in PsA and their correlation with clinical characteristicsMethods:The study included patients diagnosed with PsA according to the CASPAR criteria. They underwent a thorough clinical examination with special regard to the presence of enthesitis using the Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Index.The US study bilaterally explored entheses at six sites: proximal plantar fascia, distal Achilles tendon, distal and proximal patellar tendon insertion, distal quadriceps tendon and distal brachial triceps tendon. We evaluated the following elemental lesions of enthesis at each site: thickness and structure of the tendon, calcifications, bursae, erosions, power Doppler signal in bursa or enthesis full tendon.Results:Of the 33 patients, 39.4 % were male. The mean age was 51.2±12.5 years. The mean disease duration was 13.5±10.2 years.The mean DAPSA was 22.8± 19.7 [0.1-84.5]: remission(n=9), low activity (n=5),moderate activity (n=11),high activity(n=8).At inclusion, 11 patients (33.4%) patients presented with psoriatic onychopathy (45 fingernails) with a mean mNAPSI of 14.1±16. Out of the 528 entheseal sites, 92 were tender at the palpation (17,4%) with a mean SPARCC at 2.87.A total of 396 entheseal sites were examined by US. In 140 of them (35.35%), US found at least 1 sign indicative of enthesopathy. The most affected tendon was the distal Achilles tendon (42/396), followed by proximal plantar fascia (32/396), distal patellar tendon (20/396), quadriceps tendon (20/396), distal brachial triceps tendon(14/396) and finally proximal patellar tendon (12/396).The most common elemental lesions were enthsophytes (176), erosions (114) and calcifications (50).We found a positive correlation between age and both calcification (r=0,4, p=0.021) and enthesophytes (r=0.479, p=0.005).We found a positive correlation between enthesophyte and the tender and swollen joints count (r= 0.352, p=0.045, r=0.378, p=0.03) and the SPARCC score (r=0.397, p=0.022).Patients with higher BASDAI had thicker tendons (r=0.355, p=0.05).Patients with nail dystrophy had more bursitis and erosions.US scores did not correlate with sexe, disease duration and disease activity measures (ASDAS, DAPSA, DAS28 and PASI). Patients with subclinical entheseal involvement didn’t have higher inflammatory biomarkers (ESR, CRP).Conclusion:US subclinical enthesopthy are not rare in psoriatic arthritis, in particular in patients with active disease.Clinical nail involvement was associated with bursitis and erosions. New studies including larger study groups are required to verify the findings of the present studyDisclosure of Interests:None declared

scholarly journals Does age matter in Psoriatic arthritis? A narrative review

2021 ◽  
pp. jrheum.210349
Author(s):  
George E. Fragoulis ◽  
Elena Nikiphorou ◽  
Iain B. McInnes ◽  
Stefan Siebert
Keyword(s):  
Psoriatic Arthritis ◽  
Late Onset ◽  
Convincing Evidence ◽  
Clinical Genetic ◽  
Psoriatic Disease ◽  
Cardiovascular Comorbidities ◽  
Complex Interactions ◽  
Increasing Risk ◽  
Effect Of Age ◽  
Research Domain

Psoriatic arthritis (PsA) affects about 0.8% of the general population. Together with psoriasis is termed psoriatic disease. Comorbidities play an important role in the clinical expression and treatment of psoriatic disease. Ageing adds another level of complexity, partly because age directly accrues increasing risk of comorbidities, but also due to its complex interactions with several factors such as depression and social determinants. Ageing seems to have a "paradoxical association" with cardiovascular comorbidities for which the relative risk is more pronounced in younger patients with psoriatic disease and also to affect treatment decisions and response in patients with psoriatic disease. Finally, there is convincing evidence that there are clinical, genetic and histopathological differences between young- and late- onset PsA and psoriasis. Herein, we review the effect of age in patients with psoriatic disease, with a focus on PsA, highlighting the need to consider this feature in routine clinical practice as well as in the research domain.

scholarly journals Characteristic and Outcome of Psoriatic Arthritis Patients with Hyperuricemia

2017 ◽  
Vol 45 (2) ◽  
pp. 213-217 ◽  
Author(s):  
Roa’A AlJohani ◽  
Ari Polachek ◽  
Justine Yang Ye ◽  
Vinod Chandran ◽  
Dafna D. Gladman
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Duration ◽  
Metabolic Diseases ◽  
Kidney Diseases ◽  
Conditional Logistic Regression ◽  
Severity Index ◽  
Disease Characteristics ◽  
Evaluation Visit ◽  
Infarction Heart ◽  
Preventive Role

Objective.To determine the characteristics of patients with psoriatic arthritis (PsA) who have hyperuricemia (HUC) and their outcomes, especially cardiovascular (CVD) and kidney diseases.Methods.Patients have been followed prospectively at the PsA clinic according to a standard protocol at 6- to 12-month intervals. We defined HUC in men > 450 µmol/l or women > 360 µmol/l. We matched patients with HUC based on sex and age ± 5 years with normal uric acid patients. Demographics information and disease characteristics were reviewed. Outcomes of patients with HUC, especially CVD and kidney diseases, were recorded. Conditional logistic regression was performed to determine factors independently associated with HUC in patients with PsA.Results.There were 325 (31.9%) out of 1019 patients with PsA who had HUC. Of these, 318 cases were matched to 318 controls. There were 11 (3.4%) out of 325 patients with HUC who had gout. Patients with HUC had longer disease duration and a higher Psoriasis Area and Severity Index. They had more concurrent comorbidities, including CVD and metabolic diseases, as well as higher prevalence of kidney stones and higher creatinine. Only 1 patient with HUC was treated with allopurinol at first evaluation visit and 7 patients during followup. Over the followup, 163 of the 318 patients had persistent HUC (pHUC) for more than 2 visits. Patients with pHUC developed more myocardial infarction, heart failure, and renal impairment. Multivariate analysis showed an association between pHUC, PsA disease duration, and obesity.Conclusion.HUC is common in patients with PsA, especially in those with longer disease duration and obesity. Proper control of HUC and metabolic diseases may play a preventive role in improving PsA outcomes.

A-70 Differences in Cognition and Disease Characteristics in Adult Vs. Late Onset Multiple Sclerosis

2021 ◽  
Vol 36 (6) ◽  
pp. 1112-1112
Author(s):  
Rachel M Butler Pagnotti ◽  
Le Hanh Hua ◽  
Justin B Miller
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Disease Duration ◽  
Late Onset ◽  
Digit Span ◽  
Cardiac Risk ◽  
Adult Intelligence Scale ◽  
Disease Characteristics ◽  
Neuropsychological Evaluations ◽  
Age Range

Abstract Objective Cognitive impairment is a common sequelae of multiple sclerosis(MS), however, relatively little is known about cognitive impairment in late-onset MS (LOMS; symptom onset &gt;50 years old). The present study investigated differences in disease characteristics and cognition in LOMS and adult-onset MS (AOMS). Methods Archival medical records and neuropsychological evaluations from an MS specialty center were reviewed. Differences in disease characteristics between 57 LOMS and 124 AOMS patients were compared using chi-square or ANOVA. To investigate differences in cognitive functioning, age-adjusted standardized scores were compared via ANCOVA, using cardiac risk factors and disease duration as covariates. Results Compared to AOMS (age range: 21–88; mean age: 49.66 +/−12.83), LOMS patients (age range 42–82; mean age: 61.88 +/− 8.57) had significantly more cardiac comorbidities (mean: 1.12+/−1.1 vs. 0.6+/−0.9; p &lt; 0.01), shorter disease duration (mean years: 13.14+/−7.9 vs. 21.0+/−12.6; p &lt; 0.001), and shorter time to diagnosis (mean years: 3.0+/−4.2 vs 6.5+/−8.5; p &lt; 0.01). LOMS patients had similar Expanded Disability Status Scale scores and number of prescribed disease-modifying therapy as AOMS. LOMS patients demonstrated greater impairment on Brief Visuospatial Memory Test-Revised learning (F(1,169) = 8.03, p &lt; 0.05; d = 0.36) and delayed recall (F(1,169) = 4.44, p &lt; 0.05; d = 0.27), and on Wechsler Adult Intelligence Scale-4th edition Digit Span Backward (F(1,176) = 5.68, p &lt; 0.05; d = 0.41) and Sequencing (F(1, 176) = 11.90, p &lt; 0.001; d = 0.55) subtests. Conclusion Despite a shorter disease duration and quicker diagnosis, LOMS patients demonstrate similar levels of physical impairment. Moreover, even after accounting for differences in disease duration and cardiac risk, LOMS showed a greater burden of cognitive impairment than AOMS, which taken together, suggests an elevated rate of disease progression in LOMS.

Cognition and disease characteristics in adult onset versus late onset multiple sclerosis

2021 ◽  
pp. 135245852110391
Author(s):  
Rachel Butler Pagnotti ◽  
Le H Hua ◽  
Justin B Miller
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Disease Duration ◽  
Late Onset ◽  
Visual Learning ◽  
Cardiac Risk ◽  
Adult Onset ◽  
Cardiac Risk Factors ◽  
Disease Characteristics

Background: Cognitive impairment is common sequelae of multiple sclerosis (MS); however, relatively little is known about cognitive impairment in late-onset multiple sclerosis (LOMS). Objective: To investigate differences in disease characteristics and cognition in LOMS and adult-onset multiple sclerosis (AOMS) patients. Methods: Archival medical records and neuropsychological evaluations from an MS specialty center were reviewed. Differences in disease characteristics between 53 LOMS and 124 AOMS were compared using chi-square or analysis of variance (ANOVA). To investigate differences in cognitive functioning, age-adjusted standardized scores were compared via analysis of covariance (ANCOVA), using cardiac risk factors and disease duration as covariates. Results: Compared to AOMS, LOMS patients had significantly more cardiac risk factors, shorter disease duration, and shorter time to diagnosis. LOMS patients had similar Expanded Disability Status Scale scores as AOMS patients. LOMS patients demonstrated significantly more impairment on tasks of visual learning and memory, and working memory than AOMS patients. Conclusion: Despite a shorter disease duration, LOMS and AOMS patients had similar levels of physical impairment. However, even after accounting for differences in disease duration and cardiac risk, LOMS patients showed a greater burden of cognitive impairment than AOMS patients, suggesting MS diagnosed later in life may progress faster due to the interaction between MS neuropathology and aging.

scholarly journals Nail disease in psoriatic arthritis. Data from the Russian Psoriatic Arthritis Registry

2021 ◽  
Vol 59 (5) ◽  
pp. 563-570
Author(s):  
E. E. Gubar ◽  
Y. L. Korsakova ◽  
E. Yu. Loginova ◽  
T. V. Korotaeva ◽  
E. A. Vasilenko ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Disease Duration ◽  
Response To Therapy ◽  
Peripheral Arthritis ◽  
Nail Psoriasis ◽  
Group 2 ◽  
Nail Involvement ◽  
Group 1

Objective of the study – to compare, in real clinical practice, according to the data of the Russian Psoriatic Arthritis Registry, characteristics of two groups of psoriatic arthritis (PsA) patients: with and without nail psoriasis.Material and methods. 588 PsA patients (277 males and 311 females) with PsA according to CASPAR criteria were included in the Russian Psoriatic Arthritis Registry. Patients’ age was 48.6±0.5 years, disease duration – 7.0±0.3 years. Patients underwent standard clinical examination of PsA activity. Disease activity measures evaluated in this study included DAPSA (Disease Activity in Psoriatic Arthritis), BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and ASDAS-СRP (Ankylosing Spondylitis Disease Activity Score). Enthesitis was measured using LEI (Leeds Enthesitis Index) index. Dactylitis was detected, the number of digits with acute dactylitis was defined. Skin lesion severity was evaluated in terms of BSA (Body Surface Area) affected, and PASI (Psoriasis Area Severity Index); PASI was calculated in case BSA > 3%. The criteria of minimal disease activity (MDA) had been used to assess the treatment efficiency. MDA was achieved if a patient met ≥5 of the 7 following categories: tender joint count (TJC) ≤1, swollen joint count (SJC) ≤1, PASI≤1 or BSA≤3%, patient pain VAS ≤15, patient global activity (PGA) VAS ≤20, Health Assessment Questionnaire Disability Index (HAQ) ≤0.5, and tender entheseal points ≤1. Patients were split into two groups: those with nail psoriasis (group 1), and those without nail psoriasis (group 2).Results. 312 (53.1%) patients had nail psoriasis and 276 (46.9%) did not. Patients’ age in group 1 was 45.7±11.9 years, in group 2 – 48.8±13.2 years (р>0.05). PsA duration in groups 1 and 2 did not differ, it was 7.1±6.6 and 7.0±6.2 years respectively (р>0.05). Higher proportions of patients with nail psoriasis were male, disabled from working and chronic smokers compared to patients without nail psoriasis: 51.9% vs 44.1% (р=0.013), 37.20% vs 26.40% (р<0.01) and 18.9% vs 8.7% (р<0.01) respectively. Patients with nail psoriasis had more severe erosive peripheral arthritis compared to patients without nail psoriasis. Median TJC was 8 [4–15] vs 5 [2–12] (р=0.002), SJC – 5 [1–9] vs 2 [0–7] (р=0.003), and erosive radiographic arthritis of feet was found in 45.0% vs 31.2% of patients (р=0.003) respectively. Group 1 patients had higher disease activity measured by DAPSA – 25 [15–39] vs 20 [12–33] (p=0.001) and ASDAS-CRP – 3.1 [2.2–4.0] vs 2.8 [1.8–3.5] (р=0.004), compared to group 2 patients. Patients with nail psoriasis had higher frequency of heel enthesitis and dactylitis; axial disease was diagnosed more often among them, compared to patients without nail psoriasis. Heel enthesitis was detected in 53 (17.0%) vs 28 (10.1%; р=0.016), dactylitis – in 76 (24.4%) vs 46 (16.7%; р=0.022), spondylitis – in 109 (35.0%) vs 73 (26.4%; р=0.025) patients respectively. Patients in group 1 had worse skin psoriasis than in group 2. Patients with nail psoriasis significantly more often had moderate and severe skin psoriasis according to BSA, compared to patients without nail psoriasis (39.9% vs 26.1% and 14.8 vs 1.1% respectively; р<0.01 for both comparisons); group 2 patients significantly more often had limited skin psoriasis compared to group 1 patients – in 72.8% vs 45.3% of cases respectively (р<0.01). Median PASI index in groups 1 and 2 was 6 [2–14] vs 3 [1–6] respectively (р<0.01). Group 1 patients gave worse assessment of their disease than group 2 patients; median PGA was 50 [40–70] mm vs 50 [30–65] mm VAS respectively (р=0.044). Less patients with nail psoriasis compared to patients without nail psoriasis had achieved MDA throughout the whole study. At the first visit MDA was detected in 3% vs 9% (р=0.006) of patients, at the second – in 12% vs 27% (р<0.001), at the third – in 14% vs 28% (р=0.011), at the fourth – in 17% vs 38% (р<0.001) and at the fifth in 27% vs 52% (р=0.004) of patients respectively. Patients with and without nail psoriasis were given equivalent therapy with diseasemodifying antirheumatic drugs (DMARDs) and biological agents (bDMARDs). DMARDs were given to 78.2% and 80.1% of patients respectively (р>0.05), it was mostly methotrexate (MTX); MTX was used in 66.0% and 64.1% of cases respectively (р>0.05). bDMARDs were prescribed to 22.1% and 28.3% (р>0.05) of patients, including tumour necrosis factor (TNF) inhibitors – in 67% and 63% of cases, interleukin (IL) inhibitors – in 33% and 37% of cases (р>0.05 for both comparisons). Taking into account the similar disease duration and equivalent therapy in both groups, it could be concluded that patients with nail psoriasis achieved MDA less frequently due to greater disease severity.Conclusion. Nail involvement is identified in more than half (53%) of PsA patients of the Russian Psoriatic Arthritis Registry. Nail psoriasis is associated with significantly worse disease status as measured by severe peripheral arthritis, enthesitis, dactylitis, spondylitis and skin lesions; higher frequency of erosive arthritis was detected in this category of patients. Patients with nail psoriasis had achieved MDA less frequently compared to patients without nail psoriasis. Nail involvement is associated with worse response to therapy and patients’ disability. These data emphasize the importance of accurate diagnostics of nail psoriasis and optimization of treatment approach, including “targeted” therapy.

Axial disease

2018 ◽  
Author(s):  
Ennio Lubrano
Keyword(s):  
Psoriatic Arthritis ◽  
State Of The Art ◽  
Imaging Techniques ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Radiological Findings ◽  
Psoriatic Disease ◽  
Axial Disease ◽  
The Difference ◽  
Axial Involvement

This chapter summarizes the state of the art for axial involvement in psoriatic arthritis (axial PsA). The definition and measurement of axial PsA still remain problematic and this, in turn, could affect the best approach of recognition and treatment of this intriguing subset of the psoriatic disease. Axial PsA has been studied over the last few years looking at the difference in function and radiological findings compared mainly to Ankylosing Spondylitis (AS), trying to differentiate it from a coincidental AS with psoriasis. Moreover, an assessment on a possible Diffuse Idiopathic Skeletal Hyperostosis (DISH) in PsA patients and clinical-radiological differences to axial PsA has been evaluated. The role of potential new imaging techniques, such as MRI, in the assessment of axial PsA has been considered in this chapter. The diagnosis and treatment of axial PsA has been reported by using the data obtained from the literature.

Impact of Having Family History of Psoriasis or Psoriatic Arthritis on Psoriatic Disease

2019 ◽  
Vol 72 (1) ◽  
pp. 63-68 ◽  
Author(s):  
Dilek Solmaz ◽  
Sibel Bakirci ◽  
Gezmis Kimyon ◽  
Esen K. Gunal ◽  
Atalay Dogru ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Family History ◽  
Psoriatic Disease ◽  
History Of

Potential Differences in Clinical Features, Disease Activity, Function and Impact of Disease Between Oligo and Polyarticular Psoriatic Arthritis

2020 ◽  
pp. 247553032097537
Author(s):  
Ennio Lubrano ◽  
Silvia Scriffignano ◽  
Mauro Fatica ◽  
Fabio Massimo Perrotta
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Clinical Features ◽  
Clinical Phenotype ◽  
Disease Characteristics ◽  
Baseline Evaluation ◽  
Axial Disease ◽  
Global Disease Activity ◽  
The Impact

Objective: The primary aim of the study was to assess the potential differences in clinical features, disease activity, function and impact of disease between Psoriatic Arthritis (PsA) patients with oligoarticular and polyarticular involvement. Methods: Consecutive PsA patients attending our unit were divided into 2 groups: 1) Oligoarticular (<5 involved joints with or without enthesitic/axial manifestations) and 2) Polyarticular (≥5 joints with or without enthesitic/axial manifestations). A full clinical examination with the assessment of disease characteristics, disease activity (DAPSA, MDA), function (HAQ-DI) and impact of disease (PsAID-12) was performed. Furthermore, a 6-month follow-up evaluation was carried out in order to assess disease differences at baseline and at follow-up. Results: Of the 102 enrolled patients, oligoarticular subset was present in 63 (61.7%), while 39 (38.3%) patients had polyarticular involvement. Patients with oligoarticular subset showed, at baseline evaluation, lower values of global disease activity assessed by physician, HAQ-DI and DAPSA compared to patients with polyarticular pattern. No differences in the impact of disease (PsAID), patient global assessment of disease activity or pain were found. At 6-month follow-up, no significant changes in each group occurred. Conclusion: Our study showed some differences in patients with oligoarticular and polyarticular involvement in terms of disease activity and HAQ-DI, while the overall impact of the disease and the presence of enthesitis, dactylitis and axial disease seem to be similar, with no substantial changes after 6-month follow-up. These results could mean that clinical phenotype might not be responsible for the impact of the disease perceived by the patient.

Sign in / Sign up

Export Citation Format

Share Document