Artritis mutilante/resortiva. Estudio de 24 pacientes de una serie de 360 artritis psoriásicas

Rodriguez-Moréno, J; Bonet, Maria; Blanco-Barnusell, Jordi Del; Castaño, Carmen; Clavaguera, Teresa; Mateo-Soria, Lourdes; Roig-Vilaseca, Daniel; Ruiz-Martin, J. M.

doi:10.1016/j.reuma.2012.06.015

Cited by 4 publications

(1 citation statement)

References 14 publications

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“…It comprises both musculoskeletal as well as non-musculoskeletal manifestations; the latter particularly include the skin and the nails, but also potentially the gut (inflammatory bowel disease) or the eyes (uveitis). Active chronic PsA also associates with cardiovascular, psychological and metabolic comorbidities, [1][2][3][4][5][6][7] which, together with the musculoskeletal manifestations, impose a significant patient burden with impact on quality of life and also accelerated mortality. [8][9][10] The day-to-day management of patients with PsA includes non-pharmacological as well as pharmacological interventions.…”

Section: Introductionmentioning

confidence: 99%

EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update

et al. 2020

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ObjectiveTo update the European League Against Rheumatism (EULAR) recommendations for the pharmacological treatment of psoriatic arthritis (PsA).MethodsAccording to the EULAR standardised operating procedures, a systematic literature review was followed by a consensus meeting to develop this update involving 28 international taskforce members in May 2019. Levels of evidence and strengths of recommendations were determined.ResultsThe updated recommendations comprise 6 overarching principles and 12 recommendations. The overarching principles address the nature of PsA and diversity of both musculoskeletal and non-musculoskeletal manifestations; the need for collaborative management and shared decision-making is highlighted. The recommendations provide a treatment strategy for pharmacological therapies. Non-steroidal anti-inflammatory drugs and local glucocorticoid injections are proposed as initial therapy; for patients with arthritis and poor prognostic factors, such as polyarthritis or monoarthritis/oligoarthritis accompanied by factors such as dactylitis or joint damage, rapid initiation of conventional synthetic disease-modifying antirheumatic drugs is recommended. If the treatment target is not achieved with this strategy, a biological disease-modifying antirheumatic drugs (bDMARDs) targeting tumour necrosis factor (TNF), interleukin (IL)-17A or IL-12/23 should be initiated, taking into account skin involvement if relevant. If axial disease predominates, a TNF inhibitor or IL-17A inhibitor should be started as first-line disease-modifying antirheumatic drug. Use of Janus kinase inhibitors is addressed primarily after bDMARD failure. Phosphodiesterase-4 inhibition is proposed for patients in whom these other drugs are inappropriate, generally in the context of mild disease. Drug switches and tapering in sustained remission are addressed.ConclusionThese recommendations provide stakeholders with an updated consensus on the pharmacological management of PsA, based on a combination of evidence and expert opinion.

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Section: Introductionmentioning

confidence: 99%

EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update

et al. 2020

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Applying precision medicine to unmet clinical needs in psoriatic disease

2020

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Psoriatic disease is a heterogeneous condition that can affect peripheral and axial joints (arthritis), entheses, skin (psoriasis) and other structures. Over the past decade, considerable advances have been made both in our understanding of the pathogenesis of psoriatic disease (PsD) and in the treatment of its diverse manifestations. However, several major areas of continued unmet need in the care of patients with PsD have been identified. One of these areas is the prediction of poor outcome, notably radiographic outcome in patients with psoriatic arthritis, so that stratified medicine approaches can be taken; another is predicting response to the numerous current and emerging therapies for PsD, so that precision medicine can be applied to rapidly improve clinical outcome and reduce the risk of toxicity. In order to address these needs, novel approaches, including imaging, tissue analysis and the application of proteogenomic technologies, are proposed as methodological solutions that will assist the dissection of the critical immune-metabolic pathways in this complex disease. Learning from advances made in other inflammatory diseases, it is time to address these unmet needs in a multi-centre partnership aimed at improving short-term and long-term outcomes for patients with PsD.

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Severe Acro-osteolysis Mimicking Arthritis Mutilans in a Patient with Primary Hyperparathyroidism: A Case Report

Sapundzhieva,

Sapundzhiev,

Klinkanov

et al. 2024

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Background: Primary hyperparathyroidism (PHPT) should be considered in the differential diagnosis of a patient with suspected secondary osteoporosis, and severe osteoporosis with multiple fractures is frequently the first clinical manifestation of the disease. Case Presentation: Mutilating arthritis (arthritis mutilans) can be part of the clinical presentation of a number of rheumatic diseases, most commonly seen in psoriatic arthritis, rheumatoid arthritis, and juvenile idiopathic arthritis, but also in systemic lupus, systemic sclerosis, and multicentric reticulohistiocytosis. Evidence exists that subperiosteal and subchondral bone resorption, seen in PHPT, could induce the so-called ‘osteogenic synovitis’, which could eventually lead to the development of a secondary osteoarthritis with bone deformities. Conclusion: Here, we present a case report of a patient initially diagnosed with PHPT who presented with mutilating arthritis of the finger joints and discuss whether the severe acro-osteolysis is a manifestation of the endocrinopathy or whether there is a co-existing undiagnosed inflammatory joint disease.

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Artritis mutilante/resortiva. Estudio de 24 pacientes de una serie de 360 artritis psoriásicas

Cited by 4 publications

References 14 publications

EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update

EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update

Applying precision medicine to unmet clinical needs in psoriatic disease

Severe Acro-osteolysis Mimicking Arthritis Mutilans in a Patient with Primary Hyperparathyroidism: A Case Report

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