Biomarkers in psoriatic arthritis: A meta-analysis and systematic review

Abstract

IntroductionPsoriatic arthritis (PsA) is a chronic inflammatory disease that frequently develops in patients with psoriasis (PsO) but can also occur spontaneously. As a result, PsA diagnosis and treatment is commonly delayed, or even missed outright due to the manifold of clinical presentations that patients often experience. This inevitably results in progressive articular damage to axial and peripheral joints and entheses. As such, patients with PsA frequently experience reduced expectancy and quality of life due to disability. More recently, research has aimed to improve PsA diagnosis and prognosis by identifying novel disease biomarkers.MethodsHere, we conducted a systematic review of the published literature on candidate biomarkers for PsA diagnosis and prognosis in MEDLINE(Pubmed), EMBase and the Cochrane library with the goal to identify clinically applicable PsA biomarkers. Meta-analyses were performed when a diagnostic bone and cartilage turnover biomarker was reported in 2 or moredifferent cohorts of PsA and control. ResultsWe identified 1444 publications and 124 studies met eligibility criteria. We highlighted bone and cartilage turnover biomarkers, genetic markers, and autoantibodies used for diagnostic purposes of PsA, as well as acute phase reactant markers and bone and cartilage turnover biomarkers for activity or prognostic severity purposes. Serum cartilage oligometrix metalloproteinase levels were significantly increased in the PsA sera compared to Healthy Control (HC) with a standardized mean difference (SMD) of 2.305 (95%CI 0.795-3.816, p=0.003) and compared to osteoarthritis (OA) with a SMD of 0.783 (95%CI 0.015-1.551, p=0.046). The pooled serum MMP-3 levels were significantly higher in PsA patients than in PsO patients with a SMD of 0.419 (95%CI 0.119-0.719; p=0.006), but no significant difference was highlighted when PsA were compared to HC. While we did not identify any new genetic biomarkers that would be useful in the diagnosis of PsA, recent data with autoantibodies appear to be promising in diagnosis, but no replication studies have been published. ConclusionIn summary, no specific diagnostic biomarkers for PsA were identified and further studies are needed to assess the performance of potential biomarkers that can distinguish PsA from OA and other chronic inflammatory diseases.

Difficult‐to‐Treat Psoriatic Arthritis: A Conceptual Approach

“…30 Similarly, serum biomarkers such as COMP, MMP3, and the autoantibodies anti-ADAMTS-L5 and anti-LL-37 have shown potential as markers of disease activity and treatment response but still need to be validated for use in clinical practice. [31][32][33] Biopsy-driven management has shown promising results to guide the choice of therapy based on disease endotypes in RA and might be applicable to PsA as well including skin and entheseal samples. 34 Lastly, artificial intelligence-based methods have shown promising results by Table 1.…”

“…For instance, stratifying patients based on the proportion of activated T helper (Th)1 and Th17 cells has proven useful to inform the choice of therapy between TNFi and IL17i 30 . Similarly, serum biomarkers such as COMP, MMP3, and the autoantibodies anti–ADAMTS‐L5 and anti–LL‐37 have shown potential as markers of disease activity and treatment response but still need to be validated for use in clinical practice 31‐33 . Biopsy‐driven management has shown promising results to guide the choice of therapy based on disease endotypes in RA and might be applicable to PsA as well including skin and entheseal samples 34 .…”

Higher Synovial Immunohistochemistry Reactivity of IL-17A, Dkk1, and TGF-β1 in Patients with Early Psoriatic Arthritis and Rheumatoid Arthritis Could Predict the Use of Biologics

“…Early treatment strategy is gradually improving the prognosis of patients with newly diagnosed RA or PsA, and the search for new prognostic biomarkers is becoming increasingly necessary [23][24][25][26][27]. Having a diagnostic tool to predict the evolution of these patients could be very useful [28].…”

Therapeutic potential of Coptis chinensis for arthritis with underlying mechanisms

“…Studies have shown that CC can treat a variety of arthritis, and it is better for OA, RA and GA. CC has the characteristics of multiple components, multiple targets, and multiple pathways in the treatment of arthritis. Currently, IL-10, IL-1β, IL-6, MMP-3, TNF-α and other targets have been verified to play a role in treating arthritis by CC ( Table 2 ) ( Sun et al, 2011 ; Yuan et al, 2014 ; Kienhorst et al, 2015 ; Huang et al, 2019 ; Thomas, 2020 ; Che et al, 2021 ; Li et al, 2021 ; Wu et al, 2021 ; Arra et al, 2022 ; Zhang et al, 2022 ; Cao et al, 2022 ; Du et al, 2022 ; Pacifici, 2022 ; Wirth et al, 2022 ; Xiao et al, 2022 ; Yang et al, 2022 ; Sun et al, 2023a ; Barbarroja et al, 2023 ; Li et al, 2023 ; Brix et al, 2023 ; Wang et al, 2023b ; Wang et al, 2023 ; Ghosh et al, 2023 ; González-Chávez et al, 2023 ; Hecquet et al, 2023 ; Jahantigh et al, 2023 ; Ji et al, 2023 ; La Bella et al, 2023 ; Leung et al, 2023 ; Lin et al, 2023 ; Luo et al, 2023 ; Zeng et al, 2023 ; Zhang et al, 2023 ). However, the types of arthritis treated with these targets are not completely clear.…”