Extra-articular manifestations in psoriatic arthritis patients

Abstract

Psoriatic arthritis (PsA) is an inflammatory rheumatic disorder, associated with skin and/or nail psoriasis. It has been included in the spondyloarthropathies (SpA) group, with which it shares clinical, radiologic, and serologic features and familial and genetic relationship. Inclusion of disease among SpA is also based on their striking points of similarity for extra-articular manifestations (EAMs). The aim of study was to describe the EAMs in patients with PsA, evaluating the prevalence and clinical features associated with established and early PsA. The study was a retrospective analysis of case records of 387 PsA patients. Data recorded were demographic data, disease properties, laboratory tests, drug use, and presence of EAMs. Of 387 PsA patients, 190 have shown EAMs: 33.16 % had bowel involvement, 32.63 % ocular, 28.42 % cardiovascular, 25.79 % urogenital, 8.42 % skin (excluding psoriasis), 1.05 % pulmonary, and 0.53 % renal. A higher prevalence of EAMs was found in axial subset (p < 0.0001) and in established PsA patients (p = 0.03). The disease activity in PsA patients with EAMs was significantly higher (p < 0.0005). Smoker PsA patients had a significantly higher prevalence of EAMs than nonsmoker PsA patients (p < 0.0005). EAMs in PsA patients are common than expected and frequently associated with established form and axial subset. EAMs were more frequent in male gender, and the contemporary presence of male gender and axial subset showed a higher risk to develop EAMs. EAMS were more frequent in patients with a long disease duration and active disease. Moreover, these results suggest that in PsA patients, an initial checkup and a regular screening for EAMs are requested to ensure an appropriate management.

Extra-Articular Symptoms in Constellation with Selected Serum Cytokines and Disease Activity in Spondyloarthritis

“…Peluso et al [7] presented that 89.2% of PsA patients had psoriasis, and that PsA patients with skin psoriasis had longer disease duration and more frequent axial disease. In our study the percentage of PsA patients with psoriasis was the same, but data concerning disease activity and disease duration were reversible.…”

“…Peluso et al have presented psoriatic onychopathy in 89.2% PsA patients [7]. In SpA patients 66.4% had psoriatic onychopathy.…”

An overview of psoriatic arthritis – epidemiology, clinical features, pathophysiology and novel treatment targets

“…in 2015 could demonstrate an EAM prevalence of 49 % in a retrospective analysis of 387 PsA patients. Most were male patients with axial disease and a significantly longer disease duration than PsA patients without EAM [10]. The most common EAM affect the eyes, the gastrointestinal tract, the heart and arteries and the urogenital system and are summarized in Table 1.…”

Pharmacological treatment of spondyloarthritis: exploring the effectiveness of nonsteroidal anti-inflammatory drugs, traditional disease-modifying antirheumatic drugs and biological therapies

“…TNF-α inhibitors might decrease the cardiovascular manifestations and atherosclerotic cardiovascular risk in SpA patients [Di Minno et al 2011, 2015. Moreover, regardless of the type of diet, a successful weight loss (⩾5% from baseline values) is associated with a higher rate of achievement of MDA in overweight/obese SpA patients who start treatment with TNF-α inhibitors [Di Minno et al 2014].…”