Psoriatic arthritis. When the heterogeneity requires normality

Abstract

Psoriatic arthritis (PsA) is characteristically associated with a large spectrum of disorders, some of which are peculiars, such as enthesopathy, dactilytis, osteitis and axial involvement. Due to the heterogeneity of its expression, definition and classification of PsA have been unsatisfactory until recent years, with consequences on the reliability of epidemiological studies. Other confounding factors for diagnosis and classification of PsA are the radiological changes, sometimes found in asymptomatic patients with psoriasis, and the frequent normality of acute phase response indices, in particular erythrocyte sedimentation rate and C reactive protein. All these aspects are frequently neglected and probably account also for the unsatisfactory response of PsA to traditional drugs, such as NSAIDs, steroids and DMARDs. Furthermore, these drugs showed only a partial ability to influence radiographic progression and psoriasis. The anti-TNF agents have demonstrated to be able to influence all the multiple aspects of the PsA disease and indeed, to slow radiographic progression and to improve patients' quality of life. This seems obtained with a convenient cost-effectiveness ratio.

Serological markers in psoriatic arthritis: promising tools

“…Psoriatic arthritis (PsA) is an inflammatory joint disease with marked clinical heterogeneity that affects 0.3-1% of the population. [1][2][3] Unlike rheumatoid arthritis, PsA lacks specific biomarkers. 4 Serological markers to detect an early preclinical stage of the disease diagnosis and to monitor disease activity and treatment response would be extremely useful.…”

Progression de l’athérosclérose chez les patients ayant un rhumatisme psoriasique malgré un traitement par anti-TNF-alpha : étude prospective observationnelle de 2 ans

“…Comme le TNF-␣ semble jouer un rôle majeur dans la physiopathologie du RP [10], la thérapie anti-TNF s'est affirmée comme un traitement très efficace [14]. En effet, selon les recommandations récentes de l'European League against Rheumatism (EULAR) les anti-TNF-␣ doivent être utilisés chez les patients ayant un RP qui ne répondent pas ou qui sont intolérants aux médicaments conventionnels [15,16]. Parmi les anti-TNF approuvés actuellement pour le traitement du RP, l'étanercept, l'adalimumab et l'infliximab sont les plus largement prescrits.…”

Low back pain in young women: an unusual case.

“…Chronic low back pain (LBP) is complex, dynamic and multidimensional, sustained by experiences of persistent distressing pain, loss and low self-worth, depression, premature aging due to a bad quality of life (1,2). LBP could be a typical example of clinical features reflecting numerous morbidities including atypical manifestations of spondyloarthrophaties (3).…”