Objective The aim of this study was to compare patients with ankylosing spondylitis with psoriasis (ASP) and without psoriasis (AS), to axial PsA (axPsA) patients. Methods Two adult cohorts were recruited from the AS clinic: ASP and AS. These two cohorts were compared with two adult cohorts recruited from the PsA clinic: axPsA (radiographic sacroiliitis: ⩾bilateral grade 2 or unilateral grade 3 or 4); and Peripheral PsA. All patients were followed prospectively according to the same protocol. The demographic, clinical and radiographic variables were compared. Adjusted means were used to account for varying intervals between visits. A logistic regression was performed and adjusted for follow-up duration. Results There were 477 axPsA patients, 826 peripheral PsA, 675 AS and 91 ASP patients included. AS patients were younger (P < 0.001), more male and HLA-B*27 positive (76%, 72% vs 64%, P ⩽ 0.001, 82%, 75%, vs 19%, P = 0.001). They had more back pain at presentation (90%, 92% vs 19%, P = 0.001), worse axial disease activity scores (bath ankylosing spondylitis disease activity index: 4.1, 3.9 vs 3.5 P = 0.017), worse back metrology (bath ankylosing spondylitis metrology index: 2.9, 2.2 vs 1.8, P < 0.001), worse physician global assessments (2.4, 2.2 vs 2.1, P < 0.001), were treated more with biologics (29%, 21% vs 7%, P = 0.001) and had a higher grade of sacroiliitis (90%, 84% vs 51%, P < 0.001). Similar differences were detected in the comparison of ASP to axPsA and in a regression model. Conclusion AS patients, with or without psoriasis, seem to be different demographically, genetically, clinically and radiographically from axPsA patients. axPsA seems to be a distinct entity.

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.

Objective.We aimed to determine the prevalence and incidence, and to identify the factors associated with liver abnormalities in patients with psoriatic arthritis (PsA).Methods.From a longitudinal cohort study, we identified PsA patients with either elevated serum transaminase or alkaline phosphatase levels or liver disease after the first visit to the PsA clinic (cases). Controls were subjects from the same cohort who never had such abnormalities or liver disease. Cases and controls were matched 1:1 by sex, age at the first clinic visit, and followup duration; variables at the onset of the first appearance of liver test abnormality associated with liver abnormalities were identified using univariate logistic and multivariate logistic regression analyses.Results.Among 1061 patients followed in the PsA clinic, 343 had liver abnormalities. Two hundred fifty-six patients who developed liver abnormalities after the first visit were identified as cases, and 718 patients were identified as controls. The prevalence of liver abnormalities was 32% and the incidence was 39/1000 patient-years where there were 256 cases over 6533 total person-years in the PsA cohort. Liver abnormalities were detected after a mean (SD) followup duration of 8.3 ± 7.8 years. The common causes of liver abnormalities were drug-induced hepatitis and fatty liver. Independent factors associated with liver abnormalities were higher body mass index (BMI), daily alcohol intake, higher damaged joint count, elevated C-reactive protein, and use of methotrexate, leflunomide, or tumor necrosis factor inhibitors.Conclusion.Liver abnormalities are common among patients with PsA and are associated with higher BMI, more severe disease, and certain therapies.

Objectives The mean age at onset of psoriatic arthritis (PsA) ranges between the 4th-6th decades of life. However, little is known about fertility and pregnancy outcome in PsA patients. The aim of this study was to examine whether fertility and pregnancy outcome of PsA patients are different from healthy controls and to evaluate PsA and psoriasis disease activity perception during pregnancy and the year postpartum. Methods A questionnaire-based study, including demographic, fertility, pregnancy outcome, and disease activity questions, was conducted in PsA patients and healthy controls. The inclusion criterion was diagnosis of PsA before at least 1 pregnancy. Descriptive statistics are provided. T tests and Pearson chi-square tests were used to analyze the differences between continuous and categorical variables, respectively. Results The 74 PsA patients and 74 healthy controls were not significantly different in most of the demographic variables. The mean number of pregnancies, children, and infertility diagnosis were not significantly different between the groups. The pregnancy outcomes in the PsA group (n = 151) and in the control group (n = 189) were similar in: live birth (76% vs. 76%, P = 0.3), vaginal delivery (48% vs. 51%, P = 0.6), gestation age (38.5 vs. 38.3, P = 0.3), weight at birth (3.4 kg vs. 3.4 kg, P = 0.5), low rate of maternal and fetal complications, and the duration and rate of breastfeeding. Most (58%) patients reported favorable joint activity during pregnancy and 50% reported worsening during the 1st postpartum year. Conclusions PsA patients do not have more infertility or worse pregnancy outcomes compared to healthy controls.