Axial psoriatic arthritis: an intriguing clinical entity or a subset of an intriguing disease?

Lubrano, Ennio; Spadaro, Antonio

doi:10.1007/s10067-012-1990-8

Cited by 22 publications

(16 citation statements)

References 33 publications

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“…It is possible that MTX improves joint symptoms in the subset of patients with PsA without axial disease, but not in those with axial involvement. Patients with axial manifestations may account for 25% to 75% of patients with PsA, depending on disease duration and the accuracy of diagnosis 11 . However, the prevalence of axial disease is not reported in many retrospective PsA studies, and thus its potential effect on the reported response of PsA to MTX treatment has not been investigated.…”

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confidence: 99%

Does Concomitant Methotrexate with Adalimumab Influence Treatment Outcomes in Patients with Psoriatic Arthritis? Data from a Large Observational Study

Behrens

Koehm²,

Arndt³

et al. 2015

J Rheumatol

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Objective.To examine the influence of concomitant methotrexate (MTX) with adalimumab (ADA) on outcomes in patients with psoriatic arthritis (PsA) using data from an observational study of ADA.Methods.Data from a German noninterventional study of patients with PsA starting treatment with ADA were analyzed retrospectively for effects of concomitant MTX on key outcomes, including Disease Activity Score-28 joints, tender and swollen joint counts, skin assessments, and safety. Patients were categorized into those with symptoms of axial involvement and those with no symptoms of axial involvement as judged by the examining clinician.Results.A total of 1455 patients met the study criteria, 296 with axial involvement (ADA monotherapy = 165; plus MTX = 131) and 1159 with no axial involvement (ADA monotherapy = 658; plus MTX = 501). ADA, alone or combined with MTX, resulted in strong and comparable reductions in disease activity measures in patients with and those without axial disease over 24 months of therapy. In multiple regression analyses, concomitant MTX did not affect joint or skin outcomes in either the group with axial manifestations or the group without axial disease. Neither adverse event rates nor withdrawal rates were significantly influenced by concomitant MTX.Conclusion.ADA is an effective treatment option for patients with PsA with or without axial involvement. Compared with ADA monotherapy, the use of concomitant MTX with ADA does not improve articular or skin outcomes in patients with PsA regardless of axial symptoms. Trial registration: Clinicaltrials.govNCT01111240

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confidence: 99%

Does Concomitant Methotrexate with Adalimumab Influence Treatment Outcomes in Patients with Psoriatic Arthritis? Data from a Large Observational Study

Behrens

Koehm²,

Arndt³

et al. 2015

J Rheumatol

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“…Axial PsA represents an unmet need in the outcome measures for PsA, since its definition and measurement still remain problematic (28)(29)(30)(31). Axial PsA has been defined in many ways, varying from an isolated unilateral grade 2 sacroiliitis to those criteria used for Ankylosing Spondylitis (AS) (32)(33).…”

Section: Definition Of Axial Psamentioning

confidence: 99%

Measuring psoriatic disease in clinical practice. An expert opinion position paper

Lubrano

Cantini

Costanzo

et al. 2015

Autoimmunity Reviews

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“…Osteopaenia of affected joints is not normally prominent (Jensen & Steinbach, ). Axial disease frequently involves the apophyseal joints, and this may occasionally be the only spinal alteration (McEwan et al, ; Lubrano & Spadero, ). Frequency of apophyseal joint involvement may be underestimated as it is difficult to visualise on conventional spinal radiographs and does not feature in clinical diagnostic algorithms (Lubrano & Spadero, ).…”

Section: Diagnosismentioning

confidence: 99%

An Unusual Erosive Arthropathy from Medieval England

Mays

Watt

Loe

2016

Intl J of Osteoarchaeology

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In palaeopathology, diagnosis of skeletal disease is classically made with reference to changes wrought by known diseases in modern or recent cases. This report presents a skeleton from medieval England which shows a form of erosive arthropathy. A more precise diagnosis is problematic because the alterations appear inconsistent with any of the principle forms of erosive arthropathy in current clinical classification. The distribution of lesions in the axial and appendicular skeleton resembles that in seronegative spondyloarthropathies. The nature of the lesions however, which are almost entirely lytic and concentrated principally at synovial articulations rather than entheses, is inconsistent with seronegative spondyloarthropathies and is more consistent with pathophysiology of rheumatoid arthritis. These observations raise the possibility that the manifestations of erosive arthropathies may have altered over time and/or that our clinical understanding of the skeletal distribution of lesions in these diseases may be incomplete. These scenarios would have profound implications for our ability to identify the various forms of erosive arthritis in archaeological populations, but further work investigating erosive arthritis in patients, together with systematic studies of skeletal cases, would be required before firm conclusions can be made.

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Axial psoriatic arthritis: an intriguing clinical entity or a subset of an intriguing disease?

Cited by 22 publications

References 33 publications

Does Concomitant Methotrexate with Adalimumab Influence Treatment Outcomes in Patients with Psoriatic Arthritis? Data from a Large Observational Study

Does Concomitant Methotrexate with Adalimumab Influence Treatment Outcomes in Patients with Psoriatic Arthritis? Data from a Large Observational Study

Measuring psoriatic disease in clinical practice. An expert opinion position paper

An Unusual Erosive Arthropathy from Medieval England

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