Psoriatic arthritis epidemiology, comorbid disease profiles and risk factors: results from a claims database analysis

Rech, Jürgen; Sticherling, Michael; Stoessel, Daniel; Biermann, Mona; Häberle, Benjamin M.; Reinhardt, Maximilian

doi:10.1093/rap/rkaa033

Cited by 13 publications

(15 citation statements)

References 36 publications

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“…Indeed, symptoms and signs of prodromal and early PsA may be subtle and fluctuating, as shown by a recent German retrospective analysis that found that unspecific arthritic symptoms (such as acute rheumatism) precede the development of PsA. 12 Similarly, a Bayesian network model found that the musculoskeletal symptoms that predict the development of PsA in psoriatic patients are non-specific arthritis, fatigue, swelling, arthralgia, myalgia and pain in the back, finger, hand and knee. 13 In addition, inflammatory markers are commonly normal or only minimally elevated in early PsA.…”

Section: Clinical Manifestationsmentioning

confidence: 98%

Reducing the Risk of Developing Psoriatic Arthritis in Patients with Psoriasis

Gisondi¹,

Bellinato²,

Maurelli³

et al. 2022

PTT

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Psoriatic arthritis (PsA) is a heterogeneous chronic inflammatory arthritis associated with psoriasis, which may manifest with different domains such as dactylitis, enthesitis, synovitis and spondylitis. The estimated prevalence of PsA in patients with psoriasis ranges widely between 6% and 42%. In most cases, PsA is preceded by skin involvement by an average time of 7–8 years. In the complex patho-mechanisms involved in the transition from psoriasis to PsA, the gut and skin have been proposed as the sites of immune activation triggering or contributing to the development of PsA. In such a transition, a subclinical phase has been identified, characterized by enthesopathy where soluble biomarkers and imaging findings but no clinical symptoms are detectable. Recent studies have provided some evidence that timely treated psoriasis may reduce the risk of developing PsA.

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Section: Clinical Manifestationsmentioning

confidence: 98%

Reducing the Risk of Developing Psoriatic Arthritis in Patients with Psoriasis

Gisondi¹,

Bellinato²,

Maurelli³

et al. 2022

PTT

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“…Patients with specific psoriasis phenotypes (scalp, inverse, and nail psoriasis) and risk factors such as obesity, family history of PsA, and severe psoriasis should receive particular attention since they have greater chances of developing PsA [ 4 ]. Additionally, as shown by a retrospective analysis of data from the Institute of Applied Health Research Berlin, patients with psoriasis who experienced acute rheumatism or pain in unspecific joints are at an increased risk of developing PsA as well [ 5 ]. Dermatologists should particularly assess complaints of joint pain, stiffness, and swelling, with particular attention to their onset, duration, and relationship to exercise.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary Rheuma–Derma Clinics: 5 Years of Experience at the San Marco Hospital in Catania

Foti¹,

Giuffrida²,

Ramondetta³

et al. 2022

Dermatol Ther (Heidelb)

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Introduction Early psoriatic arthritis (PsA) diagnosis is critical to prescribe timely treatment to prevent the irreversible joint damage and the many other problems that patients with PsA experience. This retrospective study aimed to highlight the benefits of a Rheuma–Derma Clinic focused on the early diagnosis and prompt treatment of PsA with a shared approach among Italian psoriasis patients. Diagnosing PsA early is the main goal to reduce joint damage and disability in the patients affected. Studies describing the results of rheuma–derma clinics aimed to reach this goal emerged in the last decade. This study presents limitations and advantages typical of retrospective designs. Methods A Rheuma–Derma Clinic was created in 2017 at the Rheumatology Department of the Hospital Policlinico Gaspare Rodolico of the University of Catania in San Marco, Italy. This study compared the number of patients under disease-modifying antirheumatic treatment 5 years before and after the joint clinic was created. A rheumatologist and dermatologist simultaneously assessed patients with psoriasis and/or PsA to obtain a rapid multidisciplinary diagnostic approach and a shared therapeutic strategy. In addition, demographic, clinical, and clinimetrics data were collected. Results The number of patients with PsA receiving biological disease-modifying antirheumatic drugs increased 47% (from 255 to 374 patients) before and after the joint clinic was implemented. Likewise, those receiving conventional synthetic disease-modifying antirheumatic drugs increased by 47% (from 367 to 539) as well. Additionally, for all the clinimetrics evaluated (DAS28, HAQ, BASDAI, DAPSA, PASI, PGA), there was an improvement over the 12 months under the Rheuma–Derma Clinic care. The measures that improved the most were DAPSA, PGA, PASI, and BASDAI. Conclusion The implementation of the Rheuma–Derma Clinic was associated with an increase in the number of patients diagnosed, the number of patients with PsA receiving DMARD treatments, and improvements in clinimetrics among the study participants.

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“…Psoriasis is an inflammatory cutaneous disorder with prevalence up to 3% of people in industrialized countries ( 1 ). Originally described as a skin and/or articular pathology, psoriasis appears as a disease involving other tissue damage.…”

Section: Introductionmentioning

confidence: 99%

Ex vivo cytokine production in psoriatic disease: Towards specific signatures in cutaneous psoriasis and peripheral psoriatic arthritis

et al. 2022

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ObjectivesPsoriatic arthritis (PsA) and cutaneous psoriasis (PsO) are different phenotypes of psoriatic disease (PsD), whose underlying specific mechanisms remain incompletely understood. As cytokines are key elements to induce and tune up immune responses to drive inflammatory diseases, our objective was to assess whether clinical features, disease phenotype and PsA and PsO activity were associated with a particular ex vivo cytokine production profile.MethodsForty-eight patients (37 PsA and 11 PsO) and 11 healthy subjects (HS) were studied. Cytokine production by peripheral blood mononuclear cells (PBMC) that were either unstimulated, or stimulated with LPS or anti-CD3/CD28 antibodies, were analysed by multiplex assay in the culture supernatants.ResultsCytokine signature of PsD includes a high level of TNFα in supernatants of LPS-stimulated PBMC, higher levels of IL-6 and lower levels of IFN-γ and IL-17A after CD3-CD28 stimulation, as well as higher spontaneous IL-1RA and TNFα production compared to HS. High body mass index (BMI) was associated with lower levels of IL-1β, and metabolic syndrome with lower levels of IFN-γ after LPS stimulation. In PsD, dermatological activity was related with higher IL-17A level, while rheumatic activity was linked with lower levels of IFN-γ and TNFα. Comparing each PsD subtype to HS, IL-1β and IL-6 productions are higher when using LPS stimulation in PsO patients with higher levels of IL-1β and IL-1α in peripheral PsA patients after CD3/CD28 stimulation. LPS stimulation induced high levels of IL-17A in peripheral PsA compared to axial PsA. PsA patients with axial PsA share some features with PsO but shows a distinct cytokine pattern compared to peripheral PsA.ConclusionPsO and the different PsA subtypes exhibit distinct ex vivo cytokine production profiles and common features of the so-called PsD. Analysis of IL-1 cytokine family and IL-6 seems to be of particular interest to distinguish PsO and peripheral PsA since it depends on monocytes in PsO and T-lymphocytes in peripheral PsA. Peripheral cytokine profiles are influenced by rheumatic and dermatological activity of the disease, and also by metabolic syndrome features. Our results highlight the crucial role of immune cell interactions with different patterns of interaction depending on clinical phenotype.

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Psoriatic arthritis epidemiology, comorbid disease profiles and risk factors: results from a claims database analysis

Cited by 13 publications

References 36 publications

Reducing the Risk of Developing Psoriatic Arthritis in Patients with Psoriasis

Reducing the Risk of Developing Psoriatic Arthritis in Patients with Psoriasis

Multidisciplinary Rheuma–Derma Clinics: 5 Years of Experience at the San Marco Hospital in Catania

Ex vivo cytokine production in psoriatic disease: Towards specific signatures in cutaneous psoriasis and peripheral psoriatic arthritis

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