Risk Factors for Progression from Subclinical to Clinical Phase of Psoriatic Arthritis: A Case–Control Study

Abstract

Introduction: The objective of this study is to identify the potential risk factors for progression from subclinical to clinical psoriatic arthritis (PsA). Methods: A retrospective, longitudinal, case-control study was conducted at a single hospital, including 25 patients with clinically confirmed PsA in the case group and 137 controls without confirmed PsA. All patients in both groups had a medical history of subclinical PsA. Various baseline covariates were collected from all patients when they had a status of subclinical PsA. Univariate, multivariate, stratified, and interaction analyses were employed to identify potential risk factors of transiting to clinical PsA from subclinical PsA. Results: In multivariate logistic regression analysis, older age (OR 10.15, 95% CI 2.79-36.91, p = 0.00), alcohol drinking (OR 3.43, 95% CI 1.17-10.12, p = 0.03), elevated high-sensitivity C-reactive protein (hs-CRP) (OR 1.05, 95% CI 1.01-1.09, p = 0.03) were identified as risk factors for transition from subclinical to clinical PsA. Stratified and logistic regression analyses suggest a significant interaction between age and fatty liver. For patients aged less than 45 years old, the association between fatty liver and clinical PsA was statistically significant. Conclusions: Older age, alcohol drinking, elevated hs-CRP, and the presence of fatty liver at less than 45 years old appear to increase the risk of transition from subclinical to clinical PsA. These findings call for a need to manage these risk factors.

The relationship between blood lipid and risk of psoriasis: univariable and multivariable Mendelian randomization analysis

“…Other observational studies also reached the same conclusion ( 16 , 32 ). In addition, in some observational studies of psoriatic arthritis (PSA), the serum TG, HDL-C, TC, and LDL-C have no significant association with psoriatic arthritis ( 33 – 35 ). The relationship between psoriasis and blood lipid is still unclear due to the evidence of publication bias and confounding factors in the environment.…”

Development of a Predictive Model for Screening Patients with Psoriasis at Increased Risk of Psoriatic Arthritis

“…In accordance with the inclusion and exclusion criteria of clinical studies in our center [ 17 ], the inclusion criteria for the non-PsA group were as follows: (i) aged 18–65 years with no gender restriction; (ii) with a clear diagnosis of psoriasis confirmed by two experienced dermatologists. Exclusion criteria were (i) current or historical diagnosis of any arthritis including psoriatic arthritis, rheumatoid arthritis, osteoarthritis, gouty arthritis, ankylosing spondylitis, and similar conditions; (ii) pregnancy; (iii) a history of trauma or heavy manual labor prior to US examination; (iv) with other comorbidities including hematological system diseases, malignant tumors, serious hepatic dysfunction, renal dysfunction, or other visceral organ dysfunction.…”

Psoriatic arthritis: Overcoming the obstacles of early diagnosis and optimal management

“…The Classification Criteria for Psoriatic Arthritis (CASPAR) require patients to fulfill the prerequisite of presenting with inflammatory arthritis manifestations 8 . Complementarily, musculoskeletal ultrasonography is considered one of the most sensitive techniques for detecting clinical/subclinical inflammation and aiding in early clinical diagnosis 9 .…”