Risk of uveitis and inflammatory bowel disease in people with psoriatic arthritis: a population-based cohort study

Charlton, Rachel; Green, Amelia; Shaddick, Gavin; Snowball, Julia; Nightingale, Alison; Tillett, William; Smith, Catherine; McHugh, Neil

doi:10.1136/annrheumdis-2017-212328

Cited by 54 publications

(63 citation statements)

References 22 publications

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“…The high rate of disorders of impaired metabolism among the CP community is consistent with previous studies demonstrating a greater likelihood of obesity, hypertension, hypertriglyceridemia, hypercholesterolemia, diabetes, and sleep apnea [ 45 – 51 ]. In addition, 20% of CP users reported an autoimmune-related comorbidity consistent with prior studies detecting an increased autoimmune disease prevalence among patients with psoriasis and PsA such as uveitis, alopecia areata, celiac disease, systemic sclerosis, and Crohn disease [ 32 , 52 , 53 ].…”

Section: Discussionsupporting

confidence: 84%

Building a Citizen Pscientist: Advancing Patient-Centered Psoriasis Research by Empowering Patients as Contributors and Analysts

Sanchez

Shankle

Wan

et al. 2018

Dermatol Ther (Heidelb)

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IntroductionTo design and implement a novel cloud-based digital platform that allows psoriatic patients and researchers to engage in the research process.MethodsCitizen Pscientist (CP) was created by the National Psoriasis Foundation (NPF) to support and educate the global psoriatic disease community, where patients and researchers have the ability to analyze data. Psoriatic patients were invited to enroll in CP and contribute health data to a cloud database by responding to a 59-question online survey. They were then invited to perform their own analyses of the data using built-in visualization tools allowing for the creation of “discovery charts.” These charts were posted on the CP website allowing for further discussion.ResultsAs of May 2017, 3534 patients have enrolled in CP and have collectively contributed over 200,000 data points on their health status. Patients posted 70 discovery charts, generating 209 discussion comments.ConclusionWith the growing influence of the internet and technology in society, medical research can be enhanced by crowdsourcing and online patient portals. Patient discovery charts focused on the topics of psoriatic disease demographics, clinical features, environmental triggers, and quality of life. Patients noted that the CP platform adds to their well-being and allows them to express what research questions matter most to them in a direct and quantifiable way. The implementation of CP is a successful and novel method of allowing patients to engage in research. Thus, CP is an important tool to promote patient-centered psoriatic disease research.

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Section: Discussionsupporting

confidence: 84%

Building a Citizen Pscientist: Advancing Patient-Centered Psoriasis Research by Empowering Patients as Contributors and Analysts

Sanchez

Shankle

Wan

et al. 2018

Dermatol Ther (Heidelb)

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“…It is actively collecting data on around 7% of the U.K. population . It is generally representative of the U.K. population and has previously been used to study both psoriasis and PsA …”

Section: Methodsmentioning

confidence: 99%

Modifiable risk factors and the development of psoriatic arthritis in people with psoriasis

et al. 2019

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Summary Background Psoriatic arthritis (PsA) is a progressive and often destructive joint disease affecting approximately 20% of people with psoriasis. Objectives To investigate associations between obesity, changes in body mass index (BMI), alcohol intake and smoking status and the development of PsA in people with psoriasis. Methods We undertook a cohort study involving incident cases of psoriasis identified from the U.K. Clinical Practice Research Datalink between 1998 and 2014. The associations between smoking, alcohol and BMI and development of PsA were assessed using generalized additive models. Additionally, the risks associated with a change in BMI during follow‐up were investigated using distributed lag nonlinear models. Results We identified 90 189 incident cases of psoriasis (42% male, mean age 51 years), of whom 1409 had a subsequent record of PsA diagnosis. BMIs of 25·0–29·9, 30·0–34·9 and ≥ 35·0 kg m−2 were significantly associated with an increased risk of developing PsA compared with BMIs < 25·0 kg m−2: adjusted odds ratios (95% confidence intervals) 1·79 (1·46–2·19), 2·10 (1·67–2·63) and 2·68 (2·09–3·43), respectively. Reducing BMI over a 10‐year period (linearly) was associated with a reduction in the risk of developing PsA compared with BMI remaining constant over the same period. Increased risks of developing PsA were associated with moderate drinking but not with former or heavy drinking or with current or past smoking status. Conclusions In this incident psoriasis cohort, increased BMI and moderate drinking, but not heavy drinking or smoking status, were associated with an increased risk of PsA in people with psoriasis. Importantly, we have shown that reducing weight may result in a reduction in the risk of developing PsA. What's already known about this topic? There is some evidence that increased body mass index is associated with an increased risk of developing psoriatic arthritis. There are conflicting results surrounding the relationship between smoking and the development of psoriatic arthritis among patients with psoriasis. What does this study add? Using a nonlinear and lagged effect of body mass index measured over time we have shown that reducing body mass index may be associated with a reduction in the risk of developing psoriatic arthritis. We have found no evidence that smoking alters the risk of developing psoriatic arthritis in patients with psoriasis.

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“…Nail pitting, onycholysis, and hyperkeratosis also affect many patients with PsA, and the presence of enthesitis can differentiate patients with PsA from those with RA [2, 6]. Additionally, inflammatory bowel disease and uveitis are characteristic extra-articular manifestations that affect a small but significant proportion of patients with PsA [1, 7].…”

Section: Introductionmentioning

confidence: 99%

Psoriatic Arthritis: What is Happening at the Joint?

Belasco¹,

Wei²

2019

Rheumatol Ther

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Psoriatic arthritis (PsA) is a heterogeneous and inflammatory disease with diverse clinical manifestations, including psoriasis, nail psoriasis, peripheral joint disease, axial joint disease, enthesitis, and dactylitis. Typically, this varied clinical presentation complicates the clinician’s ability to distinguish PsA from other forms of arthritis. In the synovium of individuals with PsA, upregulation of the genes WNT3A , BMPR2 , and TGFBR1 results in bone erosion and new bone formation, a pattern unique to the disease. Additionally, genes associated with angiogenesis and vascularization such as VEGF and TGFB1 facilitate inflammation and joint damage. Gross pathogenesis of PsA is driven by proinflammatory cytokines, and key cytokines affecting joint structures include tumor necrosis factor-α, interleukin (IL)-6, IL-17A, IL-21, IL-22, and IL-23. Early diagnosis is critical for providing treatment that prevents irreversible disease progression and function loss. This narrative review discusses differentiation of PsA from other forms of arthritis. Additionally, we detail the role of cytokines at the joint in mediating PsA pathogenesis. Funding: Novartis Pharmaceuticals Corporation.

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Risk of uveitis and inflammatory bowel disease in people with psoriatic arthritis: a population-based cohort study

Abstract: In a primary care-based incidence cohort of patients with PsA, there were substantial risks of developing uveitis and/or Crohn's disease, but not ulcerative colitis, when compared with the general population and psoriasis controls.

Cited by 54 publications

References 22 publications

Building a Citizen Pscientist: Advancing Patient-Centered Psoriasis Research by Empowering Patients as Contributors and Analysts

Building a Citizen Pscientist: Advancing Patient-Centered Psoriasis Research by Empowering Patients as Contributors and Analysts

Modifiable risk factors and the development of psoriatic arthritis in people with psoriasis

Psoriatic Arthritis: What is Happening at the Joint?

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