The preclinical phase of PsA: a challenge for the epidemiologist

Ogdie, Alexis

doi:10.1136/annrheumdis-2017-211109

Cited by 23 publications

(18 citation statements)

References 24 publications

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“…The inclusion of only patients with incident PsA was an advantage for looking at the temporal relationship; however, one challenge when studying PsA, particularly when looking at comorbidities and risk factors, is disentangling preclinical PsA from psoriasis and/or delayed diagnosis 21. It is therefore possible that some patients within the psoriasis only group may have actually had PsA and this could potentially have elevated the incidence rates in this group.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…It is well established that joint damage can occur early in the course of PsA, so early disease recognition is imperative. Given that psoriasis predates PsA by a decade or more, then skin involvement offers the opportunity to investigate risk factors and predictors of PsA development 2. The incidence of PsA in different psoriasis cohorts is between 0.3% and 3.5% per annum 2 3.…”

Section: Introductionmentioning

confidence: 99%

“…Given that psoriasis predates PsA by a decade or more, then skin involvement offers the opportunity to investigate risk factors and predictors of PsA development 2. The incidence of PsA in different psoriasis cohorts is between 0.3% and 3.5% per annum 2 3. In rheumatoid arthritis, anti citrullinated protein antibodies (ACPA)+ cases have a preclinical phase of disease characterised by clinically suspected arthralgia4 and imaging studies have shown that this phase of disease is associated with synovitis and tenosynovitis 5 6…”

Section: Introductionmentioning

confidence: 99%

Transition phase towards psoriatic arthritis: clinical and ultrasonographic characterisation of psoriatic arthralgia

et al. 2019

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ObjectiveNon-specific musculoskeletal pain is common in subjects destined to develop psoriatic arthritis (PsA). We evaluated psoriatic patients with arthralgia (PsOAr) compared with psoriasis alone (PsO) and healthy controls (HCs) using ultrasonography (US) to investigate the anatomical basis for joint symptoms in PsOAr and the link between these imaging findings and subsequent PsA transition.MethodsA cross-sectional prevalence analysis of clinical and US abnormalities (including inflammatory and structural lesions) in PsOAr (n=61), PsO (n=57) and HCs (n=57) was performed, with subsequent prospective follow-up for PsA development.ResultsTenosynovitis was the only significant sonographic feature that differed between PsOAr and PsO (29.5% vs 5.3%, p<0.001), although synovitis and enthesitis were numerically more frequent in PsOAr. Five patients in PsOAr and one in PsO group developed PsA, with an incidence rate of 109.2/1000 person-years in PsOAr vs 13.4/1000 person-years in PsO (p=0.03). Visual Analogue Scale pain, Health Assessment Questionnaire, joint tenderness and US active enthesitis were baseline variables associated with PsA development.ConclusionTenosynovitis was associated with arthralgia in subjects with psoriasis. Baseline US evidence of enthesitis was associated with clinical PsA development in the longitudinal analysis. These findings are relevant for enriching for subjects at risk of imminent PsA development.

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“…Psoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal condition associated with psoriasis vulgaris (PsV) that affects populations of people worldwide. Although the prevalence of PsA is rare in the general population (<0.5%) 1 , it occurs in ~30% of psoriasis patients 2 , and its symptoms (joint pain, swelling, and limitation of movement and deformity) typically arise after psoriasis has been diagnosed based on skin lesions 3 . PsA has been shown to cause reduced quality of life and is associated with comorbidities that increase mortality 4 , thus posing a significant social and economic burden to society.…”

Section: Introductionmentioning

confidence: 99%

Genetic signature to provide robust risk assessment of psoriatic arthritis development in psoriasis patients

et al. 2018

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Psoriatic arthritis (PsA) is a complex chronic musculoskeletal condition that occurs in ~30% of psoriasis patients. Currently, no systematic strategy is available that utilizes the differences in genetic architecture between PsA and cutaneous-only psoriasis (PsC) to assess PsA risk before symptoms appear. Here, we introduce a computational pipeline for predicting PsA among psoriasis patients using data from six cohorts with >7000 genotyped PsA and PsC patients. We identify 9 new loci for psoriasis or its subtypes and achieve 0.82 area under the receiver operator curve in distinguishing PsA vs. PsC when using 200 genetic markers. Among the top 5% of our PsA prediction we achieve >90% precision with 100% specificity and 16% recall for predicting PsA among psoriatic patients, using conditional inference forest or shrinkage discriminant analysis. Combining statistical and machine-learning techniques, we show that the underlying genetic differences between psoriasis subtypes can be used for individualized subtype risk assessment.

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The preclinical phase of PsA: a challenge for the epidemiologist

Cited by 23 publications

References 24 publications

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

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

Transition phase towards psoriatic arthritis: clinical and ultrasonographic characterisation of psoriatic arthralgia

Genetic signature to provide robust risk assessment of psoriatic arthritis development in psoriasis patients

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