Related ArticlesTowards international guidelines for the management of psoriatic arthritis.
J Rheumatol. 2006 Jul;33(7):1228-30
Authors: Gladman DD, Mease PJ
PMID: 16821263 [PubMed - in process]
]]>
Related ArticlesPredominant cervical involvement in patients with psoriatic arthritis: report of two cases.
Joint Bone Spine. 2006 Jul 21;
Authors: Ouédraogo DD, Palazzo E, Nlomé-Nzé M, Somogyi N, Ballard M, Hayem G, Meyer O
Cervical spine involvement is common but usually delayed in patients with psoriatic arthritis. We report two cases with early and predominant involvement of the upper cervical spine. Synovitis of the atlanto-odontoid joint and fusion of multiple facet joints were noted in one patient. In the other patient, the main finding was atlanto-axial subluxation with erosions of the odontoid process and anterior arch of C1. No abnormalities were noted in the peripheral joints, sacroiliac joints, or thoracolumbar spine. Analgesics and conventional antiinflammatory agents were only minimally effective. TNFalpha antagonist therapy (infliximab followed by etanercept) in one patient and phenylbutazone therapy in the other improved the symptoms and led to shrinkage of the pannus.
PMID: 16987680 [PubMed - as supplied by publisher]
]]>
Related ArticlesClassification criteria for psoriatic arthritis: Development of new criteria from a large international study.
Arthritis Rheum. 2006 Jul 26;54(8):2665-2673
Authors: Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H
OBJECTIVE: To compare the accuracy of existing classification criteria for the diagnosis of psoriatic arthritis (PsA) and to construct new criteria from observed data. METHODS: Data were collected prospectively from consecutive clinic attendees with PsA and other inflammatory arthropathies. Subjects were classified by each of 7 criteria. Sensitivity and specificity were compared using conditional logistic regression analysis. Latent class analysis was used to calculate criteria accuracy in order to confirm the validity of clinical diagnosis as the gold standard definition of “case”-ness. Classification and Regression Trees methodology and logistic regression were used to identify items for new criteria, which were then constructed using a receiver operating characteristic curve. RESULTS: Data were collected on 588 cases and 536 controls with rheumatoid arthritis (n = 384), ankylosing spondylitis (n = 72), undifferentiated arthritis (n = 38), connective tissue disorders (n = 14), and other diseases (n = 28). The specificity of each set of criteria was high. The sensitivity of the Vasey and Espinoza method (0.97) was similar to that of the method of McGonagle et al (0.98) and greater than that of the methods of Bennett (0.44), Moll and Wright (0.91), the European Spondylarthropathy Study Group (0.74), and Gladman et al (0.91). The CASPAR (ClASsification criteria for Psoriatic ARthritis) criteria consisted of established inflammatory articular disease with at least 3 points from the following features: current psoriasis (assigned a score of 2; all other features were assigned a score of 1), a history of psoriasis (unless current psoriasis was present), a family history of psoriasis (unless current psoriasis was present or there was a history of psoriasis), dactylitis, juxtaarticular new bone formation, rheumatoid factor negativity, and nail dystrophy. These criteria were more specific (0.987 versus 0.960) but less sensitive (0.914 versus 0.972) than those of Vasey and Espinoza. CONCLUSION: The CASPAR criteria are simple and highly specific but less sensitive than the Vasey and Espinoza criteria.
PMID: 16871531 [PubMed - as supplied by publisher]
]]>
Related ArticlesSafety issues with biological therapies for inflammatory bowel disease.
Curr Opin Gastroenterol. 2006 Jul;22(4):370-6
Authors: Van Assche G, Vermeire S, Rutgeerts P
PURPOSE OF REVIEW: The purpose of this review is to summarize recent evidence describing specific complications associated with the use of biological therapy derived from controlled trials and from post-marketing surveillance. RECENT FINDINGS: Biological therapies, particularly anti-tumour necrosis factor antibodies, are increasingly used in patients with Crohn’s disease and ulcerative colitis. Some adverse events, such as serious infections, are a consequence of the immunomodulatory effect of biological agents, while other complications, such as the induction of autoimmune phenomena, neurotoxicity and the development of an immune response to engineered proteins, are class or molecule-specific. Although the immunopathogenesis of these side effects is often a matter of debate, they have been observed not only in inflammatory bowel disease, but also in other immune disorders such as rheumatoid arthritis and psoriasis. SUMMARY: The benefits of biological agents clearly outweigh the risks. Nevertheless, they are associated with specific toxicity, and this requires the attention of the clinician.
PMID: 16760752 [PubMed - indexed for MEDLINE]
]]>
Increased expression of CD154 (CD40L) on stimulated T-cells from patients with psoriatic arthritis.
Rheumatology (Oxford). 2006 Jul 22;
Authors: Daoussis D, Antonopoulos I, Andonopoulos AP, Liossis SN
Objectives. CD40L is a costimulatory molecule and an early activation marker of T-lymphocytes. Based on the hypothesis that activated T-cells may play a role in the pathogenesis of psoriatic arthritis (PsA), we evaluated the level of CD40L expression on T-cells from patients with PsA. Methods. We analysed 12 patients with PsA, six patients with rheumatoid arthritis (RA) and four healthy volunteers. T-cell surface expression of CD40L was evaluated using two-colour flow cytometry in (i) the resting state and (ii) following stimulation with phorbol myristate acetate/ionomycin, with or without ciclosporin (CsA)-mediated inhibition. Results. Expression of CD40L was significantly increased on activated T-cells from patients with PsA, particularly those with active disease, when compared with normal individuals and patients with RA (mean percentages of CD3(+) CD40L(+) cells: 23.74, 11.59 and 9.57% for patients with active PsA, patients with RA and healthy volunteers, respectively). CsA-mediated inhibition of CD40L induction was equally effective in all study groups. Conclusion. CD40L is overexpressed on T-cells from patients with active PsA. This may indicate a role for CD40L in PsA pathogenesis. Larger-scale studies are warranted to address these issues.
PMID: 16861707 [PubMed - as supplied by publisher]
]]>
Related ArticlesIncreased expression of CD154 (CD40L) on stimulated T-cells from patients with psoriatic arthritis.
Rheumatology (Oxford). 2006 Jul 22;
Authors: Daoussis D, Antonopoulos I, Andonopoulos AP, Liossis SN
Objectives. CD40L is a costimulatory molecule and an early activation marker of T-lymphocytes. Based on the hypothesis that activated T-cells may play a role in the pathogenesis of psoriatic arthritis (PsA), we evaluated the level of CD40L expression on T-cells from patients with PsA. Methods. We analysed 12 patients with PsA, six patients with rheumatoid arthritis (RA) and four healthy volunteers. T-cell surface expression of CD40L was evaluated using two-colour flow cytometry in (i) the resting state and (ii) following stimulation with phorbol myristate acetate/ionomycin, with or without ciclosporin (CsA)-mediated inhibition. Results. Expression of CD40L was significantly increased on activated T-cells from patients with PsA, particularly those with active disease, when compared with normal individuals and patients with RA (mean percentages of CD3(+) CD40L(+) cells: 23.74, 11.59 and 9.57% for patients with active PsA, patients with RA and healthy volunteers, respectively). CsA-mediated inhibition of CD40L induction was equally effective in all study groups. Conclusion. CD40L is overexpressed on T-cells from patients with active PsA. This may indicate a role for CD40L in PsA pathogenesis. Larger-scale studies are warranted to address these issues.
PMID: 16861707 [PubMed - as supplied by publisher]
]]>
Related ArticlesThe antiquity of psoriatic arthritis.
Clin Exp Rheumatol. 2006 Jul-Aug;24(4):351-3
Authors: Pasero G, Marson P
PMID: 16956422 [PubMed - in process]
]]>
Related ArticlesDemyelinating disease in a patient with psoriatic arthritis and family history of multiple sclerosis treated with infliximab.
J Rheumatol. 2006 Jul;33(7):1457-8
Authors: Ruiz-Jimeno T, Carvajal A, Mata C, Aurrecoechea E
PMID: 16862660 [PubMed - in process]
]]>
Polyarticular psoriatic arthritis is more like oligoarticular psoriatic arthritis, than rheumatoid arthritis.
Ann Rheum Dis. 2006 Jul 13;
Authors: Helliwell PS, Porter G, Taylor WJ
BACKGROUND: Since the original description of psoriatic arthritis sub-groups by Moll and Wright there has been some discrepancy in the precise frequency of the different sub-groups and in particular the proportion of cases with polyarthritis. The higher frequency of the polyarthritis sub-group may be due to the inclusion of cases with seronegative rheumatoid arthritis with co-incidental psoriasis. The CASPAR study database provided an opportunity to examine this question. METHODS: The CASPAR study collected clinical, radiological and laboratory data on 588 patients with physician diagnosed psoriatic arthritis (PsA) and 525 controls with other inflammatory arthritis, 70% of which had rheumatoid arthritis. Case of PsA were divided into two groups: polyarthritis and non-polyarthritis (which included the Moll and Wright sub-groups of spinal disease, distal interphalangeal predominant and arthritis mutilans) and were compared to cases of rheumatoid arthritis (RA). Comparisons were made between all three groups and, if a significant difference occurred, between the two groups of PsA. RESULTS: The three groups differed significantly with regards to all clinical and laboratory variables except duration of disease. Significant differences were also found between the two groups of PsA in terms of age, gender, total number of involved joints, disability score, and symmetry. However, there were no differences between the groups of patients with PsA in terms of seropositivity for rheumatoid factor and antibodies to cyclic citrullinated peptide, enthesitis, and spinal pain and stiffness. Further, dactylitis was commonly seen in PsA (57% in polyarticular group, 45% in non- polyarticular group) and uncommonly found in RA (5%). With the exception of entheseal changes, syndesmophytes and osteolysis, typical radiological features of PsA were again unable to distinguish between the PsA subgroups. CONCLUSIONS: There is no evidence that the changing frequency of the polyarticular sub-group of psoriatic arthritis is due to physicians including cases of seronegative rheumatoid arthritis with co-incidental psoriasis.
PMID: 16840501 [PubMed - as supplied by publisher]
]]>
Related ArticlesThe relationship between the extensor tendon enthesis and the nail in distal interphalangeal joint disease in psoriatic arthritis–a high-resolution MRI and histological study.
Rheumatology (Oxford). 2006 Jul 11;
Authors: Tan AL, Benjamin M, Toumi H, Grainger AJ, Tanner SF, Emery P, McGonagle D
Objectives. Diffuse swelling of the distal interphalangeal (DIP) joint beyond the joint margin is a common feature of arthritis in psoriatic arthritis (PsA). The purpose of this study was to explore the microanatomical basis for the inflammation and nail disease in PsA using a combined high-resolution magnetic resonance imaging (MRI) and histological studies. Methods. High-resolution MRIs of the DIP joint were obtained in 30 subjects [10 PsA, 10 osteoarthritis (OA) and 10 normal volunteers]. The relationship between the DIP joint capsule and associated tendon enthesis and the nail bed and root were evaluated. Histological studies to define the relationship between the normal cadaveric DIP joint capsule and the nail root were performed on the middle and ring fingers of 10 dissecting room cadavers. Results. On MRI, the dorsal capsular enthesis was the epicentre of an inflammatory reaction. This extended to involve the soft tissues adjacent to the nail in 8 of 10 cases in PsA, but only 4 of 10 cases in OA where the inflammation is less intense and in none of the normal fingers. The DIP joint capsule was intimately linked with the nail complex on histology, with the dorsal, volar and lateral aspects of the nail bed being ensheathed in fibres extending from the entheses. Conclusion. The study suggests that the extended nature of the enthesis organ associated with the DIP joint may explain the diffuse nature of the inflammatory response around the nail in PsA. Therefore the nail is as much an integral part of the enthesis organ as it is of one skin, which has implications for a better understanding of the disease.
PMID: 16837473 [PubMed - as supplied by publisher]
]]>