Literature on Psoriatic Arthritis

Related ArticlesCan a Multi-Dimensional Health Assessment Questionnaire (MDHAQ) and Routine Assessment of Patient Index Data (RAPID) scores be informative in patients with all rheumatic diseases?

Best Pract Res Clin Rheumatol. 2007 Aug;21(4):733-53

Authors: Pincus T, Sokka T

A multidimensional health assessment questionnaire (MDHAQ) is useful in standard care of patients with all rheumatic diseases in a busy clinical setting. The MDHAQ was adapted from the classical health assessment questionnaire (HAQ) for feasibility in standard clinical care, with reduction of the number of activities from 20 to 10, visual analog scales (VAS) as 21 circles rather than 10 cm lines, availability of all core data set patient self-report measures and scoring templates on the front side, and a review of systems symptom checklist and review of recent medical history on the reverse side of a single page. Scoring templates are also available for routine assessment of patient index data (RAPID) scores, based on a composite of the three patient reported outcome (PRO) measures from the core data set included on the HAQ and MDHAQ, physical function pain, and patient estimate of global status. Flow sheets illustrating use of the MDHAQ in standard clinical care of patients with various rheumatic diseases, including psoriatic arthritis, systemic lupus erythematosus, ankylosing spondylitis, gout, scleroderma, vasculitis, fibromyalgia, inflammatory bowel disease arthritis, Behcet’s syndrome, and familial Mediterranean fever, are presented to illustrate use of this simple questionnaire to add to clinical decisions and document patient courses and outcomes in standard clinical care of patients with all rheumatic diseases.

PMID: 17678833 [PubMed - indexed for MEDLINE]

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Related ArticlesHigh prevalence of subclinical atherosclerosis in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factors.

Arthritis Rheum. 2007 Aug 15;57(6):1074-80

Authors: Gonzalez-Juanatey C, Llorca J, Amigo-Diaz E, Dierssen T, Martin J, Gonzalez-Gay MA

OBJECTIVE: To assess the presence of subclinical atherosclerosis in patients with psoriatic arthritis (PsA) without clinically evident atherosclerosis or its complications, and to assess whether demographic or clinical factors affect the development of atherosclerotic disease in a series of patients with PsA attended to in a community hospital. METHODS: Fifty-nine patients with PsA who fulfilled the Moll and Wright criteria were recruited from Hospital Xeral-Calde (Lugo, Spain). Patients seen during the period of recruitment who had classic cardiovascular risk factors or had experienced cardiovascular or cerebrovascular events were excluded. Fifty-nine healthy matched controls were also studied. Carotid artery intima-media thickness (IMT) and carotid plaques were measured in the right common carotid artery. The study was performed using high-resolution B-mode ultrasound. RESULTS: Patients with PsA exhibited greater carotid artery IMT than did matched controls (mean +/- SD 0.699 +/- 0.165 mm versus 0.643 +/- 0.111 mm; P = 0.031; difference of means 0.056; 95% confidence interval 0.005-0.108). Adjusted for age, the carotid IMT was correlated with age at the time of PsA diagnosis (partial correlation coefficient [r] = -0.264, P = 0.04), disease duration (r = 0.264, P = 0.04), total cholesterol (r = 0.233, P = 0.01), and low-density lipoprotein cholesterol (r = 0.243, P = 0.01). CONCLUSION: The present study demonstrates that patients with PsA without cardiovascular risk factors or clinically evident cardiovascular disease have a high prevalence of macrovascular disease in the form of increased carotid artery IMT compared with ethnically matched controls.

PMID: 17665475 [PubMed - indexed for MEDLINE]

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Related ArticlesImproved survival in psoriatic arthritis with calendar time.

Arthritis Rheum. 2007 Aug;56(8):2708-14

Authors: Ali Y, Tom BD, Schentag CT, Farewell VT, Gladman DD

OBJECTIVE: To determine whether there has been a change in mortality rates over the last 3 decades in patients with psoriatic arthritis (PsA) whose cases were followed prospectively. METHODS: Patients receiving followup care according to a standard protocol at the University of Toronto PsA Clinic between 1978 and 2004 were included. Information on patient deaths was collected prospectively. Mortality data for the general population of Ontario, Canada, stratified by 5-year age bands, sex, and calendar year from 1978 to 2004, were used to calculate the reference rates. Standardized mortality ratios (SMRs) were calculated through use of Poisson regression models for the number of observed deaths. Time trend analyses were performed through the use of 10-year “rolling-average” SMRs and followup period-specific SMRs stratified by the period of entry into clinic. RESULTS: Of 680 patients with PsA, 106 (15.6%) (55 women and 51 men) have died. Major causes of death were disease of the circulatory system, neoplasms, diseases of the respiratory system, diseases of the gastrointestinal system, injuries/poisoning, and unknown. The overall SMR for the period 1978-2004 was 1.36 (95% confidence interval 1.12, 1.64). The estimated number of life-years lost by the PsA patient cohort overall was 2.99 years (95% confidence interval 1.14, 4.77). For patients who entered the cohort during the years 1978-1986, the SMRs were 1.89, 1.83, and 1.21 for followup periods 1978-1986, 1987-1995, and 1996-2004, respectively. For patients who entered the cohort during the years 1987-1995, the SMRs were 0.55 and 0.82, while the SMR for those who entered during 1996-2004 was 0.56. CONCLUSION: The drop in SMRs in this PsA clinic population suggests that the mortality risk has improved over time. This improved survival may reflect disease severity at presentation in the earlier cohort as well as earlier diagnosis and more aggressive treatment in the more recent followup period.

PMID: 17665458 [PubMed - indexed for MEDLINE]

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Related ArticlesThe concept of a “synovio-entheseal complex” and its implications for understanding joint inflammation and damage in psoriatic arthritis and beyond.

Arthritis Rheum. 2007 Aug;56(8):2482-91

Authors: McGonagle D, Lories RJ, Tan AL, Benjamin M

PMID: 17665450 [PubMed - indexed for MEDLINE]

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Related ArticlesDevelopment of psoriasis after B cell depletion with rituximab.

Arthritis Rheum. 2007 Aug;56(8):2715-8

Authors: Dass S, Vital EM, Emery P

The B cell-depleting monoclonal antibody rituximab is a novel therapy for the rheumatic diseases, with an increasing body of evidence regarding its safety and efficacy in an expanding range of indications. However, there is uncertainty over its potential use in, and impact on, autoantibody-negative diseases. We describe 3 patients, with no known risk factor for psoriasis, who developed psoriasis (and 1 who also developed features of psoriatic arthritis) after receiving rituximab for a variety of indications, namely, seropositive and seronegative rheumatoid arthritis and systemic lupus erythematosus. In all cases, the underlying disease responded well to rituximab. The interpretation of this possible side effect of rituximab remains unclear, but a B cell-depleted environment may induce abnormal T cell responses, possibly provoked either by subclinical infection or by the removal of mechanisms whereby B cells regulate T cells. These cases suggest that the pathogenesis of psoriasis may not require normal numbers of B cells and that proposed treatment of psoriasis and psoriatic arthritis with rituximab may result in unpredictable responses.

PMID: 17665440 [PubMed - indexed for MEDLINE]

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Related ArticlesInfliximab inhibits progression of radiographic damage in patients with active psoriatic arthritis through one year of treatment: Results from the induction and maintenance psoriatic arthritis clinical trial 2.

Arthritis Rheum. 2007 Aug;56(8):2698-707

Authors: van der Heijde D, Kavanaugh A, Gladman DD, Antoni C, Krueger GG, Guzzo C, Zhou B, Dooley LT, de Vlam K, Geusens P, Birbara C, Halter D, Beutler A

OBJECTIVE: To evaluate the effect of infliximab on progression of structural damage over 1 year in patients with active psoriatic arthritis (PsA) enrolled in the Induction and Maintenance Psoriatic Arthritis Clinical Trial 2. METHODS: In this double-blind, placebo-controlled study, 200 patients with active PsA were randomly assigned (1:1 ratio) to receive infusions of infliximab (5 mg/kg) or placebo at weeks 0, 2, and 6, and every 8 weeks thereafter through week 54. At week 24, patients initially assigned to receive placebo crossed over to receive infliximab (5 mg/kg). Based on predefined criteria, patients randomized to receive placebo could enter early escape by receiving infliximab (5 mg/kg) starting at week 16, and patients randomized to receive infliximab could have the dose increased to 10 mg/kg starting at week 38. Patients were analyzed according to the treatment they were randomized to receive. Radiographs of hands and feet were obtained at baseline and at weeks 24 and 54. Two readers blinded to treatment assignment and radiograph sequence independently evaluated erosions and joint space narrowing using the Sharp/van der Heijde scoring method modified for PsA. RESULTS: At week 24, patients randomized to receive infliximab 5 mg/kg had significantly less radiographic progression compared with patients randomized to receive placebo, with mean +/- SD changes from baseline in the total Sharp/van der Heijde score of -0.70 +/- 2.53 and 0.82 +/- 2.62, respectively (P

PMID: 17665424 [PubMed - indexed for MEDLINE]

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