Literature on Psoriatic Arthritis

Related ArticlesThe effect of etanercept on osteoclast precursor frequency and enhancing bone marrow edema in patients with psoriatic arthritis.

Ann Rheum Dis. 2007 Oct 29;

Authors: Anandarajah AP, Schwarz EM, Totterman S, Monu J, Feng C, Shao T, Haas-Smith SA, Ritchlin CT

OBJECTIVE: The frequency of osteoclast precursors (OCPF) and the presence of bone marrow edema (BME) are potential response biomarkers in psoriatic arthritis (PsA). Previous studies suggest a central role for TNF in the formation of osteoclast precursors. To better understand this association, the effect of etanercept on OCPF and BME was analyzed in PsA patients with erosive arthritis. METHODS: Twenty PsA patients with active erosive PsA were enrolled. Etanercept was administered twice weekly for 24 weeks. OCPF was measured and clinical assessments were performed at baseline, 2, 12 and 24 weeks. Gadolinium enhanced MR images were obtained at baseline and 24 weeks. RESULTS: Significant improvement in joint score (p

PMID: 17967829 [PubMed - as supplied by publisher]

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Related ArticlesVisceral leishmaniasis in a patient with psoriatic arthritis treated with infliximab: reactivation of a latent infection?

Clin Rheumatol. 2007 Oct 26;

Authors: Tektonidou MG, Skopouli FN

Tumor necrosis factor (TNF) is a proinflammatory cytokine that plays a key role in the pathogenesis of autoimmune diseases and is an important constituent of the human immune response to infection. We report the case of a 45-year-old man with psoriatic arthritis, receiving treatment with infliximab, who presented with high-grade fever, rigor, splenomegaly, acute reactive proteins, and pancytopenia. The diagnosis of visceral leishmaniasis was established. The patient reported that his dog died from Leishmania infection 5 years ago, while he was living in an area endemic for Leishmania. The use of anti-TNF biologic agent in this patient might result in new infection or reactivation of a latent infection with Leishmania, 5 years after the exposure. A detailed current and past medical history should be obtained of every patient candidate for treatment with biologic agents, and a close monitoring is needed for serious opportunistic infections, including visceral leishmaniasis.

PMID: 17963018 [PubMed - as supplied by publisher]

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Related ArticlesPrevalence and characteristics of uveitis in spondylarthropathies: a systematic literature review.

Ann Rheum Dis. 2007 Oct 25;

Authors: Zeboulon N, Dougados M, Gossec L

OBJECTIVES: Uveitis is reported as the most frequent extra articular manifestation in spondylarthritis (SPA) however its prevalence and characteristics are not well established. The objective was to perform a systematic literature review in order to address these issues. METHODS: DATA SOURCES: A systematic literature analysis was conducted in the Medline database up to October 2006 and in the abstracts of rheumatology scientific meetings for the years 2004, 2005 and 2006. A hand search of references was also performed. Review methods: Articles were analysed if they reported the prevalence or the characteristics of uveitis in SPA. Data abstraction was standardized. Statistical analysis was mainly descriptive. RESULTS: Among the 957 articles selected by the search, 126 articles (29,877 patients) allowed a calculation of the prevalence of uveitis in SPA; 36 articles (1,989 patients) described its characteristics. Prevalence of uveitis was 32.7+/-0.5%; it varied with the type of SPA, e.g. 33.2+/-0.8% for ankylosing spondylitis versus 25.1+/-2.3% for psoriatic arthritis. This prevalence increased with mean disease duration and was higher in HLA B27 positive patients with an odds ratio of 4.2. Uveitis was acute in 88.7+/-2.5%, anterior in 90.5+/-2.0%, unilateral in 87.3+/-2.8%. Recurrence concerned 50.6+/-2.6% and a reduction of visual acuity was observed in 8.3+/-3.8%. CONCLUSION: Prevalence of uveitis varies with disease duration and according to the type of SPA. Reduction of visual acuity is not exceptional. Because of recent promising data concerning the effects of anti tumor necrosis factor therapy on uveitis flares in SPA, it was important to determine this baseline prevalence.

PMID: 17962239 [PubMed - as supplied by publisher]

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Related Articles[Development of systemic lupus erythematosus with focal proliferative lupus nephritis during anti-TNF-alpha therapy for psoriatic arthritis]

Med Klin (Munich). 2007 Oct 15;102(10):852-7

Authors: Haake H, Köneke J, Amann K, vom Dahl J, Janssen U

BACKGROUND: Treatment with tumor necrosis factor-(TNF-)alpha-blocking agents is used in a variety of autoimmune diseases. In anti-TNF-alpha therapy for rheumatoid arthritis, occasionally, the development of autoantibodies as well as lupus-like syndromes have been observed, rarely, glomerulonephritides are also induced. The authors first report the development of lupus erythematosus with renal involvement in a patient with psoriatic arthritis during therapy with the soluble TNF-alpha receptor etanercept. CASE REPORT: A 70-year-old patient with long-standing psoriatic arthritis developed pleuritis, pericarditis, as well as marked arthralgias during therapy with etanercept. Laboratory investigation showed markedly increased parameters of inflammation, antinuclear antibodies (ANA), a proteinuria of 3.2 g/day, mild impairment of renal function, as well as a nephritic urinary sediment. A subsequently performed renal biopsy was diagnostic for focal proliferative lupus nephritis. After withdrawal of etanercept and initiation of a cyclophosphamide pulse therapy in combination with oral steroids, parameters of inflammation and renal function rapidly normalized; pleuritis and pericarditis were not detectable anymore. CONCLUSION: Anti-TNF-alpha therapy in patients with psoriatic arthritis or other autoimmune diseases may lead to induction of systemic lupus with renal involvement.

PMID: 17928969 [PubMed - indexed for MEDLINE]

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Related ArticlesInfliximab: new indication. Psoriatic arthritis: just another intravenous me-too drug.

Prescrire Int. 2007 Oct;16(91):188

Authors:

Minimal assessment, based on a non comparative prospective cohort study of single-agent therapy.

PMID: 17926824 [PubMed - indexed for MEDLINE]

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Related ArticlesMethotrexate: new indication. Psoriatic arthritis: approved at last.

Prescrire Int. 2007 Oct;16(91):182

Authors:

Efficacy is mainly based on long experience but must be weighed against potentially severe adverse effects.

PMID: 17926820 [PubMed - indexed for MEDLINE]

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Related ArticlesThe impact of infliximab treatment on quality of life in patients with inflammatory rheumatic diseases.

Arthritis Res Ther. 2007 Oct 8;9(5):R103

Authors: Han C, Smolen JS, Kavanaugh A, van der Heijde D, Braun J, Westhovens R, Zhao N, Rahman MU, Baker D, Bala M

ABSTRACT: In this study, we compare the health-related quality of life (HRQoL) of patients with moderate-to-severe rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS), and study the effect of treatment with infliximab on the HRQoL of patients with these diseases. Short Form Health Survey-36 (SF-36) data from the placebo-controlled phases of 4 studies of infliximab in patients with inflammatory rheumatic diseases (n = 1990) were evaluated. Data came from the Anti-TNF Trial in Rheumatoid Arthritis with Concomitant Therapy (ATTRACT) (n = 428), the Safety Trial for Rheumatoid Arthritis with REMICADE Therapy (START) (n = 1083), the Ankylosing Spondylitis Study for the Evaluation of Recombinant Infliximab Therapy (ASSERT) (n = 279), and the Infliximab Multinational Psoriatic Arthritis Clinical Trial II (IMPACT II) (n = 200). SF-36 assessments were made at weeks 0, 10, 30, and 54 in ATTRACT, weeks 0, 6, and 22 in START, weeks 0, 12, and 24 in ASSERT, and weeks 0 and 14 in IMPACT II. All patient populations had significantly impaired physical aspects of HRQoL at baseline relative to the general population of the United States, and the magnitude of impairment was similar across the diseases. Mean baseline physical component summary scores were 29 in the RA cohort, 32 in the PsA cohort, and 29 in the AS cohort. In all 3 diseases, patients who received infliximab showed significant improvement in physical component summary scores compared with those who received placebo. The magnitude of the difference of improvement (effect size, 95%CI) between infliximab and placebo groups was similar in the AS (10.1, 9.2-11.0), PsA (8.6, 7.8-9.4), and RA (10.1, 9.2-11.0) cohorts. Patients with RA and those with PsA treated with infliximab also showed greater improvement in the mental component summary score than those in the placebo group with an effect size of 4.6 (4.2-5.1) in RA and 2.7 (2.4-3.1) in PsA. Patients in large randomized controlled studies of infliximab in RA, PsA, and AS had similar impairment in physical aspects of HRQoL at baseline and showed significantly greater improvement in HRQoL after treatment with infliximab.

PMID: 17922913 [PubMed - as supplied by publisher]

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Related ArticlesResolution of treatment-related arthralgias and serologic findings with a switch of TNF antagonist therapies in a patient with psoriatic arthritis.

J Clin Rheumatol. 2007 Oct;13(5):294-5

Authors: Fischer P

PMID: 17921804 [PubMed - in process]

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Related ArticlesRecent advances in medical dermatology.

Int J Dermatol. 2007 Oct;46(10):1005-10

Authors: Clark LN, Lebwohl M

Collectively, new developments in the field of medical dermatology will ultimately lead to improved patient care. We review several new findings in the dermatologic literature including the following: new questions regarding the malignant potential of anti-tumor necrosis factor agents, which are widely used for the treatment of moderate to severe psoriasis as well as psoriatic arthritis; anti-interleulin-12, a promising anticytokine for the treatment of psoriasis; diagnostic advances in the detection of latent Mycobacterium tuberculosis; advances in the primary prevention of human papillomavirus and herpes zoster; and new therapeutic options with existing medications for neuropathic pain and pruritus.

PMID: 17910704 [PubMed - indexed for MEDLINE]

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Related ArticlesPatient profiles in psoriatic disease: a case-based approach.

Dermatol Nurs. 2007 Oct;Suppl:5-19; quiz 20-1

Authors: Wiatrowski M, Furfaro N

Psoriasis and psoriatic arthritis are related conditions that can have numerous untoward consequences. Moreover, appropriate management of these conditions can be challenging, as each affected patient has unique needs that must be addressed. With that in mind, the authors discuss three real-life cases, highlighting principles that may facilitate the effective case-by-case management of psoriatic disease.

PMID: 18341241 [PubMed - indexed for MEDLINE]

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