Literature on Psoriatic Arthritis

Related ArticlesQuality of life and treatment satisfaction among patients with psoriasis and psoriatic arthritis and patients with psoriasis only : results of the 2005 Spring US National Psoriasis Foundation Survey.

Am J Clin Dermatol. 2008;9(2):111-7

Authors: Ciocon DH, Horn EJ, Kimball AB

INTRODUCTION: Five to forty percent of patients with cutaneous psoriasis develop an inflammatory, oligoarticular spondyloarthropathy known as psoriatic arthritis. OBJECTIVE: To compare health-related quality of life (QOL) between cutaneous psoriatic patients with and without psoriatic arthritis. METHOD: Secondary cross-sectional analysis of data obtained from the 2005 Spring US National Psoriasis Foundation Quality of Life Telephone/Internet Survey. 426 patients with psoriasis and/or psoriatic arthritis were included in the 2005 survey. Among these respondents, the self-reported disease histories of 140 patients with cutaneous psoriasis and psoriatic arthritis were compared with those of 278 patients with cutaneous psoriasis only. Both groups were compared with respect to demographics, skin disease severity, treatment history and satisfaction, and QOL using previously validated assessment scales. RESULTS: Compared with those with skin psoriasis only, respondents with cutaneous psoriasis and psoriatic arthritis were slightly older, more likely to be female and members of the National Psoriasis Foundation, and more likely to report a younger age of disease onset. They were also more likely to be unemployed, to report their job was affected by their condition, and to report a higher mean estimate of lost annual wages. On both univariate and multivariate analysis, however, no significant differences between groups were detected in skin disease severity, overall QOL, and satisfaction with current treatment options. At the same time, individuals with skin psoriasis and psoriatic arthritis were more likely to be taking systemic agents. They also reported higher mean scores for pain, while those with cutaneous psoriasis reported higher mean scores for self-consciousness only. CONCLUSION: In contrast to previous reports that did not control for skin disease severity, this study demonstrates that patients with cutaneous psoriasis and psoriatic arthritis do not report significantly worse health-related QOL compared with patients with cutaneous psoriasis only. Nor do they report significantly greater dissatisfaction with current treatment options. These findings may reflect the intrinsic inadequacy of the QOL instruments used in this study for capturing the additional burden of joint disease. Alternatively, these findings may reflect the existence of a threshold of joint disease in patients with skin psoriasis and psoriatic arthritis below which joint symptoms are perceived as negligible relative to cutaneous disease.

PMID: 18284265 [PubMed - indexed for MEDLINE]

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Related Articles[Early spondyloarthritis.]

Internist (Berl). 2008 Mar;49(3):271-7

Authors: Märker-Hermann E

The spondyloarthritides (SpA) are often included in the differential diagnosis of early arthritis with or without low back pain. This is namely true for reactive arthritis which occurs as acute or subacute arthritis in association with urogenital or gastrointestinal bacterial infection. Reactive arthritis can result in chronic or relapsing disease. The SpA group also includes ankylosing spondylitis (axial form or with peripheral arthritis), psoriatic arthritis and SpA in association with inflammatory bowel disease. (Early) undifferentiated SpA has now come into the focus of many researchers since more effective and specific therapy has become available for the SpA. Diagnostic algorithms have been developed and evaluated.

PMID: 18265956 [PubMed - in process]

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Related ArticlesWhen there is no single best biological agent: psoriasis and psoriatic arthritis in the same patient responding to two different biological agents.

Clin Exp Dermatol. 2008 Mar;33(2):164-6

Authors: Adişen E, Karaca F, Gürer MA

Guidelines and treatment strategies for the new biological agents have been developed, but dermatologists continue to face difficulties in adopting these guidelines into their daily practices. We report a patient with psoriasis and psoriatic arthritis whose skin lesions responded only to efalizumab, and the arthritis to etanercept. This case shows that different biological agents may achieve different success rates even in the same patient. Each biological agent offers different advantages and disadvantages, which sometimes make it difficult to choose the single best agent for a patient. Psoriasis often becomes one of the most difficult diseases to treat and does not respond to any single antipsoriatic agent. Perhaps in the future, rotational or combination treatment with different biological treatments will be used.

PMID: 18257837 [PubMed - indexed for MEDLINE]

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Related ArticlesManifestation of palmoplantar pustulosis during or after infliximab therapy for plaque-type psoriasis: report on five cases.

Arch Dermatol Res. 2008 Mar;300(3):101-5

Authors: Mössner R, Thaci D, Mohr J, Pätzold S, Bertsch HP, Krüger U, Reich K

Infliximab is a monoclonal antibody directed against TNF-alpha. It has been approved for use in rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease, psoriatic arthritis and plaque-type psoriasis. In case reports, positive effects on pustular variants of psoriasis have also been reported. However, paradoxically, manifestation of pustular psoriasis and plaque-type psoriasis has been reported in patients treated with TNF antagonists including infliximab for other indications. Here, we report on 5 patients with chronic plaque-type psoriasis who developed palmoplantar pustulosis during or after discontinuation of infliximab therapy. In two of the five cases, manifestation of palmoplantar pustulosis was not accompanied by worsening of plaque-type psoriasis. Possibly, site-specific factors or a differential contribution of immunological processes modulated by TNF inhibitors to palmoplantar pustulosis and plaque-type psoriasis may have played a role.

PMID: 18239925 [PubMed - indexed for MEDLINE]

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Related ArticlesTreatment of psoriatic arthritis and rheumatoid arthritis with disease modifying drugs — comparison of drugs and adverse reactions.

J Rheumatol. 2008 Mar;35(3):472-6

Authors: Helliwell PS, Taylor WJ,

OBJECTIVE: Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are chronic inflammatory diseases of the musculoskeletal system. Although it seems likely that these conditions have a different pathogenesis, the drugs used to treat them are the same. Our study used a cross-sectional clinical database to compare drug use and side-effect profile in these 2 diseases. METHODS: The CASPAR study collected data on 588 patients with PsA and 536 controls, 70% of whom had RA. Data on disease modifying drug treatments used over the whole illness were recorded, together with their outcomes, including adverse events, for RA and PsA. RESULTS: For both diseases methotrexate (MTX) was the most frequently used disease modifying drug (39% of patients with PsA, 30% with RA), with over 70% of patients in both diseases still taking the drug. Other drugs were used with the following frequencies in PsA and RA, respectively: sulfasalazine 22%/13%, gold salts 7%/11%, antimalarial drugs 5%/14%, corticosteroids 10%/17%, and anti-tumor necrosis factor (TNF) drugs 6%/5%. Compared to RA, cyclosporine and anti-TNF agents were less likely to be ineffective in PsA. Compared to RA, subjects with PsA were less likely to be taking MTX and more likely to be taking anti-TNF agents. Hepatotoxicity with MTX was more common in PsA and pulmonary toxicity with MTX was found more often in RA. CONCLUSION: These data provide insight into prescribing patterns of disease modifying drugs in RA and PsA in a large international cohort, together with the differential adverse events of these drugs between these diseases.

PMID: 18203324 [PubMed - indexed for MEDLINE]

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