Abstract
Psoriatic arthritis is a heterogeneous disease including various rheumatologic and skin manifestations. Frequent comorbidities contribute to impaired quality of life and increased morbidity and mortality. Metabolic and cardiovascular comorbidities, represented by cardiovascular diseases, metabolic syndrome, type 2 diabetes and non-alcoholic fatty liver disease, account for a considerable burden. Beyond the role of inflammation in the development of cardiovascular diseases during chronic inflammatory rheumatic diseases, adipose tissue and the production of adipokines may play a critical role. Moreover, anxiety, depression, and fibromyalgia are also major comorbidities that need to be addressed. Recommendations for the management of comorbidities common to chronic inflammatory rheumatic diseases (cancers, infections) have been proposed and are now part of good practice. Fewer studies have addressed emerging comorbidities (sleep apnea syndrome, chronic obstructive bronchitis, sexual dysfunction) and they will require a better evaluation to improve the holistic management of patients. Systematic screenings and management recommendations have been found to be useful for patients but raise the question of implementation of recommendation and clinical inertia. The involvement of rheumatology nurses and the development of advanced practice nurses are important issues for improving prevention and overall management of patients with chronic diseases.
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