Psoriatic Arthritis Group Research Articles

Ultrasonography of the nail unit reveals quantitative and qualitative alterations in patients with psoriasis and psoriatic arthritis.

The nail unit is a matter of interest both for dermatologist and rheumatologist. The nail is considered one of thepossible targets of assessment, especially when ultrasonography is performed.The aim of the study is to highlight peculiar features and alterations of the nail unit in patients affected by psoriasis andpsoriatic arthritis versus healthy controls using ultrasonography. The study sample included 82 patientsaffected by psoriasis and/or psoriatic arthritis and 50 healthy controls. The patients were consecutively enrolled duringtheir routine visit in the outpatient clinic and they performed clinical and ultrasonographic evaluation of the nail. The evaluationof disease activity was done using Disease Activity in Psoriatic Arthritis (DAPSA), Psoriasis Activity Severity Index(PASI), and Nail Psoriasi Severity Index (NAPSI). Multivariate analysis of variance was performed between groups.Post hoc analysis underlined the differences between healthy and affected regarding nail plate thickness (0.063±0.011 cm forpatients with psoriasis, 0.065±0.014 cm for patients with psoriatic arthritis and 0.051±0.006 cm for healthy controls, p<0.05).Elementary lesions of nail plate and nail bed were compared using Pearson's chi square test between patients in psoriasis andpsoriatic arthritis groups, with no differences except for a trend for onycholisis and crumbling (p=0.07 and 0.06, respectively)in the psoriatic arthritis group. ROC curves were calculated (AUC = 0.68) obtaining also quantitative cut offs for nail plate andnail bed thickness in the affected vs healthy patients. Our study shows that ultrasonography may be a potentialadvantage in clinical practice. Our results strengthen the information already available in the literature and add quantitativeparameters for ultrasonography of the nail.

Power Doppler Ultrasound Evaluation of Peripheral Joint, Entheses, Tendon, and Bursa Abnormalities in Psoriatic Patients: A Clinical Study.

To evaluate the prevalence rates of peripheral joint, enthesis, tendon, and bursa abnormalities by power Doppler (PD) ultrasonic examination in patients with psoriatic arthritis (PsA), psoriatic patients without clinical signs of arthritis (non-PsA psoriasis group), and healthy individuals, to detect subclinical PsA. A total of 253 healthy volunteers, 242 non-PsA psoriatic patients, and 86 patients with PsA were assessed by 2-dimensional and power Doppler (PD) ultrasound. Peripheral joint, enthesis, tendon, and bursa abnormalities were observed, characterizing abnormal PD. The affected patients and sites with abnormalities in various ages were compared among groups; PD signal grades for the abnormalities were also compared. In the PsA group, significantly higher percentages of sites showing joint effusion/synovitis, enthesitis, and tenosynovitis in all age groups, and markedly higher rates of sites with bursitis were found in young and middle age groups, compared with the non-PsA and control groups (all p < 0.01). Meanwhile, the non-PsA group showed significantly higher rates of joint effusion/synovitis and enthesitis sites, and elevated PD signal grades of synovitis, enthesitis, and tenosynovitis in comparison with the control group, both in young and middle age groups (all p < 0.01). Patients with PsA have high percentages and PD signal grades of peripheral joint, tendon, enthesis, and bursa involvement. Young and middle-aged non-PsA patients have high synovitis and enthesitis percentages, and elevated PD signal grades of synovitis, enthesitis, and tenosynovitis.

Magnetic resonance imaging (MRI) of feet demonstrates subclinical inflammatory joint disease in cutaneous psoriasis patients without clinical arthritis.

We evaluated inflammation at the small joints of feet in psoriasis patients without clinical arthritis (PsO) as against clinically overt psoriatic arthritis (PsA) patients, using a low field magnet extremity MRI (eMRI). Patients with psoriasis recruited from dermatology and rheumatology clinics of a tertiary care institution in southern India were divided into PsO and PsA groups. Demographic and physical examination details were recorded. Consenting patients underwent non-contrast eMRI of the right foot. Two trained readers scored the MRI parameters of inflammation (synovitis, tenosynovitis, osteitis) using a modification of the PsA magnetic resonance imaging score (PsAMRIS). Proportion of patients with any sign of MRI inflammation was noted. Clinical variables were compared with inflammation scores for any association. A total of 83 patients (30 PsA and 53 PsO), with 75% males and mean age of 42.2±11.6years were included. There was no statistical difference between the median eMRI inflammatory scores in PsA and PsO patients (p=0.493). Evidence of inflammation was present in 33.9% and 50% patients in the PsO and PsA groups, respectively. Early arthritis for psoriatic patients screening questionnaire (EARP) score of ≥3 was significantly associated with imaging features of inflammation in PsO group (p=0.044). This study corroborates a high proportion of subclinical inflammation in small joints of foot in PsO patients, which needs to be reproduced in larger, longitudinal cohorts to predict risk factors for progression tofuture PsA development.

Increased risk of periodontitis in patients with psoriatic disease: a nationwide population-based retrospective cohort study.

AimsPeriodontitis and psoriatic disease, including psoriasis (PS) and psoriatic arthritis (PsA), share the common risk factors and co-morbidities. However, the risk of periodontitis in patients with psoriatic disease still needs further investigation. This study was a nationwide population-based retrospective cohort study assessing the risk of periodontitis from psoriatic disease exposure.Materials and MethodsPatients with newly diagnosed psoriatic disease from 2003 to 2012 were identified from the Taiwanese National Health Insurance Research Database. The 1:4 ratio propensity score matched controls were selected from no psoriatic disease participations. The subsequent risk of periodontitis was evaluated in exposure and comparison groups. Multiple Cox proportional hazard models were used for the estimation.ResultsA total of 3,487 psoriatic disease patients and 13,948 controls were identified. Incidence rate of periodontitis was higher in patients with PsA. The adjusted hazard ratio (aHRs) for moderate/severe periodontitis were 0.85 (95% CI [0.65–1.11]) in PS group and 1.66 (95% CI [0.99–2.78]) in PsA group. The aHRs of PsA were increased over time, aHRs was changed from 0.65 (0–11 months from index date) to 1.34 (≥12 months from index date) in all types of periodontitis and from 1.09 to 1.79 in moderate/severe periodontitis group, respectively.ConclusionsThe increased risk of periodontitis was observed, especially the association between PsA and moderate/severe periodontitis. The patients with psoriatic disease should receive regular periodontal evaluation.

Burden of Arthritic Manifestations on Psoriatic Patients - Sub-Analysis of Pessoa, A Patient Reported Outcomes Study In Portugal

Psoriasis (PsO) and psoriatic arthritis (PsA) is a chronic inflammatory disorder, presenting several types of manifestations with significant impact on quality of life (QoL). This analysis aimed to characterize PsO patients with and without concomitant PsA, and evaluate the disease impact on QoL and resource use. PeSsoA was a cross-sectional study in 564 adult Portuguese patients with PsO. Data was collected through an electronic questionnaire entered directly by patients (Jun-Jul2016). Comparisons were executed between PsA patients (patients with PsO and PsA) and patients with PsO only. 126 patients (22.4%) reported PsA. 63.5% (n=80) were females, mean(SD) age 47.2±12.9 years. Most common type of psoriasis was plaque psoriasis (67.5%). Based on patient reported Body Surface Area, 67.8% had moderate to severe psoriasis. Comparing to other patients, PsA patients presented higher prevalence of depression/ anxiety (37.7% vs 21.9%; p=0.002) and hypertension (30.2% vs 16.6%; p<0.001). The majority of patients were seen by dermatologist in both groups (54.4% in PsA group vs 64.0%) although more patients in PsA group were followed by rheumatologist (23.0% vs 0.8%). Patients with PsA reported higher monthly medication/ heath product cost (56€ vs 36€) and more frequent physician appointments (66% vs 40% with visiting interval < 6 months). EQ-5D-3L results showed that PsA patients had worse scores in anxiety/depression dimension (62.6% were moderately anxious or depressed; 9,3% extremely anxious or depressed) and in pain/discomfort dimension (60,7% had moderate pain or discomfort; 14,9% had extreme pain or discomfort). PsA patients also had a significant worse overall EQ-5D-3L VAS score (59.4 vs 70.6; p<0.001). This sub-analysis reinforces the humanistic burden of PsA in patients with PsO diagnosis. PsA patients had higher prevalence of comorbidities and health resource use. Patients’ perspective should increasingly be integrated in clinical practice to improve disease awareness and obtain more real-life outcomes evaluation.

In psoriatic arthritis Dkk-1 and PTH are lower than in rheumatoid arthritis and healthy controls.

Psoriatic Arthritis (PsA) is characterized by bone erosive damage often associated with exuberant bone formation especially in enthesial sites. Dkk-1 and sclerostin are the main inhibitors of the WNT/β-catenin signaling pathway and play a key role in the regulation of both bone formation and resorption. We performed this study in order to compare the serum levels of the WNT-pathway regulators along with bone turnover markers (BTM) and parathyroid hormone (PTH) between three different groups: one group of female patients affected by PsA, one group of female patients affected by rheumatoid arthritis (RA), and healthy female controls (HC). This is a cross-sectional study including 33 patients with PsA classified with the CASPAR criteria, 35 HC, and 28 patients with RA classified with the ACR/EULAR 2010 criteria. Intact N-propeptide of type I collagen (PINP), C-terminal telopeptide of type I collagen (CTX-I), Dickkopf-related-protein 1 (Dkk-1), sclerostin, PTH, and 25OH-vitamin D serum levels were dosed. The PsA group showed significantly lower Dkk-1 levels when compared to the HC and RA groups. Dkk-1 in the RA group was significantly higher than HC. A similar trend was documented for PTH. In the PsA group, CTX-I was found to be lower than in both the RA and HC groups. This study demonstrated for the first time that Dkk-1 levels in PsA are lower than HC, in contrast with RA, in which they are increased. These results might contribute to explain the different bone involvement of the two different diseases.

Endocrine Comorbidities in Patients with Psoriatic Arthritis: A Population-based Case-controlled Study.

To investigate endocrine comorbidities in patients with psoriatic arthritis (PsA). A retrospective, cross-sectional study was performed with the database of Clalit Health Services, the largest healthcare provider in Israel, between 2002 and 2014. Patients with PsA were identified and matched by age and sex to healthy controls. The following morbidities were analyzed: hypo/hyperthyroidism, hypo/hyperparathyroidism, hyperprolactinemia, Cushing disease, Addison disease, diabetes insipidus, diabetes mellitus (DM), pituitary adenoma, acromegaly, and osteoporosis. Descriptive statistics were applied. The associations between PsA and endocrine comorbidities were analyzed by univariable and multivariable analysis. The study included 3161 patients with PsA, 53.4% women, mean age 58.4 ± 15.4 years, and 31,610 controls. Comparative analyses yielded higher proportion of hypothyroidism (12.7% vs 8.6%, p < 0.0001), Cushing disease (0.3% vs 0.1%, p < 0.0001), osteoporosis (13.2% vs 9.1%, p < 0.0001), and DM (27.9% vs 20.7%, p < 0.0001) in the PsA group compared with the control group. In the multivariable regression analysis, the following diseases were more frequent in the PsA group: hypothyroidism (OR 1.61, 95% CI 1.47-1.81), DM (OR 1.35, 95% CI 1.18-1.42), Cushing disease (OR 3.96, 95% CI 1.67-9.43), and osteoporosis (OR 1.56, 95% CI 1.37-1.78). PsA is associated with a high frequency of hypothyroidism, osteoporosis, DM, and Cushing disease. Awareness of these comorbidities may help physicians provide the optimal medical care to patients with PsA.

Serum peptides as putative modulators of inflammation in psoriasis

BackgroundPsoriasis is a refractory inflammatory disease, however, its pathophysiology is still not fully understood. ObjectiveWe tried to identify novel serum peptides associated with the pathophysiology of psoriasis. MethodsSerum peptides from 24 patients with psoriasis vulgaris (PV), 10 patients with psoriatic arthritis (PsA), 14 patients with atopic dermatitis (AD), and 23 healthy control (HC) subjects were analyzed by mass spectrometry. The effects of some peptides on the secretion of humoral factors from dermal cells were investigated by cytokine arrays and ELISAs. ResultsA total of 93 peptides were detected. 24, 20, 23, and 2 peptides showed at least 1.2-fold difference in ion intensity between the psoriasis (PV+PsA) and HC groups, between the PV+PsA and AD groups, between the PV and PsA groups, and between patients with severe-to-moderate PV (n=6) and those with mild PV (n=18), respectively (p<0.05). 13 out of 27 peptides that showed at least 1.5-fold ion intensity difference in the abovementioned 4 comparisons were identified. The parent proteins of the identified peptides included a coagulation factor, proteins involved in the maintenance of skin, and a protein relating to cytoskeleton. We focused on 2 peptides that were increased in the PV+PsA group: a fibrinogen α chain-derived peptide (1462m/z), the unmodified form of which was fibrinopeptide A-des-alanine (FPAdA), and a filaggrin (FLG)-derived peptide (1977m/z), a modified form of FLG2099–2118 (Q2099pE, Q2115E; FLG-pEE). FPAdA stimulation increased the secretion of GROα from dermal microvascular endothelial cells (dMVECs) and decreased the secretion of lipocalin-2 from keratinocytes in comparison to FPAdA-resequenced peptide stimulation (GROα, 280.9±7.3pg/mL vs. 229.6±5.0pg/mL, p<0.001; lipocalin-2, 273±13pg/mL vs. 350±10pg/mL, p<0.01). Interestingly, FLG-pEE stimulation decreased the secretion of GROα, IL-8, and MCP-1 from dMVECs in comparison to FLG-derived control peptide stimulation (GROα, 844.3±47.5pg/mL vs. 1038.5±96.9pg/mL, p<0.05; IL-8, 2240.1±172.6pg/mL vs. 3221.8±523.7pg/mL, p<0.05; MCP-1, 4057.8±157.2pg/mL vs. 4619.1±213.4pg/mL, p<0.05). ConclusionsThe results suggested that some serum peptides are involved in the pathophysiology of psoriasis, regulating the secretion of inflammatory chemokines and an antimicrobial protein. The modulation of serum peptides may be a potential therapeutic strategy for psoriasis.

Association between mean platelet volume and disease severity in patients with psoriasis and psoriatic arthritis.

IntroductionMean platelet volume (MPV) is an important marker that shows the activation and function of the platelets, which is effective in the inflammatory diseases.AimTo show the relationship between MPV and the development of psoriatic arthritis (PA) in patients with psoriasis vulgaris (PV) and the correlation between MPV and psoriasis severity score (PASI).Material and methodsOur study included 116 patients with psoriatic arthritis (68 female, 48 male) and 41 patients in the psoriasis group (19 female, 22 male) and 90 subjects in the control group (55 female, 35 male). The demographic data of the patients, duration of disease, PASI, the nature of the disease were evaluated retrospectively.ResultsMean platelet volume levels of both the PV group (8.79 ±0.86 fl) and the PA group (9.18 ±1.26 fl) were significantly higher compared to the control group (8.42 ±0.74 fl). There was a weak statistically positive correlation between the PASI and the MPV according to the correlation analysis (r = 0.165; p = 0.046).ConclusionsOur results show that MPV may be helpful as an indicator of the clinical course of PV and PA. In this regard, that study should be supported by prospective studies to find strong correlations.

Serum thymosin α 1 levels in patients with chronic inflammatory autoimmune diseases.

Thymosin alpha 1 (Tα1) is a powerful modulator of immunity and inflammation. Despite years of studies, there are a few reports evaluating serum Tα1 in health and disease. We studied a cohort of healthy individuals in comparison with patients affected by chronic inflammatory autoimmune diseases. Sera from 120 blood donors (healthy controls, HC), 120 patients with psoriatic arthritis (PsA), 40 with rheumatoid arthritis (RA) and 40 with systemic lupus erythematosus (SLE), attending the Transfusion Medicine or the Rheumatology Clinic at the Policlinico Tor Vergata, Rome, Italy, were tested for Tα1 content by means of a commercial enzyme-linked immunosorbent assay (ELISA) kit. Data were analysed in relation to demographic and clinical characteristics of patients and controls. A gender difference was found in the HC group, where females had lower serum Tα1 levels than males (P < 0·0001). Patients had lower serum Tα1 levels than HC (P < 0·0001), the lowest were observed in PsA group (P < 0·0001 versus all the other groups). Among all patients, those who at the time of blood collection were taking disease-modifying anti-rheumatic drugs (DMARD) plus steroids had significantly higher Tα1 levels than those taking DMARD alone (P = 0·044) or no treatment (P < 0·0001), but not of those taking steroids alone (P = 0·280). However, whichever type of treatment was taken by the patients, serum Tα1 was still significantly lower than in HC and there was no treatment-related difference in PsA group. Further prospective studies are necessary to confirm and deepen these observations. They might improve our understanding on the regulatory role of Tα1 in health and disease and increase our knowledge of the pathogenesis of chronic inflammatory autoimmune diseases.

Psoriasis and Psoriatic Arthritis-Related Uveitis: Different Ophthalmological Manifestations and Ocular Inflammation Features

ABSTRACTPurpose: To compare clinical features of uveitis in patients affected by psoriasis and psoriatic arthritis (PsA). Methods: A retrospective case-control study. Results: 117 patients were affected by uveitis and psoriasis or PsA (92 and 25 patients, respectively) from 2003 to 2013. Axial PsA was associated with unilateral uveitis onset compared to the peripheral pattern (p < 0.03). The prevalence of eyes with at least one complication involving anterior segment was significantly more represented in the PsA group than the psoriasis one (p = 0.024). Anterior segment complications were more frequently associated with posterior ones in PsA patients than in psoriasis patients (p = 0.005). Most common complications in total sample at baseline examination were cataract (29.7%), ocular hypertension (17%), macular edema (7%), and pupillary seclusion (4.4%). Conclusion: Uveitis in patients with psoriasis and PsA may have distinguishing clinical features. PsA patients have more ocular complications than those with psoriasis. Both groups need an ophthalmological examination to promptly detect ocular co-morbidity.

Chondrocyte activity is increased in psoriatic arthritis and axial spondyloarthritis.

BackgroundPsoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) are chronic inflammatory rheumatic diseases with complex origins. Both are characterized by altered extracellular matrix remodeling in joints and entheses that results in destructive and osteochondral proliferative lesions. There is a need for biomarkers reflecting core disease pathways for diagnosis and disease mapping. Pro-C2 reflects mature cartilage collagen type IIB formation, while C-Col10 represents turnover of type X collagen, which is exclusively expressed by hypertrophic chondrocytes. The objectives of this study were to study cartilage metabolism in axSpA and PsA by assessing Pro-C2 and C-Col10 and to evaluate their diagnostic utility against a healthy reference population.MethodsPatients with PsA (n = 101) or axSpA (n = 110) were recruited consecutively from three rheumatology outpatient clinics. Demographic and clinical disease measures were recorded. Pro-C2 and C-Col10 were quantified in serum by using newly developed and specific competitive enzyme-linked immunosorbent assays based on monoclonal antibodies. One-way analysis of variance and Tukey’s multiple comparison tests were performed on log-transformed data. ROC curve analysis was carried out to evaluate their discriminative power.ResultsPro-C2 levels in serum were significantly increased in both axSpA (median concentration 1.11 ng/ml, 0.67–1.64) and PsA (median concentration 1.03 ng/ml, 0.53–1.47) compared with healthy controls (median concentration 0.30 ng/ml, 0.16–0.41) (p < 0.0001). Pro-C2 did not differ according to treatment. C-Col10 was slightly but equally elevated in the PsA and axSpA groups vs. the control group, but it was significantly lower in patients with axSpA undergoing tumor necrosis factor-α inhibitor (TNFi) treatment. ROC curve analysis revealed AUCs of 0.85 (95 % CI 0.79–0.89) for axSpA and 0.81 (95 % CI 0.75–0.86) for PsA.ConclusionsThese findings indicate that cartilage collagen metabolism was enhanced in the axSpA and PsA groups compared with the healthy control group. The lower C-Col10 level in patients with axSpA undergoing TNFi treatment may reflect that hypertrophic chondrocytes in axSpA are targeted by TNFi. ROC curve analysis showed a diagnostic potential for Pro-C2 in axSpA and PsA.

Plantar forefoot pressures in psoriatic arthritis-related dactylitis: an exploratory study.

Dactylitis is a common feature of psoriatic arthritis (PsA); local physical trauma has been identified as a possible contributing factor. The aim of this study was to explore differences in forefoot plantar pressures in patients with PsA with and without dactylitis and compare to healthy controls. Thirty-six participants were recruited into three groups: group A PsA plus a history of dactylitis; group B PsA, no dactylitis; group C control participants. Forefoot plantar pressures were measured barefoot and in-shoe at the left second and fourth toes and corresponding metatarsophalangeal joints. Temporal and spatial parameters were measured and data from the foot impact scale for rheumatoid arthritis (FIS-RA), EQ5D and health assessment questionnaire (HAQ) were collected. Pressure time integral peak plantar pressure, and contact time barefoot and in-shoe were not significantly different between groups. Temporal and spatial parameters reported no significant differences between groups. ANOVA analysis and subsequent post hoc testing using Games-Howell test yielded significance in FIS-RA scores between both PsA groups versus controls, A p ≤ 0.0001 and PsA group B p < 0.0001 in the FIS-RA impairment and footwear domain, PsA group A p < 0.03 and PsA group B p ≤ 0.05 in the FIS-RA activity and participation domain compared to controls. This is the first exploratory study to investigate forefoot plantar pressures in patients with and without historical dactylitis in PsA. FIS-RA scores indicate PsA patients have significant limitations compared to controls, although a history of dactylitis does not appear to worsen patient reported outcomes.

Effect of Chronic Periodontitis on Oxidative Status in Patients With Psoriasis and Psoriatic Arthritis

Psoriasis (PS), psoriatic arthritis (PsA), and chronic periodontitis (CP) are the most common chronic inflammatory diseases and have remarkable pathologic similarities. The aim of this study is to investigate the effect of periodontal inflammation on oxidative stress in patients with PS and PsA by evaluating serum total antioxidant status, total oxidant status, oxidative stress index, levels of lipid hydroperoxides, and the activities of paraoxonase, arylesterase, and ceruloplasmin. Also measured were the levels of prolidase and total sulfhydryl groups. A total of 120 participants were divided into six groups of 20 participants: 1) PS with CP (PS-CP); 2) PS-periodontally healthy (PS-C); 3) PsA with CP (PsA-CP); 4) PsA-periodontally healthy (PsA-C); 5) systemically healthy with CP (CP); and 6) both systemically and periodontally healthy (C). Demographic, periodontal, and serum oxidative parameters were evaluated. Oxidative stress index values of PS-C, PS-CP, PsA-C, and PsA-CP groups were approximately twice as high as those of C and CP groups, and there were no differences between any of the PS (PS-C and PS-CP), and PsA (PsA-C and PsA-CP) groups. Total antioxidant status levels of the C group were higher by 27% compared with those of the PS-C and the PsA-CP groups (P <0.05). Total oxidant status levels of both PsA-C and PsA-CP groups were approximately twice as high as those of the C (P <0.05) and CP (P <0.05, P <0.001 respectively) groups. The contribution of CP on systemic oxidative levels in patients with PS and PsA or systemically healthy individuals seems limited. PS and PsA did not show any additional detrimental effect on clinical parameters in patients with CP.

Detection of asymptomatic enthesitis in psoriasis patients: An onset of psoriatic arthritis?

Presence of asymptomatic joint involvement is recognized in patients with psoriasis. However, it remains elusive whether such patients develop psoriatic arthritis (PsA). The aim of the present study was to examine the incidence of asymptomatic joint lesions, in particular, enthesitis in patients with psoriasis vulgaris (PsV) and to further assess the clinical features. Eighteen PsV and 28 PsA patients were enrolled for examination by positron emission tomography/computed tomography (PET/CT) using (18) F-fluorodeoxyglucose (FDG). Any nail, scalp and intergluteal involvements were reported. Levels of serum C-reactive protein (CRP), white blood cell (WBC) counts and erythrocyte sedimentation rate (ESR) were examined. All of the PsA patients showed FDG accumulation in the affected joints. Notably, asymptomatic enthesitis was detected in six out of 18 PsV patients (33%), and they were diagnosed as having subclinical PsA. Incidences of scalp, intergluteal and nail psoriasis in subclinical PsA patients were 100%, 83% and 64%, respectively, which were higher than those in PsV patients (67%, 25% and 40%, respectively). CRP, WBC counts and ESR were invariable between PsV and subclinical PsA groups. PET/CT imaging could discover asymptomatic enthesitis. Our data suggested that the subpopulation of subclinical PsA was much higher than expected. Higher prevalence of nail, scalp and intergluteal psoriasis confirmed the risk of PsA as previously described.

Joint functional impairment and thermal alterations in patients with Psoriatic Arthritis: A thermal imaging study

BackgroundFunctional infrared imaging (fIRI) is used to provide information on circulation, thermal properties and thermoregulatory function of the cutaneous tissue in several clinical settings. ObjectivesThis study aims to evaluate the application of fIRI in Psoriatic Arthritis (PsA) assessment, evaluating the thermoregulatory alterations due to joint inflammation in PsA patients both in basal conditions and after a mild functional (isometric) exercise; fIRI outcomes were compared with those provided by Power Doppler Ultrasonography (PWD-US). Methods10 patients with PsA and 11 healthy controls were enrolled in the study. The cutaneous temperature dynamics of 20 regions of interest located on the dominant hand were recorded by means of high-resolution thermal imaging at baseline and after a functional exercise. ResultsHigher temperature values and faster temperature variations characterized the PsA group compared to healthy controls, confirming that the PsA-related inflammatory state alters the normal thermal proprieties of the skin overlying inflamed joints. fIRI outcomes correlated with the PWD-US findings. ConclusionsfIRI applied to the study of the response to a functional stimulus may represent an innovative, non-invasive, and operator-independent method for the assessment of peripheral PsA.

Vitamin D status in men with psoriatic arthritis: a case-control study.

We determined hypovitaminosis D prevalence in men with psoriatic arthritis. This is a cross-sectional, analyst blinded, age- and sex-matched, case-control study. Men with psoriatic arthritis have significantly lower 25-hydroxyvitamin D levels. Men with psoriatic arthritis are at increased odds of suffering from hypovitaminosis D. Skeletal manifestations as a result of abrupted bone metabolism may be predominant in psoriatic arthritis (PsA). Vitamin D plays a vital role in maintenance of skeletal health and is known to modulate the immune system in various autoimmune diseases including PsA. The aim of the present study was to determine the prevalence of hypovitaminosis D in a treatment naïve, de novo psoriatic arthritis male cohort in a cross-sectional, analyst blinded, age- and sex-matched, case-control study. 25 hydroxyvitamin D (25OHD), parathyroid (PTH), osteocalcin (OC) and C-terminal telopeptides of type-I collagen (CTx) levels, and lumbar spine and femoral neck bone mineral density were compared between 53 PsA and controls. The prevalence of hypovitaminosis D (25 hydroxyvitamin D (25OHD) levels <75nmol/L) was 81 and 57% in the PsA and control groups, respectively. Compared to the healthy controls, 25OHD (67.2 (12-137) nmol/L vs. 51.9 (15-95) nmol/L; p = 0.001) was significantly lower, and osteocalcin (13.6 (5-33) μg/L vs. 18.2 (6-35) μg/L; p = 0.003) and C-terminal telopeptides of type-I collagen (0.20 (0.01-0.71) μg/L vs. 0.28 (0.06-0.69) μg/L; p = 0.008) were significantly higher in the PsA group. A significant association was found between hypovitaminosis D and PsA; the odds for patients with PsA of having hypovitaminosis D was 3.297 (95% confidence interval 1.372 to 7.922). The results of this study suggest that men with PsA have significantly lower 25-hydroxyvitamin D levels, and furthermore, men with PsA are at statistically significant increased odds of suffering from hypovitaminosis D.

THU0088 Fetuin-A and Its Association with Disease Activity in Psoriatic Arthritis

BackgroundIncreased risk of cardiovascular morbidity and mortality has been reported in psoriatic arthritis (PsA), a member of a spondyloarthropathy. Fetuin-A is a novel biomarker related with vascular calcification and atherosclerosis....

AB0673 Effectiveness of TNF Antagonists on the Treatment of Enthesitis

BackgroundThe involvement of the enthesis in the patients with spondyloarthritis (SpA) can be a factor of disability. The efficacy of the TNF antagonists on the SpA activity is well established...

FRI0053 Comparison of the Risk of Developing Comorbities and Adverse Events by Type of Diagnosis: Results from the Lorhen Registry

BackgroundThe relationship between systemic rheumatic diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) and various comorbidities has long been debated, and it has also been...