David Simon1,2, Koray Tascilar1,2, Arnd Kleyer1,2, Sara Bayat1,2, Eleni Kampylafka1,2, Maria V Sokolova1,2, Ana Zekovic3, Axel J Hueber4, Jürgen Rech1,2, Louis Schuster1,2, Klaus Engel5, Michael Sticherling6,2, Georg Schett1,2. 1. Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany. 2. Deutsches Zentrum Immuntherapie, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany. 3. Department of Rheumatology, University of Belgrade, Belgrade, Serbia. 4. Sozialstiftung Bamberg, Bamberg, Germany. 5. Siemens Healthineers, Erlangen, Germany. 6. Department of Dermatology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.
Abstract
OBJECTIVE: To test whether the presence of structural entheseal lesions in psoriasis patients influences the risk of progression to psoriatic arthritis (PsA). METHODS: We conducted a prospective cohort study of psoriasis patients without clinical evidence of musculoskeletal involvement who underwent baseline assessment of structural entheseal lesions and volumetric bone mineral density (vBMD) at entheseal and intraarticular sites by high-resolution peripheral quantitative computed tomography. Adjusted relative risks of developing PsA associated with baseline vBMD and the presence of structural entheseal lesions were calculated using multivariable Cox regression models. RESULTS: The cohort included 114 psoriasis patients (72 men and 42 women) with a mean ± SD follow-up duration of 28.2 ± 17.7 months, during which 24 patients developed PsA (9.7 per 100 patient-years [95% confidence interval (95% CI) 6.2-14.5]). Patients with structural entheseal lesions were at higher risk of developing PsA compared to patients without such lesions (21.4 per 100 patient-years [95% CI 12.5-34.3]; hazard ratio [HR] 5.10 [95% CI 1.53-16.99], P = 0.008). With respect to vBMD, a 1-SD increase in entheseal, but not intraarticular, vBMD was associated with an ~30% reduced risk of progression to PsA. Especially, higher cortical vBMD at entheseal segments was associated with a lower risk of developing PsA (HR 0.32 per 1 SD [95% CI 0.14-0.71]), and the association remained robust after multiple imputation of missing data (HR 0.64 [95% CI 0.42-0.98]). CONCLUSION: The presence of structural entheseal lesions as well as low cortical vBMD at entheseal segments are associated with an increased risk of developing PsA in patients with psoriasis.
OBJECTIVE: To test whether the presence of structural entheseal lesions in psoriasis patients influences the risk of progression to psoriatic arthritis (PsA). METHODS: We conducted a prospective cohort study of psoriasis patients without clinical evidence of musculoskeletal involvement who underwent baseline assessment of structural entheseal lesions and volumetric bone mineral density (vBMD) at entheseal and intraarticular sites by high-resolution peripheral quantitative computed tomography. Adjusted relative risks of developing PsA associated with baseline vBMD and the presence of structural entheseal lesions were calculated using multivariable Cox regression models. RESULTS: The cohort included 114 psoriasis patients (72 men and 42 women) with a mean ± SD follow-up duration of 28.2 ± 17.7 months, during which 24 patients developed PsA (9.7 per 100 patient-years [95% confidence interval (95% CI) 6.2-14.5]). Patients with structural entheseal lesions were at higher risk of developing PsA compared to patients without such lesions (21.4 per 100 patient-years [95% CI 12.5-34.3]; hazard ratio [HR] 5.10 [95% CI 1.53-16.99], P = 0.008). With respect to vBMD, a 1-SD increase in entheseal, but not intraarticular, vBMD was associated with an ~30% reduced risk of progression to PsA. Especially, higher cortical vBMD at entheseal segments was associated with a lower risk of developing PsA (HR 0.32 per 1 SD [95% CI 0.14-0.71]), and the association remained robust after multiple imputation of missing data (HR 0.64 [95% CI 0.42-0.98]). CONCLUSION: The presence of structural entheseal lesions as well as low cortical vBMD at entheseal segments are associated with an increased risk of developing PsA in patients with psoriasis.
Authors: Peter A Nigrovic; Robert A Colbert; V Michael Holers; Seza Ozen; Nicolino Ruperto; Susan D Thompson; Lucy R Wedderburn; Rae S M Yeung; Alberto Martini Journal: Nat Rev Rheumatol Date: 2021-03-17 Impact factor: 20.543
Authors: Lourdes M Perez-Chada; Rebecca H Haberman; Joseph F Merola; Jose U Scher; Vinod Chandran; Cheryl F Rosen; Christopher Ritchlin; Lihi Eder; Philip Mease; Soumya Reddy; Alexis Ogdie Journal: Nat Rev Rheumatol Date: 2021-02-15 Impact factor: 20.543
Authors: Alen Zabotti; Orazio De Lucia; Garifallia Sakellariou; Alberto Batticciotto; Gilberto Cincinelli; Ivan Giovannini; Luca Idolazzi; Gabriella Maioli; Ilaria Tinazzi; Daniel Aletaha; Salvatore De Vita; Antonio Marchesoni; Josef Smolen; Annamaria Iagnocco; Dennis McGonagle; Roberto Caporali Journal: Rheumatol Ther Date: 2021-10-01
Authors: Paolo Gisondi; Francesco Bellinato; Martina Maurelli; Davide Geat; Alen Zabotti; Dennis McGonagle; Giampiero Girolomoni Journal: Psoriasis (Auckl) Date: 2022-08-10
Authors: Anna-Maria Liphardt; Eva Manger; Sonja Liehr; Lisa Bieniek; Arnd Kleyer; David Simon; Koray Tascilar; Michael Sticherling; Jürgen Rech; Georg Schett; Axel J Hueber Journal: ACR Open Rheumatol Date: 2020-11-25