Emre Bilgin1, Sibel Zehra Aydin2, Ilaria Tinazzi3, Özün Bayindir4, Gezmiş Kimyon5, Cem Özişler6, Atalay Doğru7, Ediz Dalkiliç8, Kenan Aksu4, Gözde Yildirim Çetin9, Sema Yilmaz10, Dilek Solmaz11, Ahmet Omma12, Meryem Can13, Orhan Küçükşahin14, Şule Yavuz13, Emine Duygu Ersözlü15, Levent Kiliç1, Emine Figen Tarhan16, Müge Aydin Tufan17, Lütfi Akyol18, Muhammet Çinar19, Abdulsamet Erden12, Emel Gönüllü20, Fatih Yildiz9, Sibel Bakirci2, Funda Erbasan21, Serpil Ergülü Eşmen22, Adem Küçük23, Abdurrahman Tufan24, Ayşe Balkarli25, Rıdvan Mercan26, Şükran Erten12, Servet Akar11, Timuçin Kaşifoğlu27, Tuncay Duruöz28, Veli Yazisiz21, Umut Kalyoncu29. 1. Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey. 2. Division of Rheumatology, Department of Internal Medicine, University of Ottawa School of Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada. 3. Division of Rheumatology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy. 4. Division of Rheumatology, Department of Internal Medicine, Ege University, Izmir, Turkey. 5. Division of Rheumatology, Department of Internal Medicine, Hatay Mustafa Kemal University, Turkey. 6. Division of Rheumatology, Department of Internal Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey. 7. Division of Rheumatology, Department of Internal Medicine, Süleyman Demiral University, Isparta, Turkey. 8. Division of Rheumatology, Department of Internal Medicine, Uludağ University, Bursa, Turkey. 9. Division of Rheumatology, Department of Internal Medicine, Kahramanmaraş Sütçü İmam University, Turkey. 10. Division of Rheumatology, Department of Internal Medicine, Selcuk University, Konya, Turkey. 11. Division of Rheumatology, Department of Internal Medicine, İzmir Katip Çelebi University, Turkey. 12. Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Turkey. 13. Division of Rheumatology, Department of Internal Medicine, Marmara University, Istanbul, Turkey. 14. Division of Rheumatology, Department of Internal Medicine, Yıldırım Beyazıt University, Ankara, Turkey. 15. Adana Numune Training and Research Hospital, Adana, Turkey. 16. Division of Rheumatology, Department of Internal Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey. 17. Division of Rheumatology, Department of Internal Medicine, Başkent University, Ankara, Turkey. 18. Diyarbakır Training and Research Hospital, Diyarbakır, Turkey. 19. Division of Rheumatology, Department of Internal Medicine, Gülhane Training and Research Hospital, Ankara, Turkey. 20. Division of Rheumatology, Department of Internal Medicine, Sakarya University, Sakarya, Turkey. 21. Division of Rheumatology, Department of Internal Medicine, Akdeniz University, Antalya, Turkey. 22. Division of Rheumatology, Department of Internal Medicine, Konya Education and Research Hospital, Turkey. 23. Division of Rheumatology, Department of Internal Medicine, Necmettin Erbakan University, Konya, Turkey. 24. Division of Rheumatology, Department of Internal Medicine, Gazi University, Ankara, Turkey. 25. Antalya Training and Research Hospital, Antalya, Turkey. 26. Division of Rheumatology, Department of Internal Medicine, Namık Kemal University, Tekirdağ, Turkey. 27. Division of Rheumatology, Department of Internal Medicine, Eskişehir Osman Gazi University, Konya, Turkey. 28. Department of Physical Medicine and Rehabilitation, Marmara University, Istanbul, Turkey. 29. Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey. umut.kalyoncu@yahoo.com.
Abstract
OBJECTIVES: To explore the impact of early versus late-onset psoriasis (PsO) on the disease characteristics of psoriatic arthritis (PsA) in a large-multicentre cohort. METHODS: The data from a multicentre psoriatic arthritis database was analysed. Patients were grouped according to age at psoriasis onset (early onset; <40 years of age, late-onset; >40 years of age) and disease characteristics of the groups were compared by adjusting for BMI and PsA duration, where necessary. RESULTS: At the time of analyses, 1634 patients were recruited [62.8% females; early onset 1108 (67.8%); late-onset, 526 (32.2%)]. The late-onset group was more over-weight [66.8% vs. 86.8%, p<0.001; adjusted for age - aOR 1.55 (1.11-2.20; 95% CI)]. The early onset group had more scalp psoriasis at onset (56.7% vs. 43.0%, p<0.001), whereas extremity lesions were more common in the late-onset group (63.8% vs. 74.2%, p<0.001). Axial disease in males and psoriatic disease family history in females were significantly higher in the early onset group [38.0% vs. 25.4%; p=0.005; adjusted for PsA duration - aOR 1.76 (1.19-2.62; 95% CI) / 39.5% vs. 30.1%; p=0.003; OR 1.51 (1.15-1.99; 95% CI), respectively]. Psoriatic disease activity parameters, patient-physician reported outcomes and HAQ-DI scores were similar in both groups. CONCLUSIONS: Clinical features of PsA may be affected by the age at onset of PsO. Different genetic backgrounds in early and late-onset PsO may be driving the differences in psoriasis and PsA phenotypes.
OBJECTIVES: To explore the impact of early versus late-onset psoriasis (PsO) on the disease characteristics of psoriatic arthritis (PsA) in a large-multicentre cohort. METHODS: The data from a multicentre psoriatic arthritis database was analysed. Patients were grouped according to age at psoriasis onset (early onset; <40 years of age, late-onset; >40 years of age) and disease characteristics of the groups were compared by adjusting for BMI and PsA duration, where necessary. RESULTS: At the time of analyses, 1634 patients were recruited [62.8% females; early onset 1108 (67.8%); late-onset, 526 (32.2%)]. The late-onset group was more over-weight [66.8% vs. 86.8%, p<0.001; adjusted for age - aOR 1.55 (1.11-2.20; 95% CI)]. The early onset group had more scalp psoriasis at onset (56.7% vs. 43.0%, p<0.001), whereas extremity lesions were more common in the late-onset group (63.8% vs. 74.2%, p<0.001). Axial disease in males and psoriatic disease family history in females were significantly higher in the early onset group [38.0% vs. 25.4%; p=0.005; adjusted for PsA duration - aOR 1.76 (1.19-2.62; 95% CI) / 39.5% vs. 30.1%; p=0.003; OR 1.51 (1.15-1.99; 95% CI), respectively]. Psoriatic disease activity parameters, patient-physician reported outcomes and HAQ-DI scores were similar in both groups. CONCLUSIONS: Clinical features of PsA may be affected by the age at onset of PsO. Different genetic backgrounds in early and late-onset PsO may be driving the differences in psoriasis and PsA phenotypes.