학술논문
Risk of developing psoriatic arthritis in psoriasis cohorts with arthralgia: exploring the subclinical psoriatic arthritis stage.
Document Type
Academic Journal
Author
Zabotti A; Department of Medical and Biological Sciences, Rheumatology Clinic, University Hospital Santa Maria della Misericordia, Udine, Italy zabottialen@gmail.com.; Fagni F; Department of Internal Medicine, Rheumatology and Immunology, University of Erlangen, Erlangen, Germany.; Gossec L; INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universite, Paris, France.; APHP, Department of Rheumatology, Hopital Universitaire Pitie Salpetriere, Paris, France.; Giovannini I; Department of Medical and Biological Sciences, Rheumatology Clinic, University Hospital Santa Maria della Misericordia, Udine, Italy.; Sticherling M; Department of Dermatology, University of Leipzig, Leipzig, Germany.; Department of Dermatology, University Hospital Erlangen, Erlangen, Germany.; Tullio A; Department of Medical and Biological Sciences, Rheumatology Clinic, University Hospital Santa Maria della Misericordia, Udine, Italy.; Baraliakos X; Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany.; De Marco G; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.; De Vita S; Department of Medical and Biological Sciences, Rheumatology Clinic, University Hospital Santa Maria della Misericordia, Udine, Italy.; Errichetti E; Department of Medical and Biological Sciences University Hospital 'Santa Maria della Misericordia', Institute of Dermatology, Udine, Italy.; Quartuccio L; Department of Medical and Biological Sciences, Rheumatology Clinic, University Hospital Santa Maria della Misericordia, Udine, Italy.; Silvagni E; Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliero-Universitaria S Anna, Ferrara, Italy.; Smolen JS; Medical University of Vienna, Vienna, Austria.; Tinazzi I; Unit of Rheumatology, 'Sacro Cuore' Hospital, Negrar, Italy.; Watad A; Internal Medicine, Sheba Medical Center at Tel Hashomer, Tel Hashomer, Israel.; Schett G; Department of Internal Medicine, Rheumatology and Immunology, University of Erlangen, Erlangen, Germany.; McGonagle DG; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.; Simon D; Department of Internal Medicine, Rheumatology and Immunology, University of Erlangen, Erlangen, Germany.
Source
Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101662038 Publication Model: Electronic Cited Medium: Internet ISSN: 2056-5933 (Electronic) Linking ISSN: 20565933 NLM ISO Abbreviation: RMD Open Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: Subjects with subclinical psoriatic arthritis (PsA), defined as the presence of arthralgia in psoriasis (PsO), are at higher risk of PsA but scant real-world data exist. Our aims were to (1) estimate the probability of PsA development in subclinical PsA, (2) characterise subclinical PsA symptoms and (3) determine the clinical patterns at PsA diagnosis.
Methods: Patients with PsO, mainly subclinical PsA, were evaluated longitudinally in two European cohorts. The key outcome was new-onset PsA. Musculoskeletal symptoms including inflammatory and non-inflammatory symptoms before PsA diagnosis were collected. Occurrence of PsA was analysed with survival analysis and cumulative incidence functions (CIFs).
Results: 384 patients with PsO were included with a mean follow-up of 33.0 (±20.9) months. 311 of 384 (80.9%) had subclinical PsA with a PsA incidence rate of 7.7 per 100 patient-years. Subclinical PsA displayed a higher risk of PsA development compared with PsO (HR=11.7 (95% CI 1.57 to 86.7), p=0.016). The probability of new-onset PsA estimated by the CIF was 9.4% (95% CI 4.7% to 10.6%) at month 12 and 22.7% (95% CI 17.2% to 28.6%) at month 36. 58.9% of cases reported inflammatory symptoms in the months immediately prior to PsA diagnosis but prior non-inflammatory symptoms were evident in 83.9% prior to PsA diagnosis. Peripheral joint swelling was the predominant PsA presentation pattern (82.1%).
Conclusions: The probability of PsA development among subclinical PsA was relatively high, emphasising the importance of emergent musculoskeletal symptoms when aiming for PsA prevention. Joint swelling was the dominant feature in new-onset PsA, likely reflecting clinical confidence in recognising joint swelling.
Competing Interests: Competing interests: AZ—speakers bureau: AbbVie, Novartis, Janssen, Lilly, UCB, Amgen; paid instructor for: AbbVie, Novartis, UCB. FF—none declared. LG—consultant of: AbbVie, Amgen, BMS, Celltrion, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB; grant/research support from: Sandoz, UCB. IG—none declared. MS—none declared. AT—none declared. XB—speakers bureau: AbbVie, BMS, MSD, Sandoz, Novartis, Pfizer, Galapagos, UCB, Lilly; paid instructor for: AbbVie, BMS, MSD, Sandoz, Novartis, Pfizer, Galapagos, UCB, Lilly; consultant of: AbbVie, BMS, MSD, Sandoz, Novartis, Pfizer, Galapagos, UCB, Lilly; grant/research support from: AbbVie, MSD, Novartis; leadership or fiduciary role in other board, society, committee or advocacy groups, paid or unpaid; editorial board member of Annals of Rheumatic Diseases; ASAS president. GDM—none declared. SDV—none declared. EE—consultant of: AbbVie, Janssen, Novartis, Amgen. LQ—none declared. ES—none declared. JSS—consulting fees: AbbVie, Galapagos/Gilead, Novartis-Sandoz, BMS, Samsung Sanofi, Chugai R-Pharma, Lilly; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: Samsung, Lilly, R-Pharma, Chugai, MSD, Janssen Novartis-Sandoz; editor-in-chief of Annals of Rheumatic Diseases. IT—none declared. AW—none declared. GS—none declared. DGM—speakers bureau: AbbVie, Celgene, Janssen, Merck, Novartis, Pfizer, UCB; consultant of: AbbVie, Celgene, Janssen, Merck, Novartis, Pfizer, UCB; grant/research support from: AbbVie, Celgene, Janssen, Merck, Novartis, Pfizer. DS—none declared.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Methods: Patients with PsO, mainly subclinical PsA, were evaluated longitudinally in two European cohorts. The key outcome was new-onset PsA. Musculoskeletal symptoms including inflammatory and non-inflammatory symptoms before PsA diagnosis were collected. Occurrence of PsA was analysed with survival analysis and cumulative incidence functions (CIFs).
Results: 384 patients with PsO were included with a mean follow-up of 33.0 (±20.9) months. 311 of 384 (80.9%) had subclinical PsA with a PsA incidence rate of 7.7 per 100 patient-years. Subclinical PsA displayed a higher risk of PsA development compared with PsO (HR=11.7 (95% CI 1.57 to 86.7), p=0.016). The probability of new-onset PsA estimated by the CIF was 9.4% (95% CI 4.7% to 10.6%) at month 12 and 22.7% (95% CI 17.2% to 28.6%) at month 36. 58.9% of cases reported inflammatory symptoms in the months immediately prior to PsA diagnosis but prior non-inflammatory symptoms were evident in 83.9% prior to PsA diagnosis. Peripheral joint swelling was the predominant PsA presentation pattern (82.1%).
Conclusions: The probability of PsA development among subclinical PsA was relatively high, emphasising the importance of emergent musculoskeletal symptoms when aiming for PsA prevention. Joint swelling was the dominant feature in new-onset PsA, likely reflecting clinical confidence in recognising joint swelling.
Competing Interests: Competing interests: AZ—speakers bureau: AbbVie, Novartis, Janssen, Lilly, UCB, Amgen; paid instructor for: AbbVie, Novartis, UCB. FF—none declared. LG—consultant of: AbbVie, Amgen, BMS, Celltrion, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB; grant/research support from: Sandoz, UCB. IG—none declared. MS—none declared. AT—none declared. XB—speakers bureau: AbbVie, BMS, MSD, Sandoz, Novartis, Pfizer, Galapagos, UCB, Lilly; paid instructor for: AbbVie, BMS, MSD, Sandoz, Novartis, Pfizer, Galapagos, UCB, Lilly; consultant of: AbbVie, BMS, MSD, Sandoz, Novartis, Pfizer, Galapagos, UCB, Lilly; grant/research support from: AbbVie, MSD, Novartis; leadership or fiduciary role in other board, society, committee or advocacy groups, paid or unpaid; editorial board member of Annals of Rheumatic Diseases; ASAS president. GDM—none declared. SDV—none declared. EE—consultant of: AbbVie, Janssen, Novartis, Amgen. LQ—none declared. ES—none declared. JSS—consulting fees: AbbVie, Galapagos/Gilead, Novartis-Sandoz, BMS, Samsung Sanofi, Chugai R-Pharma, Lilly; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: Samsung, Lilly, R-Pharma, Chugai, MSD, Janssen Novartis-Sandoz; editor-in-chief of Annals of Rheumatic Diseases. IT—none declared. AW—none declared. GS—none declared. DGM—speakers bureau: AbbVie, Celgene, Janssen, Merck, Novartis, Pfizer, UCB; consultant of: AbbVie, Celgene, Janssen, Merck, Novartis, Pfizer, UCB; grant/research support from: AbbVie, Celgene, Janssen, Merck, Novartis, Pfizer. DS—none declared.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)