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Psoriatic Spondyloarthritis

Commonalities between Psoriatic Spondyloarthritis and Ankylosing Spondylitis

Psoriatic spondyloarthritis (PsSpA) refers to spondyloarthritis (SpA) that accompanies psoriasis. Spondyloarthritis (SpA) is generally made up of a range of rheumatic disorders that share common clinical features; typical musculoskeletal symptoms are divided into peripheral (arthritis, enthesitis, dactylitis) or axial (sacroiliitis, spondylitis) disease. There are few studies that compare the clinical characteristics of PsSpA, psoriatic arthritis (PsA), and ankylosing spondylitis (AS).

A recent study sought to determine the prevalence of PsSpA in a spondyloarthritis (PsA and AS) cohort and compared the clinical and radiographic axial characteristics of PsSpA with both PsA and AS. The study was a prospective single-center cross-sectional observational study, conducted at a teaching hospital with dedicated PsA and AS clinics. Participants completed several patient-reported outcome scales, and were interviewed by a rheumatologist to gather history of symptoms including, inflammatory axial symptoms, dactylitis, peripheral enthesitis, chest wall pain, uveitis and inflammatory bowel disease (IBD). Participants were further evaluated by a rheumatologist using several clinical examination indices. The most recent axial radiographs of all participants were also scored. The results showed that a significant proportion of patients with radiographic axial disease had PsSpA. Disease activity, metrology and disability were comparable in PsSpA and AS. The authors conclude that in a combined cohort of patients with either PsA or AS from a single center, 24% fulfilled classification criteria for both conditions. The results also indicate that PsSpA forms part of the SpA spectrum, flanked by PsA and AS. Using clinical indices of disease activity, PsSpA has a similar disease burden as AS, despite being less severe radiographically.

 

Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: March 20, 2017

Source: Annals of Rheumatic Diseases
Adapted from the original article.

[Image: DermNet New Zealand]