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Characteristics of patients with psoriatic arthritis in Korea: focusing on axial involvement

  • Hanna Park (Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Ji Hyun Lee (Department of Dermatology, College of Medicine, The Catholic University of Korea) ;
  • Seung-Ki Kwok (Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Ji Hyeon Ju (Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Wan-Uk Kim (Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Sung-Hwan Park (Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jennifer Jooha Lee (Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • Received : 2023.01.29
  • Accepted : 2023.07.03
  • Published : 2024.01.01

Abstract

Background/Aims: We aimed to clarify the clinical characteristics of psoriatic arthritis (PsA) in Korean patients focusing on PsA with axial involvement. Methods: A retrospective medical chart review was performed to identify PsA patients at a single tertiary center. Cases of AS patients with psoriasis were recruited from a prospective AS registry of the same center. Demographics, laboratory findings, and radiologic characteristics were assessed. Results: A total of 69 PsA patients were identified. In PsA patients, spondylitis (46.4%) was the most common form. Compared to AS patients with psoriasis, PsA patients with radiographic axial involvement were older (50.9 vs. 32.4 years; p < 0.001) and showed greater peripheral disease activity (peripheral arthritis 78.1 vs. 12.5%, p < 0.001; enthesitis 50.0 vs. 6.3%, p = 0.003). AS patients with psoriasis presented a higher rate of HLA-B*27 positivity (81.3 vs. 17.2%; p < 0.001) and a more frequent history of inflammatory back pain (100.0 vs. 75.0%; p = 0.039) than PsA patients with radiographic axial involvement. Significant proportions of PsA patients with radiographic axial involvement had cervical spine involvement (10/18, 55.6%) and spondylitis without sacroiliitis (10/23, 43.5%). Conclusions: We demonstrate that axial involvement is common in Korean PsA patients, and its characteristics can be distinct from those of AS.

Keywords

Acknowledgement

This work was supported by the Catholic Medical Center Research Foundation made in the program year of 2018 and the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (NRF-2022R1F1A1067358).

References

  1. Moll JM, Wright V. Psoriatic arthritis. Semin Arthritis Rheum 1973;3:55-78. https://doi.org/10.1016/0049-0172(73)90035-8
  2. Yap KS, Ye JY, Li S, Gladman DD, Chandran V. Back pain in psoriatic arthritis: defining prevalence, characteristics and performance of inflammatory back pain criteria in psoriatic arthritis. Ann Rheum Dis 2018;77:1573-1577. https://doi.org/10.1136/annrheumdis-2018-213334
  3. Helliwell PS, Porter G, Taylor WJ; CASPAR Study Group. Polyarticular psoriatic arthritis is more like oligoarticular psoriatic arthritis, than rheumatoid arthritis. Ann Rheum Dis 2007;66:113-117. https://doi.org/10.1136/ard.2006.054288
  4. Gladman DD, Ye JY, Chandran V, Lee KA, Cook RJ. Oligoarticular vs polyarticular psoriatic arthritis: a longitudinal study showing similar characteristics. J Rheumatol 2021;48:1824-1829. https://doi.org/10.3899/jrheum.210434
  5. McInnes IB, Anderson JK, Magrey M, et al. Trial of upadacitinib and adalimumab for psoriatic arthritis. N Engl J Med 2021;384:1227-1239. https://doi.org/10.1056/NEJMoa2022516
  6. Baraliakos X, Gossec L, Pournara E, et al. Secukinumab in patients with psoriatic arthritis and axial manifestations: results from the double-blind, randomised, phase 3 MAXIMISE trial. Ann Rheum Dis 2021;80:582-590. https://doi.org/10.1136/annrheumdis-2020-218808
  7. Shin D, Kim HJ, Kim DS, et al. Clinical features of psoriatic arthritis in Korean patients with psoriasis: a cross-sectional observational study of 196 patients with psoriasis using psoriatic arthritis screening questionnaires. Rheumatol Int 2016;36:207-212. https://doi.org/10.1007/s00296-015-3365-3
  8. Baek HJ, Yoo CD, Shin KC, et al. Spondylitis is the most common pattern of psoriatic arthritis in Korea. Rheumatol Int 2000;19:89-94. https://doi.org/10.1007/s002960050109
  9. Choi HJ, Lee YJ, Park JJ, et al. Clinical features of Korean patients with psoriatic arthritis. Korean J Med 2008;74:418-425.
  10. Veale DJ, Fearon U. The pathogenesis of psoriatic arthritis. Lancet 2018;391:2273-2284. https://doi.org/10.1016/S0140-6736(18)30830-4
  11. Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H; CASPAR Study Group. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006;54:2665-2673. https://doi.org/10.1002/art.21972
  12. Feld J, Chandran V, Haroon N, Inman R, Gladman D. Axial disease in psoriatic arthritis and ankylosing spondylitis: a critical comparison. Nat Rev Rheumatol 2018;14:363-371. https://doi.org/10.1038/s41584-018-0006-8
  13. Helliwell PS. Axial disease in psoriatic arthritis. Rheumatology (Oxford) 2020;59:1193-1195. https://doi.org/10.1093/rheumatology/kez629
  14. van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 1984;27:361-368. https://doi.org/10.1002/art.1780270401
  15. van der Heijde D, Braun J, Deodhar A, et al. Modified stoke ankylosing spondylitis spinal score as an outcome measure to assess the impact of treatment on structural progression in ankylosing spondylitis. Rheumatology (Oxford) 2019;58:388-400. https://doi.org/10.1093/rheumatology/key128
  16. Helliwell P, Marchesoni A, Peters M, Barker M, Wright V. A re-evaluation of the osteoarticular manifestations of psoriasis. Br J Rheumatol 1991;30:339-345. https://doi.org/10.1093/rheumatology/30.5.339
  17. Tsai YG, Chang DM, Kuo SY, Wang WM, Chen YC, Lai JH. Relationship between human lymphocyte antigen-B27 and clinical features of psoriatic arthritis. J Microbiol Immunol Infect 2003;36:101-104.
  18. Aydin SZ, Kucuksahin O, Kilic L, et al. Axial psoriatic arthritis: the impact of underdiagnosed disease on outcomes in real life. Clin Rheumatol 2018;37:3443-3448. https://doi.org/10.1007/s10067-018-4173-4
  19. Hanly JG, Russell ML, Gladman DD. Psoriatic spondyloarthropathy: a long term prospective study. Ann Rheum Dis 1988;47:386-393. https://doi.org/10.1136/ard.47.5.386
  20. Battistone MJ, Manaster BJ, Reda DJ, Clegg DO. The prevalence of sacroilitis in psoriatic arthritis: new perspectives from a large, multicenter cohort. A Department of Veterans Affairs Cooperative Study. Skeletal Radiol 1999;28:196-201. https://doi.org/10.1007/s002560050500
  21. Taylor WJ, Zmierczak HG, Helliwell PS. Problems with the definition of axial and peripheral disease patterns in psoriatic arthritis. J Rheumatol 2005;32:974-977.
  22. Mease PJ, Palmer JB, Liu M, et al. Influence of axial involvement on clinical characteristics of psoriatic arthritis: analysis from the corrona psoriatic arthritis/spondyloarthritis registry. J Rheumatol 2018;45:1389-1396. https://doi.org/10.3899/jrheum.171094
  23. Jadon DR, Sengupta R, Nightingale A, et al. Axial Disease in Psoriatic Arthritis study: defining the clinical and radiographic phenotype of psoriatic spondyloarthritis. Ann Rheum Dis 2017;76:701-707. https://doi.org/10.1136/annrheumdis-2016-209853
  24. Chandran V, Bull SB, Pellett FJ, Ayearst R, Rahman P, Gladman DD. Human leukocyte antigen alleles and susceptibility to psoriatic arthritis. Hum Immunol 2013;74:1333-1338. https://doi.org/10.1016/j.humimm.2013.07.014
  25. Machado P, Landewe R, Braun J, et al. Ankylosing spondylitis patients with and without psoriasis do not differ in disease phenotype. Ann Rheum Dis 2013;72:1104-1107. https://doi.org/10.1136/annrheumdis-2012-202922
  26. Perez Alamino R, Maldonado Cocco JA, Citera G, et al.; RESPONDIA Group. Differential features between primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease. J Rheumatol 2011;38:1656-1660. https://doi.org/10.3899/jrheum.101049
  27. Bengtsson K, Forsblad-d'Elia H, Deminger A, et al. Incidence of extra-articular manifestations in ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis: results from a national register-based cohort study. Rheumatology (Oxford) 2021;60:2725-2734. https://doi.org/10.1093/rheumatology/keaa692
  28. Gladman DD. Axial disease in psoriatic arthritis. Curr Rheumatol Rep 2007;9:455-460. https://doi.org/10.1007/s11926-007-0074-2
  29. Gladman DD, Brubacher B, Buskila D, Langevitz P, Farewell VT. Differences in the expression of spondyloarthropathy: a comparison between ankylosing spondylitis and psoriatic arthritis. Clin Invest Med 1993;16:1-7.
  30. Turkiewicz AM, Moreland LW. Psoriatic arthritis: current concepts on pathogenesis-oriented therapeutic options. Arthritis Rheum 2007;56:1051-1066. https://doi.org/10.1002/art.22489
  31. Coates LC, Kavanaugh A, Mease PJ, et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheumatol 2016;68:1060-1071. https://doi.org/10.1002/art.39573
  32. Gossec L, Baraliakos X, Kerschbaumer A, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis 2020;79:700-712. https://doi.org/10.1136/annrheumdis-2020-217163
  33. Fernandez-Sueiro JL, Willisch A, Pertega-Diaz S, et al. Validity of the bath ankylosing spondylitis disease activity index for the evaluation of disease activity in axial psoriatic arthritis. Arthritis Care Res (Hoboken) 2010;62:78-85. https://doi.org/10.1002/acr.20017
  34. Biagioni BJ, Gladman DD, Cook RJ, et al. Reliability of radiographic scoring methods in axial psoriatic arthritis. Arthritis Care Res (Hoboken) 2014;66:1417-1422. https://doi.org/10.1002/acr.22308