Association of Structural Entheseal Lesions With an Increased Risk of Progression From Psoriasis to Psoriatic Arthritis.
Journal
Arthritis & rheumatology (Hoboken, N.J.)
ISSN: 2326-5205
Titre abrégé: Arthritis Rheumatol
Pays: United States
ID NLM: 101623795
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
revised:
30
12
2019
received:
03
10
2019
accepted:
20
02
2020
pubmed:
28
2
2020
medline:
19
2
2022
entrez:
28
2
2020
Statut:
ppublish
Résumé
To test whether the presence of structural entheseal lesions in psoriasis patients influences the risk of progression to psoriatic arthritis (PsA). 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. 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]). 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.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
253-262Subventions
Organisme : BMBF
ID : MASCARA
Organisme : Deutsche Forschungsgemeinschaft
ID : CRC1181 Checkpoints for Resolution of Inflammation
Organisme : Deutsche Forschungsgemeinschaft
ID : DFG FOR 2886
Organisme : Else Kröner-Fresenius Foundation
ID : Else Kröner Memorial Scholarship
Organisme : ERC Synergy grant
ID : 4D Nanoscope
Organisme : Partner Fellowship Program
ID : Dr. Zekovic
Organisme : Friedrich-Alexander University Erlangen-Nuremberg
ID : Emerging Fields Initiative MIRACLE
Organisme : Innovative Medicines Initiative
ID : HIPPOCRATES
Informations de copyright
© 2021 The Authors. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.
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