Axial Involvement in PsA Linked to Higher Psoriasis Risk

Axial involvement in psoriatic arthritis (PsA) is associated with an increased risk of moderate to severe psoriasis, as well as higher disease activity and a greater impact on quality of life, according to the results of a recent study.

To explore the characteristics of patients with PsA with and without axial involvement, the researchers conducted a review of data from participants in the Corrona Psoriatic Arthritis/ Spondyloarthritis Registry.

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All patients had data on axial involvement, defined as physician-reported spinal involvement at enrollment or radiograph or magnetic resonance imaging showing sacroiliitis.

Of the 1530 patients with PsA, 192 (12.5%) had axial involvement. Those with axial involvement were younger and more likely to have enthesitis and history of depression, and more frequently used biologics at enrollment, compared with those who did not have axial involvement.

Patients with axial involvement were also more likely to have moderate to severe psoriasis and significantly worse disease activity, as well as higher nail psoriasis scores, enthesitis counts, Bath Ankylosing Spondylitis Disease Activity Index scores, Bath Ankylosing Spondylitis Functional Index scores, C-reactive protein levels, and scores for physical function, pain, and fatigue.

“Presence of axial involvement was associated with a higher likelihood of moderate/severe psoriasis, with higher disease activity and greater effect on quality of life. These findings highlight the importance of monitoring patients with PsA for signs of axial symptoms or spinal involvement.”

—Michael Potts

Reference:

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 [published online July 2018]. Journal of Rheumatology. DOI: https://doi.org/10.3899/jrheum.171094.