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Boczar KE, Beanlands RS, Glassman SJ, Wang J, Zeng W, deKemp RA, Ward NC, Fehlmann CA, Wells GA, Karsh J, Dwivedi G. Anti-inflammatory effect of biologic therapy in patients with psoriatic disease: A prospective cohort FDG PET study. J Nucl Cardiol 2023; 30:1642-1652. [PMID: 36754934 PMCID: PMC10372102 DOI: 10.1007/s12350-023-03204-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/07/2022] [Indexed: 02/10/2023]
Abstract
AIM The aim of the study was to evaluate the changes in central vascular inflammation measured by FDG PET and myocardial blood flow reserve (MFR) determined by 82Rb PET following therapy with biologic agents for 6 months in patients with psoriatic arthritis (PsA) and/or cutaneous psoriasis (PsO) (group 1) and compare with PsO subjects receiving non-biologic therapy (group 2) and controls (group 3). METHODS AND RESULTS Target-to-background ratio (TBR) by FDG PET in the most diseased segment of the ascending aorta (TBRmax) was measured to assess vascular inflammation. 82Rb PET studies were used to assess changes in left ventricular MFR. A total of 34 participants were enrolled in the study (11 in group 1, 13 in group 2, and 10 controls). A significant drop in the thoracic aorta uptake was observed in the biologic-treated group (ΔTBRmax: - .46 ± .55) compared to the PsO group treated with non-biologic therapy (ΔTBRmax: .23 ± .67). Those showing response to biologic agents maintained MFR compared to who showed no response. CONCLUSION In a cohort of psoriasis patients treated with biologics, FDG uptake in the thoracic aorta decreased over the study period. Patients who demonstrated a significant anti-inflammatory response on FDG PET imaging maintained their MFR compared to non-responders.
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Affiliation(s)
- Kevin E Boczar
- University of Ottawa Heart Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa, Ottawa, ON, Canada
- Division of Cardiology, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Jerry Wang
- University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Wanzhen Zeng
- University of Ottawa Heart Institute, Ottawa, ON, Canada
- University of Ottawa, Ottawa, ON, Canada
| | | | - Natalie C Ward
- School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Christophe A Fehlmann
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Division of Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - George A Wells
- University of Ottawa Heart Institute, Ottawa, ON, Canada
- Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Jacob Karsh
- Division of Rheumatology, The Ottawa Hospital, Ottawa, ON, Canada
| | - Girish Dwivedi
- University of Ottawa Heart Institute, Ottawa, ON, Canada.
- University of Ottawa, Ottawa, ON, Canada.
- School of Medicine, University of Western Australia, Perth, WA, Australia.
- Department of Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, Murdoch, Australia.
- Department of Cardiology, Fiona Stanley Hospital, Murdoch, WA, Australia.
- School of Biomedical Sciences, Curtin University, Bentley, WA, Australia.
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Madenidou AV, Mavrogeni S, Nikiphorou E. Cardiovascular Disease and Cardiac Imaging in Inflammatory Arthritis. Life (Basel) 2023; 13:life13040909. [PMID: 37109438 PMCID: PMC10143346 DOI: 10.3390/life13040909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/01/2023] Open
Abstract
Cardiovascular morbidity and mortality are more prevalent in inflammatory arthritis (IA) compared to the general population. Recognizing the importance of addressing this issue, the European League Against Rheumatism (EULAR) published guidelines on cardiovascular disease (CVD) risk management in IA in 2016, with plans to update going forward based on the latest emerging evidence. Herein we review the latest evidence on cardiovascular disease in IA, taking a focus on rheumatoid arthritis, psoriatic arthritis, and axial spondylarthritis, reflecting on the scale of the problem and imaging modalities to identify disease. Evidence demonstrates that both traditional CVD factors and inflammation contribute to the higher CVD burden. Whereas CVD has decreased with the newer anti-rheumatic treatments currently available, CVD continues to remain an important comorbidity in IA patients calling for prompt screening and management of CVD and related risk factors. Non-invasive cardiovascular imaging has been attracting much attention in view of the possibility of detecting cardiovascular lesions in IA accurately and promptly, even at the pre-clinical stage. We reflect on imaging modalities to screen for CVD in IA and on the important role of rheumatologists and cardiologists working closely together.
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Panagiotopoulos A, Fragoulis GE. Comorbidities in Psoriatic Arthritis: A Narrative Review. Clin Ther 2023; 45:177-189. [PMID: 36737317 DOI: 10.1016/j.clinthera.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/03/2023] [Accepted: 01/12/2023] [Indexed: 02/05/2023]
Abstract
PURPOSE Psoriatic arthritis (PsA) is a common type of inflammatory arthritis. Patients with PsA present with certain extra-articular manifestations and comorbidities (often collectively called psoriatic disease). The purpose of the present review was to highlight the main comorbidities in the setting of PsA. METHODS A narrative review was performed using data from articles found in a search of PubMed and Scopus using the terms psoriatic arthritis and comorbidities. FINDINGS Cardiovascular disease (CVD), as well as metabolic and mental health disorders, are the most common comorbidities in patients with PsA. In most cases, underlying inflammation seems to be involved in the increased risk for CVD in PsA, while a bidirectional relationship seems to operate between mental health disorders and psoriatic disease. The treatment of patients with PsA, especially with biologic disease-modifying antirheumatic drugs, has been shown to lead to favorable outcomes regarding the CVD risk. However, it is debatable whether specific drug classes are more effective than others or should be avoided in patients with CVD risk factors. Comorbidity of mental health disorders is even more complex, given the difficulties in measuring and reporting these comorbidities in clinical trials and in clinical practice. IMPLICATIONS Future studies are needed for a better understanding of the pathogenic mechanisms of, and the development of better protocols for the identification and treatment of patients with, comorbidities in patients with PsA. The education of clinicians, health care professionals in rheumatology, and patients could be useful in achieving this goal.
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Affiliation(s)
- Alexandros Panagiotopoulos
- Joint Academic Rheumatology Program, First Department of Propedeutic Internal Medicine, University of Athens, Athens, Greece
| | - George E Fragoulis
- Joint Academic Rheumatology Program, First Department of Propedeutic Internal Medicine, University of Athens, Athens, Greece; Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom.
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Effects of Antirheumatic Treatment on Cell Cholesterol Efflux and Loading Capacity of Serum Lipoproteins in Spondylarthropathies. J Clin Med 2022; 11:jcm11247330. [PMID: 36555946 PMCID: PMC9780876 DOI: 10.3390/jcm11247330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Spondyloarthropathies (SpA) are associated with increased cardiovascular risk. Among possible mechanisms is the dysfunction of serum lipoproteins in regulating cell cholesterol homeostasis. Cholesterol efflux capacity (CEC)-the atheroprotective ability of HDL (high density lipoproteins) to accept cholesterol from macrophages-might predict cardiovascular disease independently of HDL-cholesterol levels. We aimed at evaluating modifications of CEC and of the atherogenic cholesterol loading capacity (CLC) of serum lipoproteins in psoriatic arthritis (PsA) and ankylosing spondylitis (AS) following anti-rheumatic treatment. A total of 62 SpA patients (37 PsA and 25 AS) were evaluated before and after treatment with tumor necrosis factor inhibitor and/or methotrexate. CEC and CLC were measured by radioisotopic and fluorometric techniques, respectively. Endothelial function was assessed by finger plethysmography (Endopat). In the whole SpA group, total and HDL-cholesterol increased after treatment, while lipoprotein(a) decreased and CLC was unchanged. Treatment was associated with increased Scavenger Receptor class B type I (SR-BI)-mediated CEC in the AS group. SR-BI- and ABCG1-mediated CEC were negatively associated with inflammatory parameters and positively related to coffee consumption. SR-BI CEC and CLC were positively and negatively associated with endothelial function, respectively. Our pilot study suggests that anti-rheumatic treatment is associated with favorable modulation of lipoprotein quality and function in SpA, particularly in AS, in spite of the induced increase in total cholesterol levels. If confirmed in a larger population, this might represent an atheroprotective benefit beyond what is reflected by conventional serum lipid profile.
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Barbarroja N, Ruiz-Ponce M, Cuesta-López L, Pérez-Sánchez C, López-Pedrera C, Arias-de la Rosa I, Collantes-Estévez E. Nonalcoholic fatty liver disease in inflammatory arthritis: Relationship with cardiovascular risk. Front Immunol 2022; 13:997270. [PMID: 36211332 PMCID: PMC9539434 DOI: 10.3389/fimmu.2022.997270] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
Liver disease is one of the most important causes of morbidity and mortality worldwide whose prevalence is dramatically increasing. The first sign of hepatic damage is inflammation which could be accompanied by the accumulation of fat called non-alcoholic fatty liver disease (NAFLD), causing damage in the hepatocytes. This stage can progress to fibrosis where the accumulation of fibrotic tissue replaces healthy tissue reducing liver function. The next stage is cirrhosis, a late phase of fibrosis where a high percentage of liver tissue has been replaced by fibrotic tissue and liver functionality is substantially impaired. There is a close interplay of cardiovascular disease (CVD) and hepatic alterations, where different mechanisms mediating this relation between the liver and systemic vasculature have been described. In chronic inflammatory diseases such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA), in which the CVD risk is high, hepatic alterations seem to be more prevalent compared to the general population and other rheumatic disorders. The pathogenic mechanisms involved in the development of this comorbidity are still unraveled, although chronic inflammation, autoimmunity, treatments, and metabolic deregulation seem to have an important role. In this review, we will discuss the involvement of liver disease in the cardiovascular risk associated with inflammatory arthritis, the pathogenic mechanisms, and the recognized factors involved. Likewise, monitoring of the liver disease risk in routine clinical practice through both, classical and novel techniques and indexes will be exposed. Finally, we will examine the latest controversies that have been raised about the effects of the current therapies used to control the inflammation in RA and PsA, in the liver damage of those patients, such as methotrexate, leflunomide or biologics.
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The impact of a structured weight-loss treatment on physical fitness in patients with psoriatic arthritis and obesity compared to matched controls: a prospective interventional study. Clin Rheumatol 2022; 41:2745-2754. [PMID: 35648298 PMCID: PMC9474576 DOI: 10.1007/s10067-022-06164-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 11/21/2022]
Abstract
Objectives To evaluate the effects of weight loss treatment on physical fitness in patients with psoriatic arthritis (PsA) and obesity compared to matched controls. Methods In total, 46 patients with PsA (CASPAR) and BMI ≥ 33 kg/m2 and 52 obese persons were included in this 12-month prospective open intervention study with a very low energy diet (640 kcal/day), followed by structured reintroduction of an energy-restricted diet and brief support for physical activity. The primary outcome was muscle strength assessed with hand-grip strength (Grippit) and leg muscle strength (timed stand test). Secondary outcomes were cardiorespiratory fitness, body composition, and physical functioning (SF-36PCS). Outcomes were assessed at baseline, 6 (M6), and 12 months (M12). Nonparametric statistics were used. Results Median weight reduction at M6 was 18.9 kg in patients and 23.0 kg in controls, (p = 0.546). At M12, patients’ median weight loss from baseline was 16.1 kg, corresponding with significant loss of total fat mass (− 30.1%), and lean mass (total − 7.0%, arm − 13.7%, and leg − 6.0%). Leg muscle strength improved in patients and controls at M6 (p < 0.001) and remained improved at M12 (p < 0.01), while hand-grip strength was unchanged in both groups. Cardiorespiratory fitness increased in controls at M6 (p = 0.018) and M12 (p = 0.028) but not in patients. Physical functioning improved in both groups at M6 (p < 0.001) and remained improved at M12 (p = 0.008) and (p < 0.01), respectively. Conclusion The intervention resulted in positive effects on body weight and total body fat. Despite reduced lean body mass, the muscle strength did not deteriorate in patients with PsA and controls. Trial registration ClinicalTrials.gov identifier: NCT02917434, registered on September 21, 2016-retrospectively registered.
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Assessment of autonomic dysfunction with the COMPASS-31 and its relationship with disease activity and cardiovascular risks in patients with psoriatic arthritis. Rheumatol Int 2022; 42:1539-1548. [DOI: 10.1007/s00296-022-05110-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/03/2022] [Indexed: 10/18/2022]
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Urruticoechea-Arana A, Castañeda S, Otón T, Benavent D, Loza E, Martín-Martínez MA, González-Gay MÁ. Prevalence of Metabolic Syndrome in Psoriatic Arthritis: Systematic Literature Review and Results From the CARMA Cohort. J Clin Rheumatol 2022; 28:e388-e396. [PMID: 35192593 DOI: 10.1097/rhu.0000000000001738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To analyze the prevalence of metabolic syndrome (MetS) in patients with psoriatic arthritis (PsA) in a systematic literature review (SLR) and in the Spanish CArdiovascular in RheuMAtology (CARMA) cohort. METHODS A SLR and a subanalysis of the CARMA cohort were performed. In the SLR, PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov up to March 2019 were searched. Systematic literature reviews, clinical trials, and observational studies that analyzed the prevalence or frequency of MetS in PsA were analyzed. Two reviewers selected the articles, assessed the quality of the studies, and collected data, independently. In addition, data on sociodemographic characteristics and MetS in patients with PsA from the CARMA cohort were collected and analyzed. Comparative descriptive analysis was performed. RESULTS The SLR included 18 articles, of moderate to high quality, with PsA patients of both sexes, with mean ages between 42 and 59 years. The rate of MetS varied from 23.5% to 62.9%. The most commonly used classification method was that of the National Cholesterol Education Program. Additionally, 724 PsA patients from the CARMA cohort were analyzed; 327 (45.4%) were women, 157 (21.8%) smokers, with a mean age of 51 years and a mean PsA disease duration of 9 years. Hypertension was the most common abnormal finding (66.8%), followed by hyperglycemia (42.6%) and hypertriglyceridemia (30.6%). Notably, 222 patients (30.6%) had MetS. CONCLUSIONS The prevalence of MetS in PsA varies, depending on the definition. Whereas 23.5% to 62.9% of PsA patients have MetS, in the CARMA cohort almost a third of patients with PsA have MetS.
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Affiliation(s)
| | - Santos Castañeda
- Department of Rheumatology, Hospital Universitario La Princesa, IIS-Princesa, and Cátedra UAM-Roche, EPID-Futuro, Universidad Autónoma de Madrid (UAM)
| | | | - Diego Benavent
- Department of Rheumatology, Hospital Universitario La Paz, IdiPAZ
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Ciaffi J, Mele G, Mancarella L, Brusi V, Lisi L, Faranda Cordella J, Lubrano E, D'Angelo S, Meliconi R, Ursini F. Prevalence of Type 2 and Type 1 Diabetes in Psoriatic Arthritis: An Italian Study. J Clin Rheumatol 2022; 28:e324-e329. [PMID: 35192591 DOI: 10.1097/rhu.0000000000001706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Psoriatic arthritis (PsA) is burdened by an increased susceptibility to cardiovascular diseases. Comorbid diabetes may represent one of the key factors contributing to this risk. The aim of our medical records review study was to investigate the prevalence of type 2 diabetes (T2D) and type 1 diabetes (T1D) in an Italian PsA cohort. METHODS The clinical records of all patients consecutively seen at our clinic with a diagnosis of PsA during a 12-month period were reviewed to identify comorbid T2D or T1D. For comparison, a 1:1 age- and sex-matched group of individuals with noninflammatory diseases was recruited. RESULTS The final study cohort comprised 408 patients. The prevalence of T2D was 7.8% (95% confidence interval, 5.6-10.8) in PsA and 4.4% in controls (95% confidence interval, 2.8-6.9; p = 0.04). Two cases (0.49%) of T1D were identified in the PsA cohort, whereas no cases were observed in controls. In a multivariate logistic regression model including age, disease duration, and body mass index (BMI) as covariates, increasing age (odds ratio [OR], 1.079; p = 0.006) and BMI (OR, 1.188; p = 0.011) but not PsA duration predicted being classified as having T2D. In a similar model accounting for age and BMI, average disease activity score including 28 joints and C-reactive protein showed a trend toward significance (OR, 1.639; p = 0.066). CONCLUSIONS In conclusion, our data provide further support to the emerging evidence of an increased risk of T2D in PsA patients. Cardiometabolic comorbidity represents a significant aspect of integrated arthritis management to improve long-term cardiovascular outcomes and to provide a comprehensive treatment.
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Affiliation(s)
- Jacopo Ciaffi
- From the Medicine and Rheumatology Unit, Dipartimento di Patologie Ortopediche Complesse
| | - Giulio Mele
- From the Medicine and Rheumatology Unit, Dipartimento di Patologie Ortopediche Complesse
| | - Luana Mancarella
- From the Medicine and Rheumatology Unit, Dipartimento di Patologie Ortopediche Complesse
| | - Veronica Brusi
- From the Medicine and Rheumatology Unit, Dipartimento di Patologie Ortopediche Complesse
| | - Lucia Lisi
- From the Medicine and Rheumatology Unit, Dipartimento di Patologie Ortopediche Complesse
| | | | - Ennio Lubrano
- Academic Rheumatology Unit, Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio," Università degli Studi del Molise, Campobasso
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Aljohani R. Metabolic Syndrome and Its Components in Psoriatic Arthritis. Open Access Rheumatol 2022; 14:7-16. [PMID: 35210876 PMCID: PMC8860394 DOI: 10.2147/oarrr.s347797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/05/2022] [Indexed: 11/23/2022] Open
Abstract
Psoriatic arthritis (PsA) is a well-known inflammatory disorder with a wide variety of phenotypes that extend beyond the joints. It has been defined as an immune-mediated disorder in which Th-1 and Th-17 cells play a key role. It has been associated with an elevated risk of metabolic syndrome (MetS), which is characterized by abdominal obesity, hypertension, hyperglycemia, and hyperlipidemia. While the exact pathophysiology of the link between PsA and MetS has yet to be precisely determined, persistence of inflammatory abnormalities, with overexpression of pro-inflammatory cytokines, might be the cause. Studies have consistently emphasized the strong association between elevated risk of developing cardiovascular disease and MetS in individuals with underlying PsA. The literature has also shown an association between the increased PsA severity and the increased frequency of MetS components. This association has important clinical consequences when treating patients with PsA. Therefore, screening programs should be implemented for PsA patients to evaluate whether they have MetS, and appropriate treatment should be given to manage cardiometabolic risk factors. Patients should also be closely monitored for potential adverse treatment effects on co-morbidities. This article summarizes the evidence of associations between several components of MetS and PsA and analyzes the impact of treatment on these factors.
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Affiliation(s)
- Roaa Aljohani
- Department of Medicine, College of Medicine, Taibah University, Madinah, Saudi Arabia
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Gratacós J, Behrens F, Coates LC, Lubrano E, Thaçi D, Bundy C, de la Torre-Aboki J, Luelmo J, Voorneveld H, Richette P. A 12-point recommendation framework to support advancement of the multidisciplinary care of psoriatic arthritis: A call to action. Joint Bone Spine 2021; 88:105175. [PMID: 33771760 DOI: 10.1016/j.jbspin.2021.105175] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 02/22/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Making a differential diagnosis of psoriatic arthritis (PsA) is not straightforward. This is partly because of its heterogeneous presentation and partly because many patients with PsA are initially diagnosed with psoriasis and treated in primary care or by dermatologists, with referral to rheumatologists being delayed. Once diagnosed, optimal disease control requires frequent specialist monitoring, adjustment or switching of therapies, and management of comorbidities and concomitant diseases, as well as attention to patients' overall well-being. Given the breadth of expertise that diagnosis and management of PsA requires, we sought to define a collaborative, structured framework that supports the optimisation of multidisciplinary care for patients with PsA in Europe. METHODS An expert panel comprising four rheumatologists, three dermatologists, two specialist nurses and one psychologist-from Spain, the United Kingdom, The Netherlands, Germany, France and Italy-met face-to-face to take part in a modified Delphi exercise. RESULTS The result of this exercise is a set of recommendations that are based on combining published evidence with the panel's extensive clinical experience. Recommendations can be implemented in a number of ways, but the central call-to-action of this framework is the need for improved collaboration between dermatologists (or primary care physicians) and rheumatologists. This could occur in a variety of different formats: standard referral pathways, multidisciplinary physician meetings to discuss patient cases, or 'one stop', combined clinics. CONCLUSION We anticipate that when the majority of patients with PsA receive regular multidisciplinary care, improved patient outcomes will follow, although robust research is needed to explore this assumption.
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Affiliation(s)
- Jordi Gratacós
- Rheumatology Department, Hospital Universitario Parc Taulí de Sabadell, I3PT, UAB, Parc Taulí, 1 Sabadell, Barcelona, Spain
| | - Frank Behrens
- CIRI/Rheumatologie und Fraunhofer IME-Translationale Medizin und Pharmakologie, Goethe-Universität, Frankfurt am Main, Germany
| | - Laura C Coates
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, Windmill Road, Oxford, UK
| | - Ennio Lubrano
- Academic Rheumatology Unit, Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università degli Studi del Molise, Campobasso, Italy
| | - Diamant Thaçi
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - Christine Bundy
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | | | - Jesus Luelmo
- Department of Dermatology, Hospital of Sabadell, Corporació Sanitària Parc Taulí, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Pascal Richette
- Service de Rhumatologie, Hôpital Lariboisiere Centre Viggo Petersen, Université de Paris, 2, Rue Ambroise-Pare, 75010 Paris, France; Inserm UMR1132 Bioscar, Universite Paris Diderot UFR de Medecine, Paris, France.
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Caso F, Chimenti MS, Navarini L, Ruscitti P, Peluso R, Girolimetto N, Del Puente A, Giacomelli R, Scarpa R, Costa L. Metabolic Syndrome and psoriatic arthritis: considerations for the clinician. Expert Rev Clin Immunol 2020; 16:409-420. [PMID: 32149545 DOI: 10.1080/1744666x.2020.1740593] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: Metabolic Syndrome (MetS) is strictly interconnected with systemic inflammation, and increased evidence has described a close link between this condition and Psoriatic Arthritis (PsA).Areas covered: This review summarizes main studies exploring clinical aspects and prevalence of MetS in PsA cohorts. Further, there is accumulating evidence showing shared inflammatory pathways between MetS, its components, and PsA.Expert opinion: The high prevalence of MetS in PsA highlights the need for screening, evaluation, and close monitoring of MetS and its components (namely, diabetes mellitus, obesity, hypertension, and dyslipidemia) in psoriatic patients.Further studies should focus on the pathogenetic link between MetS and PsA. More studies are required to identify appropriate algorithms for the assessment and management of MetS in PsA patients.
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Affiliation(s)
- Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Luca Navarini
- Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Piero Ruscitti
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rosario Peluso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Nicolò Girolimetto
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.,Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Roberto Giacomelli
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
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Facing the Unseen - Metabolic Syndrome in Psoriatic Arthritis. CURRENT HEALTH SCIENCES JOURNAL 2020; 46:280-284. [PMID: 33304629 PMCID: PMC7716769 DOI: 10.12865/chsj.46.03.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/18/2020] [Indexed: 12/04/2022]
Abstract
Psoriatic arthritis (PsA) is a heterogeneous multifaceted inflammatory artropathy, associated or not with psoriasis, part of the spondyloarthropaties group. Beyond articular and skin manifestations, patients with psoriatic disease are prone to associated comorbidities, including cardiovascular disease (CVD), obesity and metabolic syndrome, diabetes, or fatty liver disease; in order to improve the prognosis and the quality of life for these patients, it is mandatory to prevent, identify and properly manage any of the comorbidities. We aimed to assess the presence of traditional CV risk factors and MetS in a group of PsA patients, compared to controls and their possible inter-relation. We performed an observational study on 41 consecutive patients diagnosed with PsA based on CASPAR established criteria. Our subjects met the criteria of MetS in a percentage of 43.90% of the cases and AHT, frequently reported in higher percentages for PsA or psoriasis patients, compared to general population was also revealed in significant percentages by our data. Regarding dyslipidemia, it is confirmed and validated by several studies that patients diagnosed with PsA or psoriasis associate an altered lipid metabolism and our study noticed data accordingly. As PsA is a condition characterized by chronic inflammation, a non-traditional CV risk factor, each patient should benefit from a periodic close evaluation in order to approach a compete and early therapeutic intervention and reduce further CV morbidity and mortality rates.
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Peluso R, Caso F, Tasso M, Sabbatino V, Lupoli R, Dario Di Minno MN, Ursini F, Costa L, Scarpa R. Biomarkers of subclinical atherosclerosis in patients with psoriatic arthritis. Open Access Rheumatol 2019; 11:143-156. [PMID: 31388317 PMCID: PMC6607207 DOI: 10.2147/oarrr.s206931] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/15/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Psoriatic arthritis (PsA) is a chronic immune-mediated disease. It is associated with an increase in cardiovascular risk factors (obesity, hypertension, diabetes, and dyslipidemia), giving a higher risk of major adverse cardiovascular events. Patients with PsA have an increased incidence of subclinical atherosclerosis and endothelial dysfunction. The aim of this study is to perform a review of the biomarkers of subclinical atherosclerosis in patients with PsA. Methods: A search was performed in the electronic databases (PubMed, Web of Science, Scopus, and Embase) up until July 2017. Studies were considered if they included data on biomarkers of subclinical atherosclerosis in PsA, and each article was then reviewed for quality and clinical relevance. After completing the literature search, all screened literature was summarized and discussed in our study group (CaRRDs study group). Results: The initial search produced 532 abstracts, which were limited to 258 potentially relevant articles by preliminary review of the titles and by excluding review articles and case reports (n=274). A further 102 articles were deemed ineligible after examining the abstracts. Full texts of the remaining 156 articles were retrieved. Most articles were excluded because they were not relevant to the biomarkers of subclinical atherosclerosis in psoriasis and/or PsA. In the end, 54 articles were deemed eligible for this review. Conclusion: Patients with PsA showed more severe atherosclerotic disease compared with patients with only psoriasis. This may have been due to the higher systemic inflammatory burden from the combination of both diseases. In patients with PsA some molecules may be considered as markers of atherosclerotic disease, and their detection may be a prognostic marker, in addition to imaging procedures, for the development of atherosclerotic disease, and could be suitable for the management of patients with PsA.
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Affiliation(s)
- Rosario Peluso
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
| | - Francesco Caso
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
| | - Marco Tasso
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
| | - Vincenzo Sabbatino
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
| | - Roberta Lupoli
- Department of Clinical Medicine and Surgery, Division of Internal Medicine, Federico II University, Naples, Italy
| | | | - Francesco Ursini
- Internal Medicine Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Luisa Costa
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
| | - Raffaele Scarpa
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
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Chimenti MS, Caso F, Alivernini S, De Martino E, Costa L, Tolusso B, Triggianese P, Conigliaro P, Gremese E, Scarpa R, Perricone R. Amplifying the concept of psoriatic arthritis: The role of autoimmunity in systemic psoriatic disease. Autoimmun Rev 2019; 18:565-575. [DOI: 10.1016/j.autrev.2018.11.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 11/30/2018] [Indexed: 02/08/2023]
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Pro-inflammatory adipokine profile in psoriatic arthritis: results from a cross-sectional study comparing PsA subset with evident cutaneous involvement and subset “sine psoriasis”. Clin Rheumatol 2019; 38:2547-2552. [DOI: 10.1007/s10067-019-04619-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/12/2019] [Accepted: 05/19/2019] [Indexed: 12/27/2022]
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Cardiovascular Risk in South America Compared to Other Countries. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2018. [DOI: 10.1007/s40138-018-0154-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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