Does Disease Activity Influence the Levels of Uric Acid in Psoriatic Arthritis?

The Prevalence of Asymptomatic Hyperuricemia in Patients with or Without Psoriatic Arthritis is Associated with a Similar Cardiovascular Risk

Aim: To investigate the association between cardiovascular burden and monosodium urate (MSU) deposits in the joints of patients with asymptomatic hyperuricemia and no evidence of arthritis and subjects with psoriatic arthritis and hyperuricemia.

Patients and methods: A single-center, cross-sectional study including 52 individuals: 39 with asymptomatic hyperuricemia and 13 with psoriatic arthritis and hyperuricemia. All patients underwent ultrasound of the joints by which the presence or absence of MSU crystal deposits was assessed. Subjects underwent transthoracic echocardiography by which left ventricular mass index (LVMI) was estimated. Intima-media thickness (IMT) of the common carotid arteries was measured and the presence of atherosclerotic plaques was registered.

Results: We found no difference in the distribution of cardiovascular risk factors between the two groups. Further, no difference in their distribution was found between those who were not treated and those who were treated with urate-lowering medications. The frequency of articular MSU deposits was similar between non-allopurinol-treated and allopurinol-treated individuals (p = 0.554). There was no difference in the frequency of articular deposits between benzbromarone recipients and non-recipients (p = 0.396). We observed no connection between articular MSU deposits and LVMI (p = 0.625), IMT (p = 0.117) and atherosclerotic plaques (p = 0.102). Among untreated and treated with urate-lowering drugs there was no difference in LVMI (p = 0.063), IMT (p = 0.975) and plaque distribution (p = 1.000).

Conclusion: We can assume that in patients with asymptomatic hyperuricemia and no evidence of arthritis and in subjects with psoriatic arthritis and asymptomatic hyperuricemia, only the prescription of urate-lowering medications for reduction of urate load and cardiovascular risk is not sufficient.