Recent information suggests that auto-inflammatory and immune-mediated mechanisms participate in the pathogenesis of psoriatic arthritis (PsA). The synovial vascular proliferation, an unique genetic association, and the characteristic bone MRI imaging are different from rheumatoid arthritis. Also, obesity has emerged as a strong risk factor for the development of this arthritis. Interesting, obesity relates to the metabolic syndrome characterized by hypertension, insulin resistance and hypercholesterolemia, common in PsA.
Researchers have demonstrated that CASPAR criteria perform well in diagnosis of early PsA. In addition, the Psoriasis Epidemiology Screening Trial questionnaire, the Toronto Psoriatic Arthritis Screening questionnaire and the EARP questionnaire are helpful for the diagnosis of PsA patients with or without psoriasis.
A recent metaanalysis has revealed that infliximab, adalimumab, etanercept and golimumab are equally effective are equally effective and better than placebo in achieving ACR 20/50/70 and PsA Response Criteria, and PASi50. The new small molecule apremilast a phosphodiesterase4 (PDE4) inhibitor is also effective in achieving significant skin and joint improvement
Large prospective studies and population-based studies have produced conflicting data regarding survival of PsA patients. Nevertheless, subclinical atherosclerosis and increased in the rate of cardiovascular risk factors suggest that cardiovascular events may be significant comorbidity in patients suffering from PsA
Disclosure of Interest J. Gomez-Reino Grant/research support from: UCB, MSD, Consultant for: BMS, MSD, Pfize, Roche, UCB, Paid instructor for: Abbott, GSK, BMS, MSD, Pfize, Roche, UCB,