Background Psoriatic arthritis is a major rheumatological problem. The heterogenous phenotype spectrum spans from RA like to a typical AS. There are few descriptions from India
Objectives To evaluate the clinical phenotype & immunology pattern of a patients with psoriatic arthritis.
Methods We conducted a retrospective study to define the clinical profile of psoriatic arthritis in patients attending Centre for Rheumatic Diseases (CRD), Pune clinic. Standard of care, case record forms are used to enter patient profile & medications. Investigations are carried out in dedicated lab. Data was extracted from referral database maintained from 1996 onwards. We cover study period from JAN 2001 to JUN 2013. Blood samples of 154, 354, and 136 patients respectively were analyzed for HLA B27 (PCR with sequence specific Primer), RF (Nephelometry, cut off 40 IU/ml) and anti-CCP (2nd generation ELISA, cut off 5 RU/ml). Clinical events during follow up were also analyzed (data not shown). Similarly we will present results of lipid profile & comorbidity especially cardiovascular.
ABBREVIATIONS- IA: Inflammatory arthritis, RA: Rheumatoid arthritis, AS: Ankylosing spondylitis
Results Psoriatic arthritis was classified in 1.1% of total patients case records (n=39756). 491 patients records of psoriatic arthritis were analyzed. Mean age of Presentation was 43 yrs (range 14yr-79yr). 61.1% subjects were males. In 72.3% patients, skin psoriasis preceded arthritis by a median interval 48 months, arthritis preceded skin lesion in 12.2%, occurred simultaneously in 9.3%. Dominant articular patterns were observed were polyarticular 50.1%, spondyloarthritis (Axial) 24.4%, oligoarticular 35.6%, distal interphalangeal joint arthritis (DIP alone) 2.4%. The table below shows selected patients characteristics.
Conclusions This study describes a large series of Psoriatic arthritis from India followed for several years. Overall profile was similar to classical reports but there are interesting differences of articular pattern & DIP disease in particular. Higher frequency of dactylitis & nail involvement was observed. Seropositive RF polyarthritis was intriguingly uncommon. Overall, the frequency of HLA B27 & RF is rather low while frequency of anti CCP is consistent with literature.
Taylor W et al Arthritis & Rheumatism 2006; 54(8):2665-73
Acknowledgements Arthritis Research & Care Foundation – Center for Rheumatic Diseases
Disclosure of Interest None declared