Background Psoriatic arthritis (PsA) is an immune-mediated disease affecting skin, joints, entheses, spine, and the vasculature [1,2]. Increased inflammatory mediators are held responsible for impacts on the skin and musculoskeletal system as well as comorbid situations including cardiovascular disease (CVD) and metabolic syndrome . PTX 3 is an acute phase reactant that has prognostic value for rheumatoid arthritis (RA), vasculitis, and psoriasis that also stands out as a novel biomarker for CVD in new researches .
Objectives This study aims to assess the association between PTX 3 levels, disease activity and CVD risk in patients with PsA.
Methods A total of 38 PsA patients applying to Ankara University Faculty of Medicine, Rheumatology Polyclinic and 32 age and sex-matched controls were enrolled in the study. tender and swollen joint counts, patient's and doctor's global assesment on VAS, ESR, CRP, fasting insulin, fasting glucose, total cholesterol, HDL, and LDL were noted. Also body mass index (BMI) and HOMA-IR score were calculated. Carotid intima media thickness (cIMT) was bilaterally assessed by Doppler ultrasound.
Results The mean age was 49.5 in patients and 48.9 in controls. Sixty percent of the patients and 50% of controls were female. Of the patients, 15 (39%) used DMARD monotherapy, 8 (21%) used DMARD combination therapies, and 15 (39%) used anti TNF therapies. There was no statistically significant difference between groups in terms of hypertension, LDL levels, and smoking status (p:0.775, p:0.228, p:0.136 respectively). PsA patients had significantly higher BMI scores (p:0.03). Insulin levels and HOMA-IR scores were significantly higher among PsA patients compared to controls (p:0.001, p:0.005). There was statistically significant difference between groups in terms of PTX 3 (p<0.001). PTX 3 was significantly correlated with HOMA-IR and cIMT (r:0.243 p:0.043 and r:0.421 p:0.001 respectively). However no correlation between PTX 3 and disease activity parameters such as ESR, CRP, SJC, TJC, and VAS-pain was detected (p:0.824, 0.662, 0.922, 0.924, 0.410 respectively). There was not significant difference in terms of PTX-3 levels between PsA patients on biologic treatment or other treatment strategies (p:0.27).
Conclusions Elevated levels of PTX 3 may be associated with cardiovascular involvement in PsA patients independent from the disease activity. This marker might be used for risk prediction for CVD or may represent a target for new therapies.
Braun J. New targets in psoriatic arthritis. Rheumatology (Oxford). 2016 Dec;55(suppl 2).
Egeberg A. Psoriasis and comorbidities. Epidemiological studies. Dan Med J.2016 Feb;63(2).
Rutter MK, Kane K, Lunt M, et al. Primary care based screening for cardiovascular risk factors in patients with psoriasis. Br J Dermatol. 2016 Mar 1.
Inoue K, Kodama T, Daida H. Pentraxin 3: a novel biomarker for inflammatory cardiovascular disease Int J Vasc Med. 2012;2012:657025.
Disclosure of Interest None declared