Source: Rheumatology  |  Posted 9 years ago

Peripheral joint disease should be monitored and treated in patients with psoriatic arthritis, particularly at the initial stages of disease, based on results from a recent British study.

Although studies have shown that psoriasis does not cause a poor outcome, it can be a sign of a worse short-term outcome in patients with spondylarthropathy. Furthermore, psoriasis arthritis patients have an increased likelihood of spinal and peripheral joint disease that could be prevented through available therapies for psoriasis arthritis. More information on the rate and pattern of joint damage still is required, however.

Dr. N.J. McHugh and colleagues at the Royal National Hospital for Rheumatic Diseases, Bath, United Kingdom, determined joint involvement in the progression of psoriatic arthritis in 87 patients. Their evaluation was conducted about 5 years after initial assessment.

Overall, peripheral joint disease, along with disability, increased in these patients during the follow up period. Specifically, the average number of affected joints increased from 6 to 11, with shoulder involvement showing the greatest increase in incidence from 23% of patients to 43.7%.

Further analysis also revealed that the highest rate of peripheral joint disease occurs within the first 12 months of psoriatic arthritis onset.

Another interesting result was the occurrence of damage in distal interphalangeal (IP) hand joints and IP foot joints in almost half of the patients. These regions are rarely affected in rheumatoid arthritis, suggesting a potential discriminating factor that could aid diagnosis.

"Peripheral joint disease is progressive in the majority of patients with psoriatic arthritis and reinforces the need for effective monitoring and treatment," noted Dr. McHugh.

Furthermore, due to the observation that the highest rate of joint involvement occurs early in psoriatic arthritis onset, Dr. McHugh "suggests that treatment targeted to early intervention is likely to be the most effective."