Cardiometabolic, Mental Health Disorders Common in Patients With PsA

The most common comorbidities in patients with psoriatic arthritis (PsA) are cardiovascular disease, metabolic disorders, and mental health disorders, according to a narrative review published in Clinical Therapeutics.

“The occurrence of comorbidities significantly increases the burden of the disease, affects life expectancy and quality of life, and impacts the choice of treatment,” wrote Alexandros Panagiotopoulos, MD, and George E. Fragoulis, MD, PhD, of the University of Athens in Greece. “Of note, it has been suggested that patients with PsA experience multimorbidity earlier in life than expected.”

Underlying inflammation is often behind the increased risk for cardiovascular disease in patients, the review article explained. Meanwhile, the relationship between mental health disorders and psoriatic disease appears to be bidirectional.

Biologic disease-modifying antirheumatic drugs and other treatments in patients with PsA have reportedly improved cardiovascular risk. Yet the effectiveness of specific drug classes in patients with cardiovascular risk, as well as whether certain classes are best avoided, are topics still up for debate, according to the review.

Meanwhile, the issue of mental health disorders in patients with PsA is complex. The authors specifically noted difficulties in measuring and reporting mental health comorbidities both in clinical trials and practice settings.

“Future studies are needed for a better understanding of the pathogenic mechanisms of, and the development of better protocols for, the identification and treatment of patients with comorbidities in patients with PsA,” the authors wrote. “The education of clinicians, health care professionals in rheumatology, and patients could be useful in achieving this goal.”

Reference:
Panagiotopoulos A, Fragoulis G. Comorbidities in psoriatic arthritis: a narrative review. Clinical Therapeutics. 2023;45(2): 177-189. doi.org/10.1016/j.clinthera.2023.01.006