Dactylitis, Severe PsA More Likely with Early-Onset PsO

The probability of dactylitis was more than 9 times higher in patients with psoriatic arthritis (PsA) who had early-onset vs late-onset psoriasis (PsO), according to study results published in Rheumatology and Therapy.

“The early onset of psoriasis could be a potential clinical marker of psoriatic arthritis severity,” wrote a research team from Italy. “If other future larger studies will confirm this association, early-onset psoriasis and dactylitis could be considered as potential additional factors to take into account for a tight control in a treat-to-target strategy.”

The cross-sectional analysis included 160 adults with PsA referred to the rheumatology unit of the University of Molise in Campobasso, Italy. Among them, 84 patients had early-onset PsO (onset by age 40) and 76 patients had late-onset PsO (onset after age 41).

The sole clinical feature of PsA that differed significantly between early-onset and late-onset PsO was dactylitis, according to the study. Some 45.2% of patients with early-onset PsO had dactylitis in the present or past compared with 7.9% of patients with late-onset PsO. The odds ratio for dactylitis was 9.64 in the early-onset group compared with the late-onset group.

In patients with late-onset PsO, comorbidity indices were higher, the study showed. However, the results were not confirmed after adjustment for patient age and sex.

“These data probably suggest that in our group of patients, there is a ‘comorbidity trend’ in late-onset psoriasis patients,” researchers wrote, “but other factors (like age) could have an influence.”

The study also identified treatment differences. Patients with early-onset PsO were more frequently treated with anti-interleukin 17 drugs, researchers reported. Meanwhile, patients with late-onset PsO were more commonly treated with nonsteroid anti-inflammatory drugs and conventional synthetic disease-modifying antirheumatic drugs.

—Jolynn Tumolo

Reference

Scriffignano S, Perrotta FM, di Marino M, Ciccia F, Lubrano E. Dactylitis and early onset psoriasis in psoriatic arthritis: are they markers of disease severity? A clinical study. Rheumatol Ther.. 2022;9(4):1203-1211.