Which Patients With Psoriasis Are More Likely to Develop PsA?

Patients with psoriasis who also have structural entheseal lesions, even when they have no clinical symptoms of musculoskeletal disease, are at a higher risk of developing psoriatic arthritis (PsA) than patients without entheseal lesions, according to a study presented at the European League Against Rheumatism (EULAR) E-Congress 2020.

Researchers conducted a prospective study of 114 patients with psoriasis, who were assessed by high‐resolution peripheral quantitative computed tomography (HR‐pQCT) for entheseal lesions at entheseal and intra-articular sites.

During a follow-up period of 28.2 months, 24 participants had developed PsA and 41 had developed structural entheseal lesions. The participants with the greatest number of structural entheseal lesions had an increased risk of developing PsA than those who did not have such lesions.

Findings related to arthralgia confirmed previous observations that patients without arthralgia or structural entheseal lesions progressed to PsA slower than patients with arthralgia but no structural entheseal lesions. However, presence of structural entheseal lesions increased the risk of progression to PsA regardless of arthralgia presence.

“Presence of [structural entheseal lesions] is associated with an increased risk of developing PsA in patients with psoriasis,” the researchers concluded. “If used together with pain, [structural entheseal lesions] allow defining subsets of psoriasis patients with very low and very high risk to develop PsA.”

—Rebecca Mashaw

Reference:

Simon D, Tascilar K, Kleyer A, et al. Abstract OP0051 Structural entheseal lesions in psoriasis patients are associated with an increased risk of progression to psoriatic arthritis – a prospective cohort study. Annals Rheum Dis. 2020;79(Suppl 1):33-34.  doi.org/10.1136/annrheumdis-2020-eular.1524