Advertisement

Psoriatic Arthritis

  • Fardina MalikEmail author
  • Rebecca Haberman
  • Jose U. Scher
Chapter

Abstract

Psoriatic arthritis (PsA) affects up to 30% patients with skin psoriasis and is characterized by immune-mediated synovio-entheseal inflammation. Clinical presentation is diverse and can lead to joint destruction and deformities in 50% of patients with PsA. With better understanding of pathogenesis of the disease, various disease-modifying targeted therapies have emerged in the recent decades. So early recognition of PsA is crucial as initiation of therapy targeted to achieve minimal disease activity can lead to significant improvement in joint symptoms and quality of life.

Keywords

Psoriasis Psoriatic arthritis Enthesitis Dactylitis T helper cell 17 (Th17) 

Bibliography

  1. 1.
    Ritchlin CT, Colbert RA, Gladman DD. Psoriatic arthritis. N Engl J Med. 2017;376:2095–6.  https://doi.org/10.1056/NEJMc1704342.CrossRefPubMedGoogle Scholar
  2. 2.
    Moll JM, Wright V. Psoriatic arthritis. Semin Arthritis Rheum. 1973;3:55–78.CrossRefGoogle Scholar
  3. 3.
    Gladman DD, Antoni C, Mease P, Clegg DO, Nash P. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis. 2005;64(Suppl 2):ii14–7.  https://doi.org/10.1136/ard.2004.032482.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Coates LC, et al. Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet. 2015;386:2489–98.  https://doi.org/10.1016/s0140-6736(15)00347-5.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Ogdie A, Weiss P. The epidemiology of psoriatic arthritis. Rheum Dis Clin N Am. 2015;41:545–68.  https://doi.org/10.1016/j.rdc.2015.07.001.CrossRefGoogle Scholar
  6. 6.
    Eder L, et al. Incidence of arthritis in a prospective cohort of psoriasis patients. Arthritis Care Res (Hoboken). 2011;63:619–22.  https://doi.org/10.1002/acr.20401.CrossRefGoogle Scholar
  7. 7.
    Egeberg A, et al. Incidence and prevalence of psoriatic arthritis in Denmark: a nationwide register linkage study. Ann Rheum Dis. 2017;76:1591–7.  https://doi.org/10.1136/annrheumdis-2016-210963.CrossRefPubMedGoogle Scholar
  8. 8.
    Mease PJ, et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J Am Acad Dermatol. 2013;69:729–35.  https://doi.org/10.1016/j.jaad.2013.07.023.CrossRefPubMedGoogle Scholar
  9. 9.
    Gottlieb AB, et al. Clinical characteristics of psoriatic arthritis and psoriasis in dermatologists’ offices. J Dermatolog Treat. 2006;17:279–87.  https://doi.org/10.1080/09546630600823369.CrossRefPubMedGoogle Scholar
  10. 10.
    Husted JA, Gladman DD, Farewell VT, Cook RJ. Health-related quality of life of patients with psoriatic arthritis: a comparison with patients with rheumatoid arthritis. Arthritis Rheum. 2001;45:151–8.  https://doi.org/10.1002/1529-0131(200104)45:2<151::AID-ANR168>3.0.CO;2-T.CrossRefPubMedGoogle Scholar
  11. 11.
    Rosen CF, et al. Patients with psoriatic arthritis have worse quality of life than those with psoriasis alone. Rheumatology (Oxford). 2012;51:571–6.  https://doi.org/10.1093/rheumatology/ker365.CrossRefGoogle Scholar
  12. 12.
    Tillett W, et al. Factors influencing work disability in psoriatic arthritis: first results from a large UK multicentre study. Rheumatology (Oxford). 2015;54:157–62.  https://doi.org/10.1093/rheumatology/keu264.CrossRefGoogle Scholar
  13. 13.
    Lee S, Mendelsohn A, Sarnes E. The burden of psoriatic arthritis: a literature review from a global health systems perspective. P T. 2010;35:680–9.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Coates LC, et al. Group for research and assessment of psoriasis and psoriatic arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheumatol. 2016;68:1060–71.  https://doi.org/10.1002/art.39573.CrossRefPubMedGoogle Scholar
  15. 15.
    McGonagle D. Enthesitis: an autoinflammatory lesion linking nail and joint involvement in psoriatic disease. J Eur Acad Dermatol Venereol. 2009;23(Suppl 1):9–13.  https://doi.org/10.1111/j.1468-3083.2009.03363.x.CrossRefPubMedGoogle Scholar
  16. 16.
    Dalbeth N, et al. Nail disease in psoriatic arthritis: distal phalangeal bone edema detected by magnetic resonance imaging predicts development of onycholysis and hyperkeratosis. J Rheumatol. 2012;39:841–3.  https://doi.org/10.3899/jrheum.111118.CrossRefPubMedGoogle Scholar
  17. 17.
    Gladman DD, Shuckett R, Russell ML, Thorne JC, Schachter RK. Psoriatic arthritis (PSA)–an analysis of 220 patients. Q J Med. 1987;62:127–41.PubMedGoogle Scholar
  18. 18.
    Karim Z, et al. Validation and reproducibility of ultrasonography in the detection of synovitis in the knee: a comparison with arthroscopy and clinical examination. Arthritis Rheum. 2004;50:387–94.  https://doi.org/10.1002/art.20054.CrossRefPubMedGoogle Scholar
  19. 19.
    Wakefield RJ, et al. Should oligoarthritis be reclassified? Ultrasound reveals a high prevalence of subclinical disease. Ann Rheum Dis. 2004;63:382–5.CrossRefGoogle Scholar
  20. 20.
    Gelfand JM, et al. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006;296:1735–41.  https://doi.org/10.1001/jama.296.14.1735.CrossRefPubMedGoogle Scholar
  21. 21.
    Ogdie A, et al. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis. 2015;74:326–32.  https://doi.org/10.1136/annrheumdis-2014-205675.CrossRefPubMedGoogle Scholar
  22. 22.
    Jafri K, Bartels CM, Shin D, Gelfand JM, Ogdie A. Incidence and management of cardiovascular risk factors in psoriatic arthritis and rheumatoid arthritis: a population-based study. Arthritis Care Res (Hoboken). 2017;69:51–7.  https://doi.org/10.1002/acr.23094.CrossRefGoogle Scholar
  23. 23.
    Horreau C, et al. Cardiovascular morbidity and mortality in psoriasis and psoriatic arthritis: a systematic literature review. J Eur Acad Dermatol Venereol. 2013;27(Suppl 3):12–29.  https://doi.org/10.1111/jdv.12163.CrossRefPubMedGoogle Scholar
  24. 24.
    Cohen AD, Dreiher J, Birkenfeld S. Psoriasis associated with ulcerative colitis and Crohn’s disease. J Eur Acad Dermatol Venereol. 2009;23:561–5.  https://doi.org/10.1111/j.1468-3083.2008.03031.x.CrossRefPubMedGoogle Scholar
  25. 25.
    Li WQ, Han JL, Chan AT, Qureshi AA. Psoriasis, psoriatic arthritis and increased risk of incident Crohn’s disease in US women. Ann Rheum Dis. 2013;72:1200–5.  https://doi.org/10.1136/annrheumdis-2012-202143.CrossRefPubMedGoogle Scholar
  26. 26.
    Egeberg A, et al. Association of psoriatic disease with uveitis: a Danish Nationwide Cohort Study. JAMA Dermatol. 2015;151:1200–5.  https://doi.org/10.1001/jamadermatol.2015.1986.CrossRefPubMedGoogle Scholar
  27. 27.
    Kurd SK, Troxel AB, Crits-Christoph P, Gelfand JM. The risk of depression, anxiety, and suicidality in patients with psoriasis: a population-based cohort study. Arch Dermatol. 2010;146:891–5.  https://doi.org/10.1001/archdermatol.2010.186.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    McDonough E, et al. Depression and anxiety in psoriatic disease: prevalence and associated factors. J Rheumatol. 2014;41:887–96.  https://doi.org/10.3899/jrheum.130797.CrossRefPubMedGoogle Scholar
  29. 29.
    Rahman P, Elder JT. Genetic epidemiology of psoriasis and psoriatic arthritis. Ann Rheum Dis. 2005;64(Suppl 2):ii37–9; discussion ii40–31.  https://doi.org/10.1136/ard.2004.030775.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Moll JM, Wright V. Familial occurrence of psoriatic arthritis. Ann Rheum Dis. 1973;32:181–201.CrossRefGoogle Scholar
  31. 31.
    Liu Y, et al. A genome-wide association study of psoriasis and psoriatic arthritis identifies new disease loci. PLoS Genet. 2008;4:e1000041.  https://doi.org/10.1371/journal.pgen.1000041.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Bowes J, et al. Dense genotyping of immune-related susceptibility loci reveals new insights into the genetics of psoriatic arthritis. Nat Commun. 2015;6:6046.  https://doi.org/10.1038/ncomms7046.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Bowes J, et al. PTPN22 is associated with susceptibility to psoriatic arthritis but not psoriasis: evidence for a further PsA-specific risk locus. Ann Rheum Dis. 2015;74:1882–5.  https://doi.org/10.1136/annrheumdis-2014-207187.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Stankler L. An experimental investigation on the site of skin damage inducing the Koebner reaction in psoriasis. Br J Dermatol. 1969;81:534–5.CrossRefGoogle Scholar
  35. 35.
    Tinazzi I, et al. ‘Deep Koebner’ phenomenon of the flexor tendon-associated accessory pulleys as a novel factor in tenosynovitis and dactylitis in psoriatic arthritis. Ann Rheum Dis. 2018;77:922–5.  https://doi.org/10.1136/annrheumdis-2017-212681.CrossRefPubMedGoogle Scholar
  36. 36.
    Thorarensen SM, et al. Physical trauma recorded in primary care is associated with the onset of psoriatic arthritis among patients with psoriasis. Ann Rheum Dis. 2017;76:521–5.  https://doi.org/10.1136/annrheumdis-2016-209334.CrossRefPubMedGoogle Scholar
  37. 37.
    Ogdie A, Gelfand JM. Identification of risk factors for psoriatic arthritis: scientific opportunity meets clinical need. Arch Dermatol. 2010;146:785–8.  https://doi.org/10.1001/archdermatol.2010.136.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Sherlock JP, et al. IL-23 induces spondyloarthropathy by acting on ROR-gammat+ CD3+CD4−CD8− entheseal resident T cells. Nat Med. 2012;18:1069–76.  https://doi.org/10.1038/nm.2817.CrossRefPubMedGoogle Scholar
  39. 39.
    Suzuki E, Mellins ED, Gershwin ME, Nestle FO, Adamopoulos IE. The IL-23/IL-17 axis in psoriatic arthritis. Autoimmun Rev. 2014;13:496–502.  https://doi.org/10.1016/j.autrev.2014.01.050.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Yang L, et al. Augmented Th17 differentiation leads to cutaneous and synovio-entheseal inflammation in a novel model of psoriatic arthritis. Arthritis Rheumatol. 2018;70:855–67.  https://doi.org/10.1002/art.40447.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Scher JU, et al. Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis, resembling dysbiosis in inflammatory bowel disease. Arthritis Rheumatol. 2015;67:128–39.  https://doi.org/10.1002/art.38892.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Gladman DD, Thavaneswaran A, Chandran V, Cook RJ. Do patients with psoriatic arthritis who present early fare better than those presenting later in the disease? Ann Rheum Dis. 2011;70:2152–4.  https://doi.org/10.1136/ard.2011.150938.CrossRefPubMedGoogle Scholar
  43. 43.
    Haroon M, Gallagher P, FitzGerald O. Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis. Ann Rheum Dis. 2015;74:1045–50.  https://doi.org/10.1136/annrheumdis-2013-204858.CrossRefPubMedGoogle Scholar
  44. 44.
    Kingsley GH, et al. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis. Rheumatology (Oxford). 2012;51:1368–77.  https://doi.org/10.1093/rheumatology/kes001.CrossRefGoogle Scholar
  45. 45.
    Coates LC, Helliwell PS. Methotrexate efficacy in the tight control in psoriatic arthritis study. J Rheumatol. 2016;43:356–61.  https://doi.org/10.3899/jrheum.150614.CrossRefPubMedGoogle Scholar
  46. 46.
    Cutolo M, et al. A phase III, randomized, controlled trial of apremilast in patients with psoriatic arthritis: results of the PALACE 2 trial. J Rheumatol. 2016;43:1724–34.  https://doi.org/10.3899/jrheum.151376.CrossRefPubMedGoogle Scholar
  47. 47.
    Edwards CJ, et al. Apremilast, an oral phosphodiesterase 4 inhibitor, in patients with psoriatic arthritis and current skin involvement: a phase III, randomised, controlled trial (PALACE 3). Ann Rheum Dis. 2016;75:1065–73.  https://doi.org/10.1136/annrheumdis-2015-207963.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Antoni C, et al. Infliximab improves signs and symptoms of psoriatic arthritis: results of the IMPACT 2 trial. Ann Rheum Dis. 2005;64:1150–7.  https://doi.org/10.1136/ard.2004.032268.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Kavanaugh A, et al. Golimumab, a new human tumor necrosis factor alpha antibody, administered every four weeks as a subcutaneous injection in psoriatic arthritis: twenty-four-week efficacy and safety results of a randomized, placebo-controlled study. Arthritis Rheum. 2009;60:976–86.  https://doi.org/10.1002/art.24403.CrossRefPubMedGoogle Scholar
  50. 50.
    Mease PJ, et al. Adalimumab for the treatment of patients with moderately to severely active psoriatic arthritis: results of a double-blind, randomized, placebo-controlled trial. Arthritis Rheum. 2005;52:3279–89.  https://doi.org/10.1002/art.21306.CrossRefPubMedGoogle Scholar
  51. 51.
    Mease PJ, et al. Effect of certolizumab pegol on signs and symptoms in patients with psoriatic arthritis: 24-week results of a Phase 3 double-blind randomised placebo-controlled study (RAPID-PsA). Ann Rheum Dis. 2014;73:48–55.  https://doi.org/10.1136/annrheumdis-2013-203696.CrossRefPubMedGoogle Scholar
  52. 52.
    Mease PJ, et al. Etanercept treatment of psoriatic arthritis: safety, efficacy, and effect on disease progression. Arthritis Rheum. 2004;50:2264–72.  https://doi.org/10.1002/art.20335.CrossRefPubMedGoogle Scholar
  53. 53.
    McInnes IB, et al. Efficacy and safety of ustekinumab in patients with active psoriatic arthritis: 1 year results of the phase 3, multicentre, double-blind, placebo-controlled PSUMMIT 1 trial. Lancet. 2013;382:780–9.  https://doi.org/10.1016/S0140-6736(13)60594-2.CrossRefPubMedGoogle Scholar
  54. 54.
    Mease PJ, et al. Ixekizumab, an interleukin-17A specific monoclonal antibody, for the treatment of biologic-naive patients with active psoriatic arthritis: results from the 24-week randomised, double-blind, placebo-controlled and active (adalimumab)-controlled period of the phase III trial SPIRIT-P1. Ann Rheum Dis. 2017;76:79–87.  https://doi.org/10.1136/annrheumdis-2016-209709.CrossRefPubMedGoogle Scholar
  55. 55.
    McInnes IB, et al. Secukinumab, a human anti-interleukin-17A monoclonal antibody, in patients with psoriatic arthritis (FUTURE 2): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2015;386:1137–46.  https://doi.org/10.1016/S0140-6736(15)61134-5.CrossRefPubMedGoogle Scholar
  56. 56.
    Hodge JA, et al. The mechanism of action of tofacitinib – an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. Clin Exp Rheumatol. 2016;34:318–28.PubMedGoogle Scholar
  57. 57.
    Mease P, et al. Tofacitinib or adalimumab versus placebo for psoriatic arthritis. N Engl J Med. 2017;377:1537–50.  https://doi.org/10.1056/NEJMoa1615975.CrossRefPubMedGoogle Scholar
  58. 58.
    Mease P, et al. Abatacept in the treatment of patients with psoriatic arthritis: results of a six-month, multicenter, randomized, double-blind, placebo-controlled, phase II trial. Arthritis Rheum. 2011;63:939–48.  https://doi.org/10.1002/art.30176.CrossRefPubMedGoogle Scholar
  59. 59.
    Mease PJ, et al. Efficacy and safety of abatacept, a T-cell modulator, in a randomised, double-blind, placebo-controlled, phase III study in psoriatic arthritis. Ann Rheum Dis. 2017;76:1550–8.  https://doi.org/10.1136/annrheumdis-2016-210724.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Asiri A, Thavaneswaran A, Kalman-Lamb G, Chandran V, Gladman DD. The effectiveness of leflunomide in psoriatic arthritis. Clin Exp Rheumatol. 2014;32:728–31.PubMedGoogle Scholar
  61. 61.
    Kaltwasser JP, et al. Efficacy and safety of leflunomide in the treatment of psoriatic arthritis and psoriasis: a multinational, double-blind, randomized, placebo-controlled clinical trial. Arthritis Rheum. 2004;50:1939–50.  https://doi.org/10.1002/art.20253.CrossRefPubMedGoogle Scholar
  62. 62.
    Clegg DO, et al. Comparison of sulfasalazine and placebo in the treatment of psoriatic arthritis. A Department of Veterans Affairs Cooperative Study. Arthritis Rheum. 1996;39:2013–20.CrossRefGoogle Scholar
  63. 63.
    Gupta AK, et al. Sulfasalazine therapy for psoriatic arthritis: a double blind, placebo controlled trial. J Rheumatol. 1995;22:894–8.PubMedGoogle Scholar
  64. 64.
    van der Heijde D, et al. Infliximab inhibits progression of radiographic damage in patients with active psoriatic arthritis through one year of treatment: results from the induction and maintenance psoriatic arthritis clinical trial 2. Arthritis Rheum. 2007;56:2698–707.  https://doi.org/10.1002/art.22805.CrossRefPubMedGoogle Scholar
  65. 65.
    Kane D, Stafford L, Bresnihan B, FitzGerald O. A prospective, clinical and radiological study of early psoriatic arthritis: an early synovitis clinic experience. Rheumatology (Oxford). 2003;42:1460–8.  https://doi.org/10.1093/rheumatology/keg384.CrossRefGoogle Scholar
  66. 66.
    Gladman DD, et al. Risk factors for radiographic progression in psoriatic arthritis: subanalysis of the randomized controlled trial ADEPT. Arthritis Res Ther. 2010;12:R113.  https://doi.org/10.1186/ar3049.CrossRefPubMedPubMedCentralGoogle Scholar
  67. 67.
    Araujo EG, et al. High incidence of disease recurrence after discontinuation of disease-modifying antirheumatic drug treatment in patients with psoriatic arthritis in remission. Ann Rheum Dis. 2015;74:655–60.  https://doi.org/10.1136/annrheumdis-2013-204229.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Fardina Malik
    • 1
    Email author
  • Rebecca Haberman
    • 1
  • Jose U. Scher
    • 1
  1. 1.Division of Rheumatology, Department of MedicineNew York University School of MedicineNew YorkUSA

Personalised recommendations