Journal of rheumatic diseases · 2025
Characterising axial psoriatic arthritis in clinical practice: a retrospective analysis from the Rheumatic Diseases Portuguese Registry.
СтатьяНазвание и аннотация: Перевод в очереди
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Abreu Catarina, Fraga Vanessa, Almeida Inês, Lopes Mariana Diz, Azevedo Sofia, Vilafanha Carolina, Rovisco João, Ferreira Maria Pontes, Parente Hugo, Cunha Anita, Soares Catarina Dantas, Medeiros Dina, Augusto Duarte, Sebastião Mariana Rocha, Silva Lígia, Meirinhos Tiago, Dinis Joana, Araújo Filipe, Tavares-Costa José, Vilar António, Castro Alice Morais, Santos Maria José
Аннотация
OBJECTIVE: To determine the proportion of axial psoriatic arthritis (axPsA), describe how it is diagnosed in clinical practice, and identify clinical and demographic characteristics independently associated with axPsA.
METHODS: A multicentre retrospective observational study was conducted using data from patients registered in the Rheumatic Diseases Portuguese Registry (Reuma.pt) with a diagnosis of PsA or spondyloarthritis with psoriasis. Peripheral involvement was defined as the presence of peripheral joint disease. Axial involvement was defined by the presence of physician-reported spondylitis and/or imaging findings suggestive of axial disease. Patients were divided into four non-exclusive groups axPsA, axial involvement with or without peripheral joint disease; ax-PsA_only, axial involvement exclusively; peripheral PsA (pPsA)_only, peripheral joint disease, without axial involvement; pPsA, peripheral joint disease with or without axial disease.
RESULTS: This study included 2,304 patients. axPsA was present in 37.1% of patients and axPsA_only in 8.1%. The diagnosis was made based on suggestive imaging findings in 30.1%, and on physician judgement in 69.9%. axPsA was independently associated with HLA-B27 positivity (odds ratio [OR]=2.90; p<0.001), enthesitis (OR=1.64; p<0.001), and younger age at symptom onset (OR=0.97; p<0.001); pPsA_only with dactylitis (OR=1.89; p<0.001) and nail dystrophy (OR=1.42; p=0.010). axPsA_only was independently associated HLA-B27 positivity (OR=3.35; p<0.001) and uveitis (OR=2.56; p=0.004); pPsA with nail dystrophy (OR=2.11; p=0.002), dactylitis (OR=18.18; p<0.001), and enthesitis (OR=1.74; p=0.031).
CONCLUSION: Axial involvement is present in over one-third of PsA patients, often in association with peripheral joint disease. axPsA patients demonstrate distinct clinical and demographic characteristics compared to those without axial disease.
METHODS: A multicentre retrospective observational study was conducted using data from patients registered in the Rheumatic Diseases Portuguese Registry (Reuma.pt) with a diagnosis of PsA or spondyloarthritis with psoriasis. Peripheral involvement was defined as the presence of peripheral joint disease. Axial involvement was defined by the presence of physician-reported spondylitis and/or imaging findings suggestive of axial disease. Patients were divided into four non-exclusive groups axPsA, axial involvement with or without peripheral joint disease; ax-PsA_only, axial involvement exclusively; peripheral PsA (pPsA)_only, peripheral joint disease, without axial involvement; pPsA, peripheral joint disease with or without axial disease.
RESULTS: This study included 2,304 patients. axPsA was present in 37.1% of patients and axPsA_only in 8.1%. The diagnosis was made based on suggestive imaging findings in 30.1%, and on physician judgement in 69.9%. axPsA was independently associated with HLA-B27 positivity (odds ratio [OR]=2.90; p<0.001), enthesitis (OR=1.64; p<0.001), and younger age at symptom onset (OR=0.97; p<0.001); pPsA_only with dactylitis (OR=1.89; p<0.001) and nail dystrophy (OR=1.42; p=0.010). axPsA_only was independently associated HLA-B27 positivity (OR=3.35; p<0.001) and uveitis (OR=2.56; p=0.004); pPsA with nail dystrophy (OR=2.11; p=0.002), dactylitis (OR=18.18; p<0.001), and enthesitis (OR=1.74; p=0.031).
CONCLUSION: Axial involvement is present in over one-third of PsA patients, often in association with peripheral joint disease. axPsA patients demonstrate distinct clinical and demographic characteristics compared to those without axial disease.