Risk of developing psoriatic arthritis in psoriasis cohorts with arthralgia: exploring the subclinical psoriatic arthritis stage

Zabotti A, Fagni F, Gossec L, Giovannini I, Sticherling M, Tullio A, Baraliakos X, De Marco G, De Vita S, Errichetti E, Quartuccio L, Silvagni E, Smolen JS, Tinazzi I, Watad A, Schett G, McGonagle DG, Simon D (2024)

Publication Type: Journal article

Publication year: 2024

Journal

RMD Open BMJ Publishing Group

Book Volume: 10

Article Number: e004314

Journal Issue: 2

DOI: 10.1136/rmdopen-2024-004314

Abstract

Objective Subjects with subclinical psoriatic arthritis (PsA), defined as the presence of arthralgia in psoriasis (PsO), are at higher risk of PsA but scant real-world data exist. Our aims were to (1) estimate the probability of PsA development in subclinical PsA, (2) characterise subclinical PsA symptoms and (3) determine the clinical patterns at PsA diagnosis. Methods Patients with PsO, mainly subclinical PsA, were evaluated longitudinally in two European cohorts. The key outcome was new-onset PsA. Musculoskeletal symptoms including inflammatory and non-inflammatory symptoms before PsA diagnosis were collected. Occurrence of PsA was analysed with survival analysis and cumulative incidence functions (CIFs). Results 384 patients with PsO were included with a mean follow-up of 33.0 (±20.9) months. 311 of 384 (80.9%) had subclinical PsA with a PsA incidence rate of 7.7 per 100 patient-years. Subclinical PsA displayed a higher risk of PsA development compared with PsO (HR=11.7 (95% CI 1.57 to 86.7), p=0.016). The probability of new-onset PsA estimated by the CIF was 9.4% (95% CI 4.7% to 10.6%) at month 12 and 22.7% (95% CI 17.2% to 28.6%) at month 36. 58.9% of cases reported inflammatory symptoms in the months immediately prior to PsA diagnosis but prior non-inflammatory symptoms were evident in 83.9% prior to PsA diagnosis. Peripheral joint swelling was the predominant PsA presentation pattern (82.1%). Conclusions The probability of PsA development among subclinical PsA was relatively high, emphasising the importance of emergent musculoskeletal symptoms when aiming for PsA prevention. Joint swelling was the dominant feature in new-onset PsA, likely reflecting clinical confidence in recognising joint swelling.

Authors with CRIS profile

Filippo Fagni Department of Medicine 3 – Rheumatology and Immunology Georg Schett Lehrstuhl für Innere Medizin III David Simon Department of Medicine 3 – Rheumatology and Immunology

Involved external institutions

Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ IL Israel (IL) University of Leeds GB United Kingdom (GB) Ospedale Santa Maria della Misericordia di Udine IT Italy (IT) Universität Leipzig DE Germany (DE) National Institute for Health and Medical Research / Institut national de la santé et de la recherche médicale (INSERM) FR France (FR) Rheumazentrum Ruhrgebiet DE Germany (DE) Azienda Ospedaliera Universitaria di Ferrara Arcispedale Sant'Anna IT Italy (IT) Medizinische Universität Wien AT Austria (AT) Ospedale Sacro Cuore Don Calabria IT Italy (IT)

How to cite

APA:

Zabotti, A., Fagni, F., Gossec, L., Giovannini, I., Sticherling, M., Tullio, A.,... Simon, D. (2024). Risk of developing psoriatic arthritis in psoriasis cohorts with arthralgia: exploring the subclinical psoriatic arthritis stage. RMD Open, 10(2). https://doi.org/10.1136/rmdopen-2024-004314

MLA:

Zabotti, Alen, et al. "Risk of developing psoriatic arthritis in psoriasis cohorts with arthralgia: exploring the subclinical psoriatic arthritis stage." RMD Open 10.2 (2024).

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