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Psoriatic Arthritis

Recognition and Management

  • Disease Management
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Summary

Psoriatic arthritis is an inflammatory arthritis associated with psoriasis, which is usually negative for rheumatoid factor. The disease displays a wide spectrum of articular and periarticular features which may progress with time. Although psoriatic arthritis was thought to be a benign condition, it is now clear that up to 20% of patients progress to significant joint damage and functional disability. Recently, several predictors for progression have been described and suggest the need for earlier, more aggressive, use of therapy in these patients.

The ideal treatment for psoriatic arthritis is unclear, and few randomised controlled trials have been reported to date in this condition. Prospective evaluation of the treatment of early disease is now required to assess the effect of current and future therapies on the clinical, radiological and functional outcomes of this condition.

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References

  1. Moll JMH, Wright V. Psoriatic arthritis. Semin Arthritis Rheum 1973; 3: 55–78

    Article  PubMed  CAS  Google Scholar 

  2. Alibert JL. Precise theorique et practique sur les maladies de la peau. Paris: Caille et Ravier, 1818

    Google Scholar 

  3. Wright V. Psoriasis and arthritis. Ann Rheum Dis 1956; 15: 348–56

    Article  PubMed  CAS  Google Scholar 

  4. O’Neill T, Silman A. Psoriatic arthritis: historical background and epidemiology. Baillieres Clin Rheumatol 1994; 8: 245–61

    Article  PubMed  Google Scholar 

  5. Gladman DD, Shuckett R, Russell ML, et al. Psoriatic arthritis; clinical and laboratory analysis of 220 patients. Q J Med 1987; 62: 127–41

    PubMed  CAS  Google Scholar 

  6. Moll JMH. The place of psoriatic arthritis in the spondar-thritides. Ballieres Clin Rheumatol 1994; 8: 395–417

    Article  CAS  Google Scholar 

  7. Veale D, Rogers S, Fitzgerald O. Classification of clinical subsets in psoriatic arthritis. Br J Rheumatol 1994; 33: 133–8

    Article  PubMed  CAS  Google Scholar 

  8. Jones SM, Armas JB, Cohen MG, et al. Psoriatic arthritis: outcome of disease subsets and relationship of joint disease to nail and skin disease. Br J Rheumatol 1994; 33: 834–9

    Article  PubMed  CAS  Google Scholar 

  9. Buskila D, Langevitz P, Gladman DD, et al. Patients with rheumatoid arthritis are more tender than those with psoriatic arthritis. J Rheumatol 1992; 19: 1115–9

    PubMed  CAS  Google Scholar 

  10. Helliwell P, Marchesoni A, Peters M, et al. A re-evaluation of the osteoarticular manifestations of psoriasis. Br J Rheumatol 1991; 30: 339–45

    Article  PubMed  CAS  Google Scholar 

  11. Gladman DD. Natural history of psoriatic arthritis. Baillieres Clin Rheumatol 1994; 8: 379–94

    Article  PubMed  CAS  Google Scholar 

  12. Coulton BL, Thomson K, Symmons DP, et al. Outcome in patients hospitalized for psoriatic arthritis. Clin Rheumatol 1989; 8: 261–5

    Article  PubMed  CAS  Google Scholar 

  13. Torre Alonso JC, Rodrigues Perez A, Arribas Castrillo JM, et al. Psoriatic arthritis (PA): a clinical, immunological and radiological study of 180 patients. Br J Rheumatol 1991; 30: 245–50

    Article  PubMed  CAS  Google Scholar 

  14. Gladman DD, Farewell VT, Nadeau C. Clinical indicators of progression in psoriatic arthritis (PSA): multivariate relative risk model. J Rheumatol 1995; 22: 675–9

    PubMed  CAS  Google Scholar 

  15. Gladman DD, Farewell VT. The role of HLA antigens as indicators of disease progression in psoriatic arthritis. Arthritis Rheum 1995; 38: 845–50

    Article  PubMed  CAS  Google Scholar 

  16. Abu-Shakra M, Gladman DD. Aetiopathogenesis of psoriatic arthritis. Rheumatol Rev 1994; 3: 1–7

    Google Scholar 

  17. Scarpa R, Puccino A, Iocco M, et al. The management of 138 psoriatic arthritic patients. Acta Derma Venereol 1989; 146 Suppl: 199–200

    CAS  Google Scholar 

  18. Baker H, Ryan TJ. Generalized pustular psoriasis: a clinical and epidemiological study of 104 cases. Br J Dermatol 1968; 80: 771–793

    Article  PubMed  CAS  Google Scholar 

  19. Carette S, Calin A, McCafferty JP, et al., Auranofin Cooperating Group. A double-blind placebo-controlled study of auranofin in patients with psoriatic arthritis. Arthritis Rheum 1989; 32: 158–65

    Article  PubMed  CAS  Google Scholar 

  20. Kirwan JR. The effect of glucocorticoids on joint destruction in rheumatoid arthritis. N Engl J Med 1995; 333: 142–6

    Article  PubMed  CAS  Google Scholar 

  21. Gladman DD, Blake R, Brubacher B, et al. Chloroquine therapy in psoriatic arthritis. J Rheumatol 1992; 19: 1724–6

    PubMed  CAS  Google Scholar 

  22. Sayers ME, Mazanec DJ. Use of antimalarial drugs for the treatment of psoriatic arthritis. Am J Med 1992; 93(4): 474–5

    Article  PubMed  CAS  Google Scholar 

  23. Newman ED, Perruquet JL, Harrington TM. Sulphasalazine therapy in psoriatic arthritis: clinical and immunologic response. J Rheumatol 1991; 18: 1379–82

    PubMed  CAS  Google Scholar 

  24. Fraser SM, Hopkins R, Hunter JA, et al. Sulphasalazine in the management of psoriatic arthritis. Br J Rheumatol 1993; 32: 923–5

    Article  PubMed  CAS  Google Scholar 

  25. Gupta AK, Grober JS, Hamilton TA, et al. Sulfasalazine therapy for psoriatic arthritis: a double blind, placebo-controlled trial. J Rheumatol 1995; 22: 894–8

    PubMed  CAS  Google Scholar 

  26. Clegg DO, Reda DJ, Mejias E, et al. Comparison of sulfasalazine and placebo in the treatment of psoriatic arthritis. Arthritis Rheum 1996; 39: 2013–20

    Article  PubMed  CAS  Google Scholar 

  27. Dougados M, vam der Linden S, Leirisalo Repo M, et al. Sulfasalazine in the treatment of spondylarthropathy: a randomized, multicenter, double-blind, placebo-controlled study. Arthritis Rheum 1995; 38: 618–27

    Article  PubMed  CAS  Google Scholar 

  28. Palit J, Hill J, Capell HA, et al. A multicentre double-blind comparison of auranofin, intramuscular gold thiomalate and placebo in patients with psoriatic arthritis. Br J Rheumatol 1990; 29: 280–3

    Article  PubMed  CAS  Google Scholar 

  29. Bruckle W, Dexel T, Grasedyck K, et al. Treatment of psoriatic arthritis with auranofin and gold sodium thiomalate. Clin Rheumatol 1994; 13: 209–16

    PubMed  CAS  Google Scholar 

  30. Mader R, Gladman DD, Long J, et al. Injectable gold for the treatment of psoriatic arthritis (PsA): long-term follow-up. Clin Invest Med 1995; 18: 139–43

    PubMed  CAS  Google Scholar 

  31. Black RL, O’Brien WM, Van Scott EJ, et al. Methotrexate therapy in psoriatic arthritis: double blind study on 21 patients. JAMA 1964; 189: 743–7

    Article  PubMed  CAS  Google Scholar 

  32. Willkens RF, Williams HJ, Ward JR, et al. Randomized, double-blind, placebo controlled trial of low-dose pulse methotrexate in psoriatic arthritis. Arthritis Rheum 1984; 27: 376–81

    Article  PubMed  CAS  Google Scholar 

  33. Espinoza LR, Zakraoni L, Espinoza CG, et al. Psoriatic arthritis: clinical response and side effects of methotrexate therapy. J Rheumatol 1992; 19: 872–7

    PubMed  CAS  Google Scholar 

  34. Abu-Shakra M, Gladman DD, Thorne JC, et al. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiologic outcome. J Rheumatol 1995; 22: 241–5

    PubMed  CAS  Google Scholar 

  35. Al-Awadhi A, Dale P, McKendry RJ. Pancytopenia associated with low dose methotrexate therapy: a regional survey. J Rheumatol 1993; 20: 1121–5

    PubMed  CAS  Google Scholar 

  36. Hassan W Methotrexate and liver toxicity: role of surveillance liver biopsy. Conflict between guidelines for rheumatologists and dermatologists. Ann Rheum Dis 1996; 55: 273–5

    Article  PubMed  CAS  Google Scholar 

  37. Lanse SB, Arnold GL, Gowans JDC, et al. Low incidence of hepatotoxicity associated with long-term, low dose oral methotrexate in treatment of refractory psoriasis, psoriatic arthritis and rheumatoid arthritis. Dig Dis Sci 1985; 30: 104–9

    Article  PubMed  CAS  Google Scholar 

  38. Steinsson K, Jonsdottir I, Valdimarsson H. Cyclosporin A in psoriatic arthritis: an open study. Ann Rheum Dis 1990; 49: 603–6

    Article  PubMed  CAS  Google Scholar 

  39. Spadaro A, Riccieri V, Sili-Scavalli A, et al. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study. Clin Exp Rheumatol 1995; 13: 589–93

    PubMed  CAS  Google Scholar 

  40. Tugwell P, Pincus T, Yocum D, et al. Combination therapy with cyclosporine and methotrexate in severe rheumatoid arthritis. N Engl J Med 1995; 333: 137–41

    Article  PubMed  CAS  Google Scholar 

  41. Klinkhoff AV, Gertner E, Chalmers A, et al. Pilot study of etretinate in psoriatic arthritis. J Rheumatol 1989; 16: 789–91

    PubMed  CAS  Google Scholar 

  42. Hopkins R, Bird HA, Jones H, et al. A double-blind controlled trial of etretinate and ibuprofen in psoriatic arthritis. Ann Rheum Dis 1985; 44: 189–93

    Article  PubMed  CAS  Google Scholar 

  43. Perlman SG, Gerber LH, Roberts M, et al. Photochemotherapy and psoriatic arthritis: a prospective study. Ann Intern Med 1979; 91: 717–22

    PubMed  CAS  Google Scholar 

  44. Sukenik S, Giryes H, Halevy S, et al. Treatment of psoriatic arthritis at the Dead Sea. J Rheumatol 1994; 21: 1305–9

    PubMed  CAS  Google Scholar 

  45. Snellman E, Lauharanta J, Reunanen A, et al. Effect of heliotherapy on skin and joint symptoms in psoriasis: a 6-month follow-up study. Br J Dermatol 1993; 128: 172–7

    Article  PubMed  CAS  Google Scholar 

  46. Huckins D, Felson DT, Holick M. Treatment of psoriatic arthritis with oral 1,25-dihydroxyvitamin D3: a pilot study. Arthritis Rheum 1990; 33: 1723–7

    Article  PubMed  CAS  Google Scholar 

  47. Bittener SB, Tucker WFG, Cartwright I, et al. A double-blind, randomized, placebo-controlled trial of fish oil in psoriasis. Lancet 1988; I: 378–80

    Article  Google Scholar 

  48. Veale D, Torley H, Richards I, et al. A double-blind, placebo-controlled trial of Efamol Marine on skin and joint symptoms of psoriatic arthritis. Br J Rheumatol 1994; 33: 954–8

    Article  PubMed  CAS  Google Scholar 

  49. Peloso P, Gladman DD. Fish oils in the treatment of psoriatic arthritis: an open study [abstract]. Arthritis Rheum 1992; 35Suppl. 9.: S225

    Google Scholar 

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Bruce, I.N., Gladman, D.D. Psoriatic Arthritis. BioDrugs 9, 271–278 (1998). https://doi.org/10.2165/00063030-199809040-00002

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