Journal: Arthritis & rheumatology (Hoboken, N.J.)
Article Title: The development of PsA in patients with psoriasis is preceded by a period of non-specific musculoskeletal symptoms: A prospective cohort study.
PMID/MRN: 27792862
Publication Date: 2016-Oct-28
Abstract:
We aimed to assess whether the presence of non-specific musculoskeletal symptoms, their degree and change over time predicted the development of psoriatic arthritis (PsA) in a prospective cohort of psoriasis patients without arthritis at baseline.
This prospective cohort study involved patients with psoriasis who were assessed at baseline to exclude the presence of clinical PsA. The study participants were re-assessed annually to determine if they had developed PsA. The presence of musculoskeletal symptoms and patients' scores of pain, fatigue, stiffness, physical functioning and psychological distress were recorded at each visit. These variables served as predictors for the development of PsA. Cox proportional hazard models were used to assess what symptoms predicted the development of PsA.
A total of 57 of 410 psoriasis patients developed PsA since enrollment. At baseline, the presence of arthralgia in women (Hazard Ratio (HR) 2.59, p=0.02), heel pain (HR 4.18, p=0.02), high fatigue score (HR 2.36, p=0.007) and higher stiffness score (HR 2.03, p=0.045) predicted subsequent development of PsA. In addition, an increase from baseline in fatigue score (HR 1.27, p=0.001), pain score (HR 1.34, p<0.001) and stiffness score (HR 1.21, p=0.03) and a worsening in physical function score (HR 0.96, p=0.04) predicted the development of PsA.
A preclinical phase exists in patients with PsA prior to the diagnosis of the disease. This phase is characterized by non-specific musculoskeletal symptoms including joint pain, fatigue and stiffness. This article is protected by copyright. All rights reserved.
© 2016, American College of Rheumatology.