Nature and Treatment Received for Psoriasis and Co-morbidities in Patients with Psoriatic Arthritis. A Multi-centre Observational Study from Western India

Many recent studies have suggested a changing paradigm of management of psoriatic disease. One of the main concerns is the lost opportunity of controlling ‘psoriatic disease’ during the early phase, especially when the disease is limited to the skin. The study’s main aim was to determine psoriasis (PsO) treatment before the patient’s presentation to the rheumatologist. We also studied the associated comorbidities in these patients. This was a cross-sectional study done at eight centres. Data was collected from 375 patients with psoriatic arthritis (PsA) about their demography, details of psoriatic lesions, treatment taken for them, additional co-morbidities and pattern of PsA. Only 22.4% of patients had received oral methotrexate for PsO: the majority for less than a year. Plaque and scalp PsO were the most common, and 75% of patients had body surface area involvement greater than 5%. There was a significantly higher prevalence of type II diabetes mellitus (T2DM) (24% vs. 9.1%) and obesity as compared to the general population. Few patients received sustained systemic treatment for PsO prior to the development of arthritis. There was a significant association of co-morbidities such as T2DM and obesity with PsA.