皮肤可以清除,但关节炎不会消失:关注银屑病患者在生物治疗的日常实践队列中伴随和新发银屑病关节炎。

IF 5.2 Q1 DERMATOLOGY Psoriasis (Auckland, N.Z.) Pub Date : 2020-10-05 eCollection Date: 2020-01-01 DOI:10.2147/PTT.S270619
Marloes E van Muijen, Tamara W van Hal, Hans M M Groenewoud, Juul M P A van den Reek, Elke M G J de Jong
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引用次数: 5

摘要

背景:先前确定的银屑病关节炎(PsA)的危险因素;指甲营养不良和头皮病变在中重度牛皮癣患者中非常普遍。因此,这些变量可能不能作为该人群PsA的预测因子。目的:我们评估人口统计学和临床特征对目前接受生物制剂治疗的中重度牛皮癣患者PsA发展的预测价值。此外,我们报告了该人群中新发PsA的发病率,并描述了在生物治疗期间发生PsA的患者的特征。方法:从BioCAPTURE数据库(n=427)中提取目前使用生物治疗的银屑病患者的人口统计学和治疗特征。用泊松回归计算发病率。进行多变量logistic回归以确定与PsA发病独立相关的因素。描述了在生物治疗过程中发生PsA的患者和治疗特点。结果:PsA的发生率为1.0 (95% CI 0.8-1.2) / 100牛皮癣年。除了男性患PsA的风险较低(OR 0.58, 95% CI 0.34-0.98, p值0.04)外,没有临床因素与PsA发生风险的改变显著相关。生物治疗期间,32例(9.4%)新发PsA。结论:临床危险因素可能无法准确预测使用生物制剂治疗的中重度银屑病患者的PsA发病情况。即使疾病活动度较低,使用生物制剂的牛皮癣患者仍容易发生PsA。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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The Skin May Clear But the Arthritis Won't Disappear: Focusing on Concomitant and New-Onset Psoriatic Arthritis in a Daily Practice Cohort of Psoriasis Patients on Biologic Therapy.

Background: Previously identified risk factors for psoriatic arthritis (PsA); nail dystrophy and scalp lesions are highly prevalent in patients with moderate-to-severe psoriasis. Therefore, these variables may not be useful as predictors for PsA in this population.

Objective: We assessed the predictive value of demographic and clinical characteristics for development of PsA in a cohort of patients with moderate-to-severe psoriasis, currently treated with biologics. Furthermore, we reported the incidence of new-onset PsA in this population and described the characteristics of patients that developed PsA during biologic treatment.

Methods: Demographics and treatment characteristics of psoriasis patients currently using biologic therapy were extracted from the BioCAPTURE database (n=427). Poisson regression was used to calculate incidence rates. Multivariable logistic regression was performed to identify factors independently associated with PsA onset. Patient and treatment characteristics of patients that developed PsA during biologic treatment were described.

Results: The incidence of PsA was 1.0 (95% CI 0.8-1.2) per 100 psoriasis-years. Except for a lower risk for PsA in male gender (OR 0.58, 95% CI 0.34-0.98, p-value 0.04), no clinical factors were significantly associated with an altered risk of developing PsA. During biologic therapy, 32 patients (9.4%) newly developed PsA. In this group, 53.8% had PASI<5 at PsA diagnosis. The incidence rate of PsA was 1.6 (95% CI 1.1-2.2) per 100 years on biologic therapy.

Conclusion: Clinical risk factors might be inaccurate to predict PsA onset in patients with moderate-to-severe psoriasis on biologics. Even with low disease activity, psoriasis patients on biologics are still prone to develop PsA.

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