Comparative characteristics of axial spondyloarthritis and psoriatic arthritis with axial involvement

Objective – to compare clinical characteristics of patients with axial spondyloarthritis (axSpA)/ankylosing spondylitis (AS) and with axial psoriatic arthritis (axPsA). Subjects and methods . 100 patients were examined: 45 – with axSpA/AS (group 1), 55 – with axPsA (group 2). Patients of group 1 wer...

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Published inNauchno-prakticheskai͡a︡ revmatologii͡a Vol. 62; no. 2; pp. 168 - 175
Main Authors Gubar, Е. Е., Korotaeva, Т. V., Dubinina, Т. V., Vorobyeva, L. D., Tremaskina, Р. О., Agafonova, Е. М., Korsakova, Yu. L., Loginova, Е. Yu, Sakharova, К. V., Sablina, А. О., Smirnov, А. V., Erdes, S. F., Urumova, М. М., Glukhova, S. I.
Format Journal Article
LanguageEnglish
Russian
Published IMA PRESS LLC 28.04.2024
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Summary:Objective – to compare clinical characteristics of patients with axial spondyloarthritis (axSpA)/ankylosing spondylitis (AS) and with axial psoriatic arthritis (axPsA). Subjects and methods . 100 patients were examined: 45 – with axSpA/AS (group 1), 55 – with axPsA (group 2). Patients of group 1 were included according to axSpA/AS criteria, patients of group 2 – according to CASPAR (ClASsification criteria for Psoriatic ARthritis) criteria, and having axial involvement (axPsA). Axial involvement was detected in case of radiologically significant sacroiliitis (bilateral grade ≥2 or unilateral grade ≥3) or active MRI sacroiliitis, or ≥1 syndesmophyte(s) of the cervical and/or lumbar spine. Patients were evaluated for presence of inflammatory back pain (IBP) by ASAS (Assessment of Spondyloarthritis International Society) criteria. Results and discussion. Patients of group 1 were younger (p<0.001), more often HLA-B27 positive (p<0.001), had more IBP (p=0.001). Patients of group 2 had older age (>40 years) at back pain onset (p<0.001), more often peripheral arthritis (p<0.001), dactylitis (p=0.004), and skin psoriasis (p<0.001). Nail psoriasis was found only in group 2 patients (p<0.001). Group 1 patients had more often heel enthesitis (p=0.005). Group 2 patients had worse axial disease activity scores: BASDAI (Bath Ankylosing Spondylitis Disease Activity Index; p=0.006) and ASDAS-СRP (Ankylosing Spondylitis Disease Activity Score with C-reactive protein level determination; р<0.001); and worse patient reported outcomes: BASFI (Bath Ankylosing Spondylitis Functional Index; p=0.004), patients’ pain (p=0.005) and patients’ global assessments (p=0.036). Patients of group 2 had more syndesmophytes of the lumbar (р=0.009) and cervical (р=0.007) spine. Only in group 2 patients, chunky “non-marginal” syndesmophytes were found (in 32.1%), as well as spinal lesions without sacroiliitis (in 20.0%). Patients of group 2 had more joint erosions (р=0.001), osteolysis (р=0.015), juxta-articular bone formation (р<0.001) and joint ankyloses (р=0.02). All patients of group 1 and only 80% of group 2 (р=0.003) met ASAS criteria for axSpA. AxSpA/AS and axPsA seem to be two different diseases. In our cohort of patients, axPsA patients had worse disease status compared to axSp and AS.
ISSN:1995-4484
1995-4492
DOI:10.47360/1995-4484-2024-168-175