Early diagnosis of psoriatic arthritis among psoriasis patients: clinical experience sharing

• Published in: Clinical rheumatology Vol. 39; no. 12; pp. 3677 - 3684
• Main Author: Su, Yu-Jih
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2020; Springer Nature B.V
• Subjects: Allergic rhinitis; Arthritis; Arthritis, Psoriatic - complications; Arthritis, Psoriatic - diagnosis; Arthritis, Psoriatic - epidemiology; Diagnosis; Early Diagnosis; Early experience; Gout; Humans; Hyperlipidemia; Inflammation; Medicine; Medicine & Public Health; Metabolic syndrome; Original; Original Article; Psoriasis; Psoriasis - complications; Psoriasis - diagnosis; Psoriasis - epidemiology; Psoriatic arthritis; Retrospective Studies; Rheumatology; Serology; Tumor necrosis factor-α; Ultrasonography; MicroRNA; Psoriasis; Metabolic syndrome; Allergic rhinitis; Psoriatic arthritis
• ISSN: 0770-3198; 1434-9949
• DOI: 10.1007/s10067-020-05132-1

Background The early detection of psoriatic arthritis (PSA) poses a challenge to rheumatologists, even when their diagnosis is aided by sonography. In order to facilitate early detection of PSA among patients with psoriasis (PSO), we retrospectively analyzed of the relationships between serological markers and comorbidities in 629 psoriatic patients, 102 of which had PSA, while the other 527 had PSO. Results Serological markers were found not to be useful in distinguishing between PSA and PSO ( p  > 0.05 for all comparisons). The prevalence rate of PSA among PSO patients was around 19.4%. Two components of metabolic syndrome—hyperlipidemia (2.94%) and gout (4.9%)—were significantly more prevalent in PSA patients than in PSO patients ( p  < 0.05). The odds ratio for PSA is 15.94 in patients with hyperlipidemia with a 95% confidence interval (CI) of 1.64–154.80; meanwhile, the odds ratio for PSA is 3.83 in patients with gout with a 95% CI of 1.19–12.31. Allergic rhinitis (5.88%) was more prevalent in PSA patients than in PSO patients ( p  < 0.01). The odds ratio was 8.17 in patients with allergic rhinitis with a 95% CI of 2.26–29.50. Plasma hs-miR-210-3p distinguishes PSA from PSO, and its levels can also be distinguished from PSA after treated with anti-TNFα biologics agents (both p  < 0.05). Conclusions No clinical available serology markers, but hyperlipidemia, gout, axial spondylopathy (inflammatory back pain), or allergic rhinitis, could differentiate between psoriatic arthritis from psoriasis. Plasma hs-miR-210-3p and comorbidities may differentiate psoriatic arthritis from psoriasis. Key Points • Clinical manifestations and comorbidities are different between psoriatic arthritis and psoriasis only patients. • Traditional serology markers are similar between psoriatic arthritis and psoriasis-only patients. • Plasma hs-miR-210-3p distinguishes PSA from PSO, and its levels can also be distinguished from PSA after treated with anti-TNFα biologics agents in our study.