Authors: Silvia Scriffignano, Fabio Massimo Perrotta, Mario di Marino, Francesco Ciccia & Ennio Lubrano
Abstract
Objectives
To stratify psoriatic arthritis (PsA) patients based on psoriasis (PsO) onset age: early onset psoriasis (EOP) vs. late onset psoriasis (LOP), and to assess if there are differences in disease characteristics, activity/function/impact of the disease, and comorbidity indices.
Methods
Cross-sectional analysis of a longitudinal PsA cohort. Patients were stratified based on PsO onset age.
Results
One hundred and sixty PsA patients were enrolled (84 in EOP and 76 in LOP group) in the study. EOP PsA patients seem to have an increased probability to have dactylitis rather than LOP ones, OR 9.64 (3.77–24.6). Comorbidity indices (Rheumatic Disease Comorbidity Index and Charlson Comorbidity Index) were higher in LOP PsA patients, but these data were not confirmed when adjusted by age and sex. There are also differences in the treatment regimen: EOP PsA patients were more frequently treated with anti-interleukin (IL) 17; instead, LOP patients were more frequently treated with non-steroid anti-inflammatory drugs and conventional synthetic disease-modifying anti-rheumatics drugs. There were no differences in the disease activity, function, or impact of the disease.
Conclusions
There are some clinical and therapeutic differences in PsA patients linked to the PsO onset age, namely dactylitis in EOP. Other characteristics found were: a “comorbidities trend” in LOP patients and a more frequent use of anti-IL17 in EOP.
Key Summary Points |
Why carry out this study?Among PsO patients, the PsO onset age distinguishes two different patterns: early onset psoriasis (0–40 years) and late-onset psoriasis (over 40 years). EOP has been identified as a more severe skin disease. Moreover, LOP in PsA patients has been associated with a higher cardiovascular risk. The aim of the present study was to assess any differences in clinical characteristics, disease activity, impact of the disease, function, and comorbidities indices in a group of PsA patients when stratified by EOP and LOP. |
What was learned from the study?In our group of PsA patients, EOP is associated with a higher probability of dactylitis and a more frequent use of anti-IL17. In the LOP group, the assessed comorbidities indices tended to have a higher score, but these data were not confirmed when corrected by age and sex. It could be useful to stratify PsA patients according to the PsO onset age for a clinical patients profiling. This, in turn, could help physicians in the disease severity assessment and in the clinical patients profiling. However, larger studies are needed to confirm these preliminary results. |