medwireNews: The presence of dactylitis may be indicative of more severe disease among DMARD-naïve patients with early psoriatic arthritis (PsA), study findings indicate.
In their analysis of 177 patients, Helena Marzo-Ortega (Leeds Musculoskeletal Biomedical Research Centre, UK) and colleagues found that the 81 with dactylitis at baseline had significantly higher median tender and swollen joint counts than the 96 without dactylitis, at nine versus four and seven versus one, respectively.
Moreover, patients with dactylitis were significantly more likely than those without to have clinical enthesitis (51.9 vs 35.4%) and elevated C-reactive protein levels (>10 mg/L; 44.4 vs 25.0%). Among the 155 people who underwent ultrasound imaging, the 69 with dactylitis had significantly greater rates of synovitis (23.6 vs 16.1%) and periarticular cortical bone lesions (29.0 vs 12.8%) relative to the 86 without.
These findings “provide an insight into the significance of dactylitis in early PsA, demonstrating that it is an indicator of a more severe phenotype,” write Marzo-Ortega et al in the Annals of the Rheumatic Diseases.
They add that their data “may further inform management strategies, including clinical trials for targeted therapy to understand differential responses within PsA phenotypes.”
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Ann Rheum Dis 2021; doi:10.1136/annrheumdis-2021-220964