Psoriatic Arthritis Research: News You Can Use From EULAR 2021

Four panels presented new understandings of psoriatic arthritis at this year’s European Alliance of Associations for Rheumatology congress.

Everyday Health Archive
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Researchers reported on the latest in PsA diagnosis and treatment at a virtual conference earlier this month.iStock

In early June, EULAR (The European Alliance of Associations for Rheumatology) held a virtual meeting of its annual congress, a forum to present the latest in advancements in rheumatology care.

Four presenters shared new data about psoriatic arthritis (PsA), a type of inflammatory arthritis affecting people with psoriasis, an autoimmune disease. According to Johns Hopkins Rheumatology, PsA affects about 1.5 million people in the United States. Around one-third of all people with psoriasis will develop PsA.

4 Top Takeaways From EULAR for People With Psoriatic Arthritis

1. Did You Have an Echocardiogram? Heart Problems in People With PsA Can Be Detected Early

What’s New?A?study presented by Alejandra B. Rodriguez-Romero of the Hospital Universitario Dr. José Eleuterio González Rheumatology Service at the Universidad Autónoma de Nuevo León in Monterrey, Mexico, compared echocardiograms (a test in which sound waves to produce images of your heart) of people with PsA with control groups of the general population and found the same amount of cardiovascular malformations as in patients with rheumatoid arthritis.

Research Details?When comparing echocardiographic findings, there was a higher amount of diastolic dysfunction in people with PsA or RA when compared with those who had no type of arthritis. Other markers, such as mild mitral valve regurgitation, mild pulmonary valve regurgitation, and the prevalence of abnormal left ventricular geometry, were also higher.

Why This Matters?The study urged doctors to use echocardiograms for a complete cardiovascular evaluation and early detection of cardiac abnormalities in their arthritis patients. This is also something for people living with PsA or RA to be aware of and bring up if their healthcare practitioner does not. The earlier the irregularities are found, the better the outcome. “We strive to educate our patient communities on heart health and studies like this emphasizes the importance of it,” says Daniel Hernandez, MD, director of medical affairs and Hispanic outreach with CreakyJoints. Dr. Hernandez was not associated with any of these studies.

2. Good News: PsA Is Not Linked With Early Death

What’s New?An Israeli study?presented by Amir Haddad, MD, of the department of rheumatology at Carmel Medical Center in Haifa, Israel, showed PsA is not associated with increased mortality. The research team found that while there were more comorbidities in the PsA group, there was no significant increase in death rate, and that treatment with DMARDs reduced mortality. Causes of death were similar to the general population.

Research Details?The research team compared information from a large Israeli population-based medical record database: 5275 people with a new diagnosis of PsA between January 1, 2003, and December 31, 2018, were identified and matched with 21,000 healthy people. The two groups were followed from the index date until the first occurrence of death from any cause or the end of follow-up (June 30, 2019).

Why This Matters?Up until now, studies were small and results were conflicting. This is a more substantial, thorough study.

3. There Are Hints That Can Help Predict When Psoriasis May Develop Into PsA

What’s New?While up to 30 percent of those living with psoriasis (PsO) are prone to develop PsA, there has been little consensus on how to identify those at higher risk. A?study?led by Alen Zabotti, MD, of the rheumatology clinic in the department of medical and biological science at the University of Udine in Italy, found the following risks for PsO patients:

  • Those with arthralgia (joint pain) were twice as likely to develop PsA within two years.
  • Those with joint inflammation or structural damage were nearly 4 times more likely to develop PsA within one to two years.
  • Those with nail pitting, obesity, or a family history of PsA were less predictive but also relevant.

Research Details?The team reviewed and analyzed literature that studied people with psoriasis who went on to develop PsA: 4698 articles were screened for eligibility, 110 underwent a full reading and 29 were finally included.

Why This Matters?“The link between psoriasis and psoriatic arthritis is known but studies like these are important to strengthen our understanding on the predictors. This helps us communicate with our patient community on what to be aware of and when is a good time to speak to their physician about these concerns,” says Hernandez, who was not a part of this study.

4. It’s Importance to Get the Right Diagnosis When It Comes to PsA

What’s New A?retrospective observational study?led by William Tillett, MD,?of the Royal National Hospital for Rheumatic Diseases in Bath, England, found that people with PsO and PsA had a higher prevalence of comorbidities, including depression, diabetes, obesity, and hypertension, as opposed to people with just PsO. Depression also appeared to be more prevalent in people with PsO and PsA receiving biologic treatment as opposed to those receiving conventional drugs.

Research Details?Looking at two cohorts of the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR) database, the researchers analyzed the results of adults with PsO who either received ustekinumab (UST) as a biologic treatment or conventional systemic anti-psoriatic medication such as methotrexate. They then evaluated baseline characteristics and comorbidities in people with psoriasis alone and those with PsA as well.

Why This Matters?This shows the importance of proper diagnosis and follow-up care of PsA and PsO to ensure best treatment of the whole person. The team concluded, “These results potentially indicate a higher inflammatory and quality-of-life burden in PsO patients with a PsA diagnosis, highlighting the need for adequate patient assessment and follow-up to ensure a best possible holistic patient management approach.”