Psoriatic arthritis in patients with spondyloarthritis conveys an increased risk of comorbidities, especially cardiovascular and metabolic diseases, as compared with spondyloarthritis alone.
The association persisted even after adjusting for demographic factors, disease duration, and length of treatment, Dr. Naba Haque of the University of Leuven (Belgium) and associates wrote in the Journal of Rheumatology (2015 Dec 15. doi: 10.3899/jrheum.141359).
In an analysis of 518 patients in the spondyloarthritis database at the university, over half (54%) had comorbidities, and those with psoriatic spondyloarthropathy had significantly more comorbidities than those without psoriatic arthropathy (P less than .001). Cardiovascular comorbidities were most common, with an increased prevalence of hypertension, coronary artery disease, and hyperlipidemia in the patients with psoriatic spondyloarthropathy (odds ratios, 1.81, 1.39, and 1.60, respectively; P less than .001). The differences persisted after adjusting for confounders such as age, sex, disease duration, and treatment.
Twice as many patients with spondyloarthritis and psoriatic arthropathy met the criteria for metabolic syndrome as did patients without psoriatric arthropathy (10% vs. 5%, P = .03). The regression model showed a significant difference in the prevalence of diabetes in the PsA patients (OR, 1.35; 95% confidence interval, 1.17-1.56; P less than .001). Psoriatic arthropathy also was linked to an increased risk of cancer (12% vs. 6%; P less than .05); however, the authors wrote that “we can only state a possible positive association … this observation needs to be studied in further detail.”
The study was supported by an unrestricted grant from the Abbvie Chair for psoriatic arthritis research (Dr. Rik J. Lories and Dr. Kurt de Vlam).