Progression of peripheral joint disease in psoriatic arthritis

The evolution of disease subgroups and frequency of progression of peripheral joint disease has been described in a recent prospective study of patients with psoriatic arthritis (PsA).Eighty-seven patients (49 females, 38 males) completed the current investigation including a study proforma at a median follow-up interval of 65 months (range 39-90). An analysis of initial plasma viscosity compared with rates of progression of joint score was also performed.Over the follow-up period 18 patients changed subgroup; 11 had an increase in the number of joints involved, six a decrease, and one changed from an oligoarticular pattern to predominant spondylitis. Within the polyarticular group 37/51 patients had an increase in the number of joints involved.For the whole population, there were significant increases in the number of joints involved (median 6 v 11, pThe rate of peripheral joint involvement was reported to be highest in the first year of arthritis (median 4.0 joints/yr) as measured in 13 patients who had onset within 12 months of baseline assessment. There were no significant differences in skin and nail scores although nine more patients had developed nail disease. There was a significant correlation between the initial viscosity and rate of progression of joint damage (Spearman correlation, pThe authors highlight the need for effective monitoring and treatment of peripheral joint disease in patients with psoriatic arthritis, particularly in view of the progressive nature of the condition for a majority of patients, as described within this study.Reference...