Axial Disease in Psoriatic Arthritis study

defining the clinical and radiographic phenotype of psoriatic spondyloarthritis

Deepak R Jadon, Raj Sengupta, Alison Nightingale, Mark Lindsay, Eleanor Korendowych, Graham Robinson, Amelia Jobling, Gavin Shaddick, Jing Bi, Robert Winchester, Jon T Giles, Neil J McHugh

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Abstract

OBJECTIVES: To compare the prevalence, clinical and radiographic characteristics of psoriatic spondyloarthritis (PsSpA) in psoriatic arthritis (PsA), with ankylosing spondylitis (AS).

METHODS: A prospective single-centre cross-sectional observational study recruited consecutive PsA and AS cases. Participants completed outcome measures, and underwent clinical examination, axial radiographic scoring and HLA-sequencing. Multivariable analyses are presented.

RESULTS: The 402 enrolled cases (201 PsA, 201 AS; fulfilling classification criteria for respective conditions) were reclassified based upon radiographic axial disease and psoriasis, as: 118 PsSpA, 127 peripheral-only PsA (pPsA), and 157 AS without psoriasis (AS) cases. A significant proportion of patients with radiographic axial disease had PsSpA (118/275; 42.91%), and often had symptomatically silent axial disease (30/118; 25.42%). Modified New York criteria for AS were fulfilled by 48/201 (23.88%) PsA cases, and Classification of Psoriatic Arthritis criteria by 49/201 (24.38%) AS cases. pPsA compared with PsSpA cases had a lower frequency of HLA-B*27 (OR 0.12; 95% CI 0.05 to 0.25). Disease activity, metrology and disability were comparable in PsSpA and AS. A significant proportion of PsSpA cases had spondylitis without sacroiliitis (39/118; 33.05%); they less frequently carried HLA-B*27 (OR 0.11; 95% CI 0.04 to 0.33). Sacroiliac joint complete ankylosis (adjusted OR, ORadj 2.96; 95% CI 1.42 to 6.15) and bridging syndesmophytes (ORadj 2.78; 95% CI 1.49 to 5.18) were more likely in AS than PsSpA. Radiographic axial disease was more severe in AS than PsSpA (Psoriatic Arthritis Spondylitis Radiology Index Score: adjusted incidence risk ratio 1.13; 95% CI 1.09 to 1.19).

CONCLUSIONS: In a combined cohort of patients with either PsA or AS from a single centre, 24% fulfilled classification criteria for both conditions. The pattern of axial disease was influenced significantly by the presence of skin psoriasis and HLA-B*27.

Original languageEnglish
Pages (from-to)701-707
Number of pages7
JournalAnnals of the Rheumatic Diseases
Volume76
Issue number4
Early online date2 Dec 2016
DOIs
Publication statusPublished - 10 Mar 2017

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Psoriatic Arthritis
Ankylosing Spondylitis
Phenotype
HLA-B Antigens
Psoriasis
Spondylitis
Radiology
Clinical Studies
Skin
Sacroiliitis
Sacroiliac Joint
Ankylosis
Observational Studies
Cross-Sectional Studies
Odds Ratio
Outcome Assessment (Health Care)

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Axial Disease in Psoriatic Arthritis study : defining the clinical and radiographic phenotype of psoriatic spondyloarthritis. / Jadon, Deepak R; Sengupta, Raj; Nightingale, Alison; Lindsay, Mark; Korendowych, Eleanor; Robinson, Graham; Jobling, Amelia; Shaddick, Gavin; Bi, Jing; Winchester, Robert; Giles, Jon T; McHugh, Neil J.

In: Annals of the Rheumatic Diseases, Vol. 76, No. 4, 10.03.2017, p. 701-707.

Research output: Contribution to journalArticle

Jadon, Deepak R ; Sengupta, Raj ; Nightingale, Alison ; Lindsay, Mark ; Korendowych, Eleanor ; Robinson, Graham ; Jobling, Amelia ; Shaddick, Gavin ; Bi, Jing ; Winchester, Robert ; Giles, Jon T ; McHugh, Neil J. / Axial Disease in Psoriatic Arthritis study : defining the clinical and radiographic phenotype of psoriatic spondyloarthritis. In: Annals of the Rheumatic Diseases. 2017 ; Vol. 76, No. 4. pp. 701-707.
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abstract = "OBJECTIVES: To compare the prevalence, clinical and radiographic characteristics of psoriatic spondyloarthritis (PsSpA) in psoriatic arthritis (PsA), with ankylosing spondylitis (AS).METHODS: A prospective single-centre cross-sectional observational study recruited consecutive PsA and AS cases. Participants completed outcome measures, and underwent clinical examination, axial radiographic scoring and HLA-sequencing. Multivariable analyses are presented.RESULTS: The 402 enrolled cases (201 PsA, 201 AS; fulfilling classification criteria for respective conditions) were reclassified based upon radiographic axial disease and psoriasis, as: 118 PsSpA, 127 peripheral-only PsA (pPsA), and 157 AS without psoriasis (AS) cases. A significant proportion of patients with radiographic axial disease had PsSpA (118/275; 42.91{\%}), and often had symptomatically silent axial disease (30/118; 25.42{\%}). Modified New York criteria for AS were fulfilled by 48/201 (23.88{\%}) PsA cases, and Classification of Psoriatic Arthritis criteria by 49/201 (24.38{\%}) AS cases. pPsA compared with PsSpA cases had a lower frequency of HLA-B*27 (OR 0.12; 95{\%} CI 0.05 to 0.25). Disease activity, metrology and disability were comparable in PsSpA and AS. A significant proportion of PsSpA cases had spondylitis without sacroiliitis (39/118; 33.05{\%}); they less frequently carried HLA-B*27 (OR 0.11; 95{\%} CI 0.04 to 0.33). Sacroiliac joint complete ankylosis (adjusted OR, ORadj 2.96; 95{\%} CI 1.42 to 6.15) and bridging syndesmophytes (ORadj 2.78; 95{\%} CI 1.49 to 5.18) were more likely in AS than PsSpA. Radiographic axial disease was more severe in AS than PsSpA (Psoriatic Arthritis Spondylitis Radiology Index Score: adjusted incidence risk ratio 1.13; 95{\%} CI 1.09 to 1.19).CONCLUSIONS: In a combined cohort of patients with either PsA or AS from a single centre, 24{\%} fulfilled classification criteria for both conditions. The pattern of axial disease was influenced significantly by the presence of skin psoriasis and HLA-B*27.",
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TY - JOUR

T1 - Axial Disease in Psoriatic Arthritis study

T2 - defining the clinical and radiographic phenotype of psoriatic spondyloarthritis

AU - Jadon, Deepak R

AU - Sengupta, Raj

AU - Nightingale, Alison

AU - Lindsay, Mark

AU - Korendowych, Eleanor

AU - Robinson, Graham

AU - Jobling, Amelia

AU - Shaddick, Gavin

AU - Bi, Jing

AU - Winchester, Robert

AU - Giles, Jon T

AU - McHugh, Neil J

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

PY - 2017/3/10

Y1 - 2017/3/10

N2 - OBJECTIVES: To compare the prevalence, clinical and radiographic characteristics of psoriatic spondyloarthritis (PsSpA) in psoriatic arthritis (PsA), with ankylosing spondylitis (AS).METHODS: A prospective single-centre cross-sectional observational study recruited consecutive PsA and AS cases. Participants completed outcome measures, and underwent clinical examination, axial radiographic scoring and HLA-sequencing. Multivariable analyses are presented.RESULTS: The 402 enrolled cases (201 PsA, 201 AS; fulfilling classification criteria for respective conditions) were reclassified based upon radiographic axial disease and psoriasis, as: 118 PsSpA, 127 peripheral-only PsA (pPsA), and 157 AS without psoriasis (AS) cases. A significant proportion of patients with radiographic axial disease had PsSpA (118/275; 42.91%), and often had symptomatically silent axial disease (30/118; 25.42%). Modified New York criteria for AS were fulfilled by 48/201 (23.88%) PsA cases, and Classification of Psoriatic Arthritis criteria by 49/201 (24.38%) AS cases. pPsA compared with PsSpA cases had a lower frequency of HLA-B*27 (OR 0.12; 95% CI 0.05 to 0.25). Disease activity, metrology and disability were comparable in PsSpA and AS. A significant proportion of PsSpA cases had spondylitis without sacroiliitis (39/118; 33.05%); they less frequently carried HLA-B*27 (OR 0.11; 95% CI 0.04 to 0.33). Sacroiliac joint complete ankylosis (adjusted OR, ORadj 2.96; 95% CI 1.42 to 6.15) and bridging syndesmophytes (ORadj 2.78; 95% CI 1.49 to 5.18) were more likely in AS than PsSpA. Radiographic axial disease was more severe in AS than PsSpA (Psoriatic Arthritis Spondylitis Radiology Index Score: adjusted incidence risk ratio 1.13; 95% CI 1.09 to 1.19).CONCLUSIONS: In a combined cohort of patients with either PsA or AS from a single centre, 24% fulfilled classification criteria for both conditions. The pattern of axial disease was influenced significantly by the presence of skin psoriasis and HLA-B*27.

AB - OBJECTIVES: To compare the prevalence, clinical and radiographic characteristics of psoriatic spondyloarthritis (PsSpA) in psoriatic arthritis (PsA), with ankylosing spondylitis (AS).METHODS: A prospective single-centre cross-sectional observational study recruited consecutive PsA and AS cases. Participants completed outcome measures, and underwent clinical examination, axial radiographic scoring and HLA-sequencing. Multivariable analyses are presented.RESULTS: The 402 enrolled cases (201 PsA, 201 AS; fulfilling classification criteria for respective conditions) were reclassified based upon radiographic axial disease and psoriasis, as: 118 PsSpA, 127 peripheral-only PsA (pPsA), and 157 AS without psoriasis (AS) cases. A significant proportion of patients with radiographic axial disease had PsSpA (118/275; 42.91%), and often had symptomatically silent axial disease (30/118; 25.42%). Modified New York criteria for AS were fulfilled by 48/201 (23.88%) PsA cases, and Classification of Psoriatic Arthritis criteria by 49/201 (24.38%) AS cases. pPsA compared with PsSpA cases had a lower frequency of HLA-B*27 (OR 0.12; 95% CI 0.05 to 0.25). Disease activity, metrology and disability were comparable in PsSpA and AS. A significant proportion of PsSpA cases had spondylitis without sacroiliitis (39/118; 33.05%); they less frequently carried HLA-B*27 (OR 0.11; 95% CI 0.04 to 0.33). Sacroiliac joint complete ankylosis (adjusted OR, ORadj 2.96; 95% CI 1.42 to 6.15) and bridging syndesmophytes (ORadj 2.78; 95% CI 1.49 to 5.18) were more likely in AS than PsSpA. Radiographic axial disease was more severe in AS than PsSpA (Psoriatic Arthritis Spondylitis Radiology Index Score: adjusted incidence risk ratio 1.13; 95% CI 1.09 to 1.19).CONCLUSIONS: In a combined cohort of patients with either PsA or AS from a single centre, 24% fulfilled classification criteria for both conditions. The pattern of axial disease was influenced significantly by the presence of skin psoriasis and HLA-B*27.

U2 - 10.1136/annrheumdis-2016-209853

DO - 10.1136/annrheumdis-2016-209853

M3 - Article

VL - 76

SP - 701

EP - 707

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 4

ER -