Risk factors for axial inflammatory arthritis in patients with psoriatic arthritis
The Journal of Rheumatology, 03/18/2010
Chandran V et al. – Axial involvement is an important manifestation of psoriatic arthritis (PsA). This study aimed to identify risk factors associated with the presence of axial PsA (AxPsA) in patients with PsA. The results of this study suggest that severe peripheral arthritis and HLA-B*27 are risk factors for AxPsA.
Patients with AxPsA (bilateral sacroiliitis ≥ grade 2/unilateral sacroiliitis ≥ 3 and inflammatory neck/back pain or limited spinal mobility) at first clinic visit were identified from the University of Toronto PsA clinic database
Risk factors associated with presence of AxPsA were determined
Patients without AxPsA at first clinic visit were identified
Under a multistate framework, proportion of patients with PsA who subsequently developed AxPsA was estimated robustly using marginal methods and Markov model
Risk factors at baseline that were associated with future development of AxPsA were identified through multiplicative time-homogeneous Markov models
Included 206 patients
50 patients had AxPsA at first clinic visit. HLA-B*27, radiographic damage to peripheral joints, and elevated ESR increased odds of having AxPsA, while family history of PsA decreased the odds
156 patients did not have AxPsA at first clinic visit
On followup, 28 developed AxPsA, and 11 died
Estimated that after 10 years of followup, 15% would develop AxPsA
Nail dystrophy, number of radiographically damaged joints, periostitis, and elevated ESR increased the risk of developing AxPsA, while swollen joints decreased risk
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