Complications and comorbidities in established psoriatic arthritis patient – case report
Authors:
L. Podrazilová 1; T. Zitko 2
Authors‘ workplace:
Revma Praha s. r. o.
1; Artmedi UPD Hostivice
2
Published in:
Čes. Revmatol., 31, 2023, No. 3, p. 152-159.
Category:
Case Report
Overview
We present a 72-year-old female patient with an established diagnosis of psoriatic arthritis (PsA), with skin manifestations since the age of 10 and joint involvement since the age of 18. The patient was diagnosed with PsA (a polyarticular form with left-sided sacroiliitis, HLA-B27 positive) only at the age of 43. At the beginning of the disease, the patient was treated with conventional synthetic disease-modifying antirheumatic drugs (cDMARDs), for clinical and laboratory activity, the patient was later transferred to biological treatment (bDMARDs) with good effect. During the disease and as a result of the therapy, the patient developed several complications and comorbidities, including infectious, cardiovascular, metabolic, and osteoporotic with a significant psychosocial impact
Keywords:
Psoriatic arthritis – biological treatment – skin manifestations – joint involvement
Sources
- Ryan C, Kirby B. Psoriasis is a systemic disease with multiple cardiovascular and metabolic comorbidities. Dermatol Clin 2015; 33: 41–55.
- Ogdie A, Schwartzman S, Eder L, Maharaj AB, Zisman D, Raychaurdhuri SP, et al. Comprehensive treatment of psoriatic arthritis: managing comorbidities and extraarticular manifestations. J Rheumatol 2014; 41: 2315–2322.
- Scarpa R, Ayala F, Caporaso N, et al. Psoriasis, psoriatic arthritis, or psoriatic disease? J Rheumatol 2006; 33: 210–212.
- Kimball AB, Szapary P, Mrowietz U, Reich K, Langley RG, You Y, et al. Underdiagnosis and undertreatment of cardiovascular risk factors in patient with moderate to severe psoriais. J Am Acad Dermatol 2012; 67: 76–85.
- Popescu C, Zofata S, Bojinca V, Jonescu R. Anti-cyclic citrullinated peptide antibodies in psoriatic arthritis cross-sectional study and literature review. J Med Life 2013; 6(4): 376–382.
- Gossec L, Smolen JS, Gaujoux-Viala C, et al. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies. Ann Rheum Dis 2012; 71: 4–12.
- Gossec L, Smolen JS, Ramiro S, et al. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Ann Rheum Dis 2016; 75: 499–510.
- Kerschbaumer A, Smolen JS, Dougados M, et al. Pharmacological treatment of psoriatic arthritis: a systemic literature research for the 2019 update of the EULAR recommendations for the management of psoriatic artrhritis. Ann Rheum Dis 2020; 79: 700–712.
- Štolfa J, Vencovský J, Pavelka K. Doporučené léčebné postupy pro psoriatickou artritidu. Čes. Revmatol. 2016; 24: 142–152.
- Vena GA, Vestia M, Cassano N. Can early treatment with biologicals modify the natural history of comorbidities. Dermatol Ther 2010; 23: 181–193.
- Biggioggero M, et al. The management of acute anterior uveitis complicating spondylartrhritis: present and future. Biomed Res Int 2018; 9460187.
- Benfaremo D, Lucheti MM, Gabrielli A. Biomarkers in inflammatory bowel disease-associated spondylarthritis: stat of the art and unmet needs. J Immun Res 2019; 8630871.
- Ferguson LD, Siebert S, McInnes IB, Sattar N. Cardiometabolic comorbidities in RA and PSA: lessons learned and future directions. Nat Rev Rheumatol 1996; 15: 461–474.
- Gisondi P, Tessari G, Conti A, Piaserico S, Schianchi S, Peserico A, et al. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study. Br J Dermatol 2007; 157: 68–73.
- Armstrong AW, Lin SW, Chambers CJ, Sockolov ME, Chin DL. Psoriasis and Hypertensin Severity: Result from a Case-Control Study. PLoS One 2011; 6: e18227.
- GonzalesGay MA, De Matias JM, Gonzales-Juanaty C, GarciaPorrua C, Sanchez-Andrade A, Martin J, et al. Anti-tumor necrosis factor-alpha blockade improves insulin resistence in patient with rheumatoid arthritis. Clin Exp Rheumatol 2006; 24: 83–86.
- Martínez-Abundis E, Reynoso-von Drateln C, HernándezSalazar E, González-Ortiz M. Effect of etanercept on insulin secretion and insulin sensitivity in a randomized trial with psoriatis patients at risk for developing typu 2 diabetes mellitus. Arch Dermatol Res 2007; 299: 461–465.
- Ma C, Harskamp CT, Armstrong EJ, Armstrong AW. The association between psoriasis nad dyslipideamia a systematic review. Br J Dermatol 2013; 168: 486–495.
- Gisondi P, Tessari G, Conti A, Piaserico S, Schinchi S, Peserico A, et al. Prevalence of metabolic syndrome in patients with psoriasis a hospital-based case-control study. Br J Dermatol 2007; 157: 68–73.
- Armstrong AW, Harskamp CT, Armstrong EJ. Psoriasis and the risk of diabetes mellitus a systmatic review and meta-analysis. JAMA Dermatol 2013; 149: 84–91.
- Puig L. Obesity and psoriasis: body weight and body mass index influence the response to biological treatment. J Eur Acad Dermatol Venereol 2013; 25: 1007–1011.
- Al-Matairi N, Nour T. The effect of weight reduction on treatment outcomes in obese patients with psoriasis on biological therapy a randomized controlled prospective trial. Exper Opin Biol.Ther 2014; 14: 749–756.
- Ahlehoff O, Skov L, Gislason G, et al. Cardiovascular disease event rates in patients with severe psoriacis treated with systematic anti-inflammatory drugs a Danish real-world cohort study. J Intern Med 2013; 273: 197–204.
- Liew JW, Ramiro S, Gensler LS. Cardiovascular morbidity and mortality in ankylosing spondylitis and psoriatic arthritis. Best Pract Res Clin Rheuamtol 2018; 32: 369–389.
- Rungapiromnan W., Yiu ZZN, Warren RB, Griffiths CEM, Ashcroft DM. Impact of biological therapies on risk of major adverse cardiovascular events in patients with psoriasis: systematic review and meta-anylysis of randomized controlled trials. Br J Dermatol 2017; 176(4): 890–901.
- Ritchlin CT, Haas Smith SA, Li P, Hicks DG, Shwarz EM. Mechanisms of TNF alpha and RANKL mediated osteoclastogenesis and bone resorption in psoriatic arthritis. J Clin Invest 2003; 111: 828–831.
- Campanati A, Ganzetti G, Di Sario A, Damiani A, Sandroni L, Rosa L, et al. The effect of etanercept on hepatic fibrosis risk in patients with non-alcoholic fatty liver disease, metabolic syndrome and psoriasis. J Gastroenterol 2013; 48: 839–846.
- Springate DA, Parisi R, Kontopantelis E, et al. Incidence, prevalence and mortality of patients with psoriasis: a U.K.populattionbased cohort study. Br J Dematol 2017; 176(3): 650–658.
- Dowlatshahi EA, Wakkee M, Arends LR, Nijisten T. The prevalence nad odds of depressive symptoms nad clinical depression in psoriasis pateints: a systematic review nad meta-analysis. Journal of Investigative Dermatology 2014; 134: 1542–1551.
- Kurd SK, Troxel AB, Crits-Christoph P, et al. The risk of depression, anxiety and suicidality in patients with psoriasis: a population-based cohort study. Arch Dermatol 2010; 146: 891–895.
- Kaushik SB, Lebwohl MG. Psoriasis: Which therapy for which patient: Psoriasis comorbidities and preffered systematic agents. J Am Acad Dermatol 2019; 80: 27–40.
Labels
Dermatology & STDs Paediatric rheumatology RheumatologyArticle was published in
Czech Rheumatology
2023 Issue 3
Most read in this issue
- The anniversary of chief radiologist Jindra Gatterová
- Quo vadis dětská revmatologie?
- Pain in axial spondyloarthritis – causes, evaluation, differential diagnosis and therapy options
- Pregnancy issues in rheumatic diseases