PsA Comorbidities

Psoriatic Arthritis Patients have More Heart Disease

A study of 90 consecutive male (50.3±11.1 years) with psoriatic arthritis (PsA) were were compared to 240 age matched controls without known cardiovascular (CV) diseases who underwent angiography for chest pain and/or multiple CV risk factors.

Increased prevalence of coronary plaque in patients with psoriatic arthritis without prior diagnosis of coronary artery disease

Objectives To evaluate coronary atherosclerosis in patients with psoriatic arthritis (PsA) and control subjects using coronary CT angiography (CCTA). Methods Ninety consecutive patients with PsA (male: 56(62.2%); 50.3±11.1 years) were recruited. 240 controls (male: 137(57.1%); 49.6±10.7 years) witho…
High-risk types more commonly detected

Psoriatic Arthritis is linked to increased cardiovascular morbidity and mortality. The mechanism is postulated to be due to heightened systemic and, in particular, vascular inflammation; leading to plaque formation in the artery wall. Worse still, the plaques in PsA patients tends to be the soft type, which is more prone to rupture and sudden coronary occlusion. Being uncalcified also means it may not be picked up in coronary CT scan as an increased calcium score

MIAMI – Patients with psoriatic arthritis had a higher prevalence and greater extent of coronary artery plaque in a pilot study comparison with healthy control patients that may point to increased risk independent of traditional cardiovascular risk factors.
Why is there an association of soft/mixed plaque formation with Psoriatic Arthritis but not with Psoriasis in this study, when another study suggested a link between Psoriasis and cardiovascular risk? One suggestion is that the Psoriasis was mainly well-controlled in the study subjects as most were on biologics.
Goes to show that people are more willing to splurge on beauty but will rather scrimp on pain relief. Will knowing that PsA can lead to irreversible joint damage and permanent disability, as well as accelerated atherosclerosis and cardiovascular events, change things? What you are willing to spend on reflects your value system.

Psoriatic Arthritis appeared to worsen during pregnancy and in the postpartum period. This may be due to patients opting to stop effective therapy for fear of side-effects to the developing foetus and the breastfed child. Pregnancy therefore needs to be planned, so that patients can be switched to pregnancy-safe DMARDs.

Pregnancy Outcomes in Psoriatic Arthritis

A UK retrospective study published in the…

It is heartening to note that for those who continued on anti-TNF throughout the first trimester (because the biologics do not cross the placenta during this period), there was no foetal malformation. In other studies, Certolizumab pegol appears safe even in the second and third trimesters as its pegylation prevents it from crossing the placenta to any meaningful degree.

Many patients benefit from better skin, although flares may come.
This Toronto study is another small scale retrospective one, but the number doubles the UK one. The conclusions are different, with the arthritis largely stable throughout pregnancy and the first year postpartum. Psoriasis seems to improve during pregnancy.
So, who to believe? This is the trouble with small numbers and retrospective data. That’s how we get facts, factoids, and alternative facts😜

Psoriatic Disease Tied to Elevated Fracture Risk

Patients with psoriatic arthritis and psoriasis may have the same increased risk for fracture as those with rheumatoid arthritis, according to a new study.