Axial involvement in a cohort of patients with psoriatic arthritis

Abstract

Aim of the work: To assess the characteristics of axial involvement in psoriatic arthritis (PsA) patients and to determine risk factors and relation to disease characteristics. Patients and methods: A hundred patients with PsA were studied, classified into two groups according to axial affection. Disease activity in PsA (DAPSA), Bath ankylosing spondylitis disease activity index (BASDAI), axial spondyloarthritis disease activity (ASDAS), psoriatic arthritis Ratingen score (PARS), psoriatic arthritis spondylitis radiology index (BASRI), Bath ankylosing spondylitis metrology index (BASMI), Bath ankylosing functional index (BASFI), health assessment questionnaire (HAQ) and visual analogue scale (VAS) scores were implemented. Results: They were 65 females and 35 males (F:M 1.9:1) with a mean age of 41.6 ± 11.85 years.49 % had axial affection versus 51 % with peripheral affection. Comparing both groups revealed significant association of axial involvement with smoking (p = 0.032), PsA duration (p < 0.001), family history of skin psoriasis or arthritis (p = 0.002), dactylitis (p = 0.036), enthesitis (p < 0.001), BASDAI (p = 0.027), DAPSA (p = 0.003), BASMI (p < 0.0001), BASFI (p = 0.016), HAQ (p < 0.0001), and VAS (p < 0.001) scores. Positive predictors of axial PsA included smoking (p = 0.035), disease onset of skin psoriasis at ≤ 18 years (p < 0.0001), PsA duration > 6 years (p < 0.0001), family history of psoriasis/PsA (p = 0.004), enthesitis (p = 0.001), dactylitis (p = 0.04), CRP > 23 (p = 0.007), DAPSA score > 42 (p = 0.001), BASDAI score > 4.2 (p = 0.003), BASMI score > 0.9 (p < 0.0001). Conclusion: Axial PsA is more frequent in smokers, patients with prolonged disease duration, a positive family history, a higher incidence of enthesitis and dactylitis, raised activity, radiographic and functional scores.