Psoriatic arthritis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]
Overview
If left untreated psoriatic arthritis may lead to severe joint destruction and deformity resulting in loss of physical function and reduced quality of life. Psoriatic arthritis is associated with various comorbid conditions including cardiovascular disease ( increased risk of atherosclerosis, myocardial infarction, heart failure), metabolic syndrome, liver disease, diabetes mellitus, depression and osteoporosis. Prognosis is good with early diagnosis and treatment. Overall survival rate also depends on management of comorbid conditions along with arthritis treatment.
Natural History, Complications and Prognosis
- If left untreated psoriatic arthritis may lead to severe joint destruction and deformity resulting in loss of physical function and reduced quality of life.
- Common complications or comorbid conditions associated with psoriatic arthritis include:[1][2][3][4][5][6][7]
- Metabolic syndrome
- Progressive joint destruction and deformity
- Hypertension
- Increase insulin resistance and diabetes mellitus
- Dyslipidemia
- Increased atherosclerotic risk
- Myocardial infarction
- Congestive heart failure
- Arrythmias
- Stroke
- Inflammatory bowel disease
- Osteoporosis
- Depression
- Increased risk for malignancy (breast, prostate, and lung)
- uveitis
- Non alcoholic fatty liver disease
- Decreased quality of life
- Prognosis is generally good with early diagnosis and treatment with DMARDs and TNF inhibitors. Overall survival rate also depends on management of comorbid conditions along with arthritis treatment.[8][9]
References
- ↑ Han C, Robinson DW, Hackett MV, Paramore LC, Fraeman KH, Bala MV (November 2006). "Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis". J. Rheumatol. 33 (11): 2167–72. PMID 16981296.
- ↑ Labitigan M, Bahče-Altuntas A, Kremer JM, Reed G, Greenberg JD, Jordan N, Putterman C, Broder A (April 2014). "Higher rates and clustering of abnormal lipids, obesity, and diabetes mellitus in psoriatic arthritis compared with rheumatoid arthritis". Arthritis Care Res (Hoboken). 66 (4): 600–7. doi:10.1002/acr.22185. PMC 3969762. PMID 24115739.
- ↑ Eder L, Wu Y, Chandran V, Cook R, Gladman DD (September 2016). "Incidence and predictors for cardiovascular events in patients with psoriatic arthritis". Ann. Rheum. Dis. 75 (9): 1680–6. doi:10.1136/annrheumdis-2015-207980. PMID 26493817.
- ↑ Rohekar S, Tom BD, Hassa A, Schentag CT, Farewell VT, Gladman DD (January 2008). "Prevalence of malignancy in psoriatic arthritis". Arthritis Rheum. 58 (1): 82–7. doi:10.1002/art.23185. PMID 18163513.
- ↑ McDonough E, Ayearst R, Eder L, Chandran V, Rosen CF, Thavaneswaran A, Gladman DD (May 2014). "Depression and anxiety in psoriatic disease: prevalence and associated factors". J. Rheumatol. 41 (5): 887–96. doi:10.3899/jrheum.130797. PMID 24692521.
- ↑ Ciacli C, Cojocaru M (2012). "Systemic osteoporosis--major complication of psoriatic arthritis". Rom J Intern Med. 50 (2): 173–8. PMID 23326962.
- ↑ Curtis JR, Beukelman T, Onofrei A, Cassell S, Greenberg JD, Kavanaugh A, Reed G, Strand V, Kremer JM (January 2010). "Elevated liver enzyme tests among patients with rheumatoid arthritis or psoriatic arthritis treated with methotrexate and/or leflunomide". Ann. Rheum. Dis. 69 (1): 43–7. doi:10.1136/ard.2008.101378. PMC 2794929. PMID 19147616.
- ↑ McLaughlin M, Ostör A (December 2014). "Early treatment of psoriatic arthritis improves prognosis". Practitioner. 258 (1777): 21–4, 3. PMID 25603589.
- ↑ Buckley C, Cavill C, Taylor G, Kay H, Waldron N, Korendowych E, McHugh N (October 2010). "Mortality in psoriatic arthritis - a single-center study from the UK". J. Rheumatol. 37 (10): 2141–4. doi:10.3899/jrheum.100034. PMID 20682670.