MedicalResearch.com Interview with:
Lihi Eder MD PhD
Rheumatologist, Women’s College Hospital
Scientist, Women’s College Research Institute
Assistant Professor of Medicine, University of Toronto
Toronto, ON, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There significant delays in the diagnosis of psoriatic arthritis (PsA) among patients with psoriasis. Many patients with psoriasis experience musculoskeletal symptoms. The majority of them do not have PsA, but other non-inflammatory conditions such as fibromyalgia or osteoarthritis.
In this study, we aimed to assess whether the presence and the degree of musculoskeletal symptoms in psoriasis patients predict the development of psoriatic arthritis. We analyzed a cohort of 410 psoriasis patients who were followed over a period of 9 years. These patients did not have arthritis at baseline. The patients were assessed annually by a rheumatologist for signs of PsA. A total of 57 patients developed psoriatic arthritis during the follow-up period.
MedicalResearch.com: What should readers take away from your report?
Response: The results of the study suggest that there is a pre-clinical phase in psoriatic arthritis where patients may experience non-specific musculoskeletal symptoms but they do not have any objective finding on physical examination of the joints. Patients who experienced higher degree of pain, stiffness and fatigue at the beginning of the study, and worsening of these symptoms over time were at higher risk of developing psoriatic arthritis. The results of the study suggest that patients with psoriasis who experience high degree of musculoskeletal symptoms should be followed closely over time as they are at higher risk of developing psoriatic arthritis.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future studies are needed to develop models to predict the risk of developing psoriatic arthritis in patients with psoriasis. Such models could include clinical information, laboratory biomarkers and imaging data. The aim would be to identify early psoriasis patients who are at high risk of psoriatic arthritis and initiate early treatment to improve long-term outcomes.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Arthritis Rheumatol. 2017 Mar;69(3):622-629. doi: 10.1002/art.39973.
The Development of Psoriatic Arthritis in Patients With Psoriasis Is Preceded by a Period of Nonspecific Musculoskeletal Symptoms: A Prospective Cohort Study.
Eder L1, Polachek A2, Rosen CF3, Chandran V3, Cook R4, Gladman DD3.
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