The risk of psoriatic arthritis remains constant following initial diagnosis of psoriasis among patients seen in European dermatology clinics
The risk of psoriatic arthritis remains constant following initial diagnosis of psoriasis among patients seen in European dermatology clinics
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DOI：
10.1111/j.1468-3083.2009.03463.x
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发表时间：
2010-05-01
影响因子：
9.2
通讯作者：
Boggs, R.
中科院分区：
文献类型：
--
作者：
Christophers, E.;Barker, J. N. W. N.;Boggs, R.
银屑病关节炎（psoriatic arthritis，PsA）在银屑病患者中的患病率差异很大（5-40%）。斑块状银屑病患者发生银屑病的时间尚不清楚。ObjectivesTo研究银屑病诊断后的时间长短是否影响发生银屑病的风险，并评估银屑病患者与银屑病患者在生活质量（QoL）、工作相关问题、合并症和医疗资源利用（HCRU）方面的差异。2006年西班牙和德国。积极治疗银屑病患者的皮肤科医生招募了10名连续的银屑病患者。PsA，体表面积（BSA）的存在与银屑病和HCRU的影响进行了记录;患者完成欧洲生活质量（EQ 5D）和就业的缺点questionnaire.ResultsPatients with银屑病（n = 1560）包括126与PsA。90%的PsA患者是由皮肤科医生看到的，他们让风湿病学家参与PsA患者的护理。生存分析表明，银屑病患者中PsA的发病率保持不变（74/1000人-年），而患病率随着银屑病诊断后的时间而增加，30年后达到20.5%。此外，目前患有银屑病的BSA高的人更有可能患上PsA（P < 0.028）。与银屑病患者相比，银屑病A患者报告生活质量降低（EQ 5D评分：0.56 vs. 0.82：P < 0.0005），以及更多的工作问题。银屑病关节炎患者更有可能住院（0.27 +/- 0.84与0.14 +/- 0.71每年; P < 0.0005），并有额外的合并症比那些没有PsA.ConclusionsThe银屑病关节炎的发病率是恒定的初步诊断银屑病后，导致更高的患病率伴随银屑病关节炎随着时间的推移。PsA与QoL降低和工作相关问题、HCRU和合并症增加相关。皮肤科医生应该在他们的患者中筛查PsA，特别是那些最初没有出现PsA的长期患者。
BackgroundEstimates of psoriatic arthritis (PsA) prevalence among psoriasis patients vary widely (5-40%). The time to development of PsA in patients with plaque psoriasis also remains unclear.ObjectivesTo examine whether length of time since diagnosis of psoriasis affects risk of developing PsA, and to assess differences in quality of life (QoL), work-related issues, comorbidities and healthcare resource utilization (HCRU) for patients with PsA vs. psoriasis.MethodsThis large cross-sectional observational study was conducted in the UK, Italy, France, Spain and Germany in 2006. Dermatologists who actively treated patients with psoriasis recruited 10 consecutive patients with psoriasis. Presence of PsA, body surface area (BSA) affected with psoriasis and HCRU were recorded; patients completed EUROQoL (EQ5D) and employment disadvantages questionnaires.ResultsPatients with psoriasis (n = 1560) included 126 with PsA. Ninety per cent of these patients with PsA were seen by dermatologists who involved a rheumatologist in the care of their patients with PsA. Survival analysis indicated that the incidence of PsA among psoriasis patients remained constant (74 per 1000 person-years), while the prevalence increased with time since diagnosis of psoriasis, reaching 20.5% after 30 years. In addition, those with high BSA currently affected by psoriasis were more likely to have developed PsA (P < 0.028). PsA patients reported reduced QoL compared with psoriasis patients (EQ5D score: 0.56 vs. 0.82: P < 0.0005), as well as more work problems. PsA patients were more likely to be hospitalized (0.27 +/- 0.84 vs. 0.14 +/- 0.71 per year; P < 0.0005) and have additional comorbidities than those without PsA.ConclusionsThe incidence of PsA was constant after initial diagnosis of psoriasis, leading to a higher prevalence of concomitant PsA over time. PsA is associated with decreased QoL and increased work-related problems, HCRU and comorbidities. Dermatologists should screen for PsA in their patients, especially long-standing patients who did not initially present with PsA.