Literature on Psoriatic Arthritis

Related ArticlesTreatment of psoriatic arthritis and psoriasis vulgaris with the tumor necrosis factor inhibitor infliximab.

Rheumatol Int. 2002 Nov;22(6):227-32

Authors: Cauza E, Spak M, Cauza K, Hanusch-Enserer U, Dunky A, Wagner E

OBJECTIVE: The aim was to evaluate the efficacy and safety of multiple infusions with achimeric, anti-tumor necrosis factor (TNF)alpha monoclonal antibody (infliximab) in patients with psoriatic arthritis (PsA) and psoriasis vulgaris. METHODS: Over 22 weeks, nine patients with both active psoriasis and PsA received five infusions of 3 mg/kg infliximab. The endpoints included changes in the swollen and tender joints counts, American College of Rheumatology (ACR) preliminary criteria for improvement response rates 20, 50, and 70, and improvement in the psoriasis area and severity index (PASI). RESULTS: The swollen count (SJC) and tender joint count (TJC) fell from means of 5.33+/-2.22 and 17.80+/-4.21 to 1.44+/-1.09 and 9.77+/-0.92, respectively, by week 2 ( P=0.02, P=0.02). This benefit was sustained through week 22 (2.00+/-1.12/7.77+/-3.68, P=0.05/ P=0.002). The ACR 20/50/70 response was achieved in 89%/56%/22% of cases. The mean PASI score improved from 19.04+/-5.41 to 4.91+/-2.51 ( P=0.002). CONCLUSION: Multiple infusions of infliximab were effective and well tolerated in patients with active psoriasis and PsA.

PMID: 12426660 [PubMed - indexed for MEDLINE]

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Psoriatic arthritis–pathogenesis and epidemiology.

Clin Exp Rheumatol. 2002 Nov-Dec;20(6 Suppl 28):S27-33

Authors: Veale DJ, FitzGerald O

Psoriatic arthritis (PsA), recognised for over 100 years, is common representing the second most frequent diagnostic category after RA and occurring in up to 10% of patients with skin psoriasis. The pathogenic connection between psoriasis and arthritis is not yet clear although our understanding of the mechanisms of disease has progressed significantly in recent years. Factors including immunogenetics, infection, autoimmunity, angiogenesis, trauma and the nervous system are implicated in the pathogenesis of PsA. Organ involvement is largely restricted to the connective tissue of the skin and joints, including both the synovial tissue and sites of entheseal attachment. This restricted inflammatory response suggests that either a common antigen driving the immune response or that antigenic proteins or cells are present at these sites only having migrated the or arising de novo. The epidemiology of Psoriasis has been extensively examined since the 1960’s, however there have been few large epidemiological studies of PsA. In addition, the lack of diagnostic criteria for the diagnosis of PsA until 1973, and the diffuse clinical manifestations of this condition have hindered meaningful conclusion regarding the epidemiology of this form of arthritis.

PMID: 12463443 [PubMed - indexed for MEDLINE]

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