Clinical Research //
1. Malignancy in Psoriatic Disease
There are conflicting data between studies of psoriasis and psoriatic arthritis (PsA), and there have been recent concerns about the potential of anti-TNF agents to facilitate malignancy. We aimed to estimate the prevalence and incidence of malignancy and its types in PsA and psoriasis without arthritis (PsC) patients, in comparison to the general population, and to identify the predictive factors for developing cancer in psoriatic disease (PsD).
2. Depression and Anxiety Reduce Probability of Achieving a State of Minimal Disease Activity in Patients with Psoriatic Arthritis
Depression and/or anxiety are comorbidities associated with psoriatic arthritis (PsA) that may affect treatment response. We aimed to determine whether the presence of depression/anxiety is associated with lower probability of achieving minimal disease activity (MDA) in patients with PsA.
3. The Value of Carotid Ultrasound in Cardiovascular Risk Stratification in Patients with Psoriatic Disease
Patients with psoriatic disease (PsD) are at a high risk of developing cardiovascular events (CVE). The performance of clinical algorithms for cardiovascular risk stratification, such as the Framingham Risk Score (FRS), is sub-optimal in this patient population. The study aims were: 1) to assess whether subclinical atherosclerosis, as evaluated by carotid ultrasound, could predict future CVE in patients with PsD and 2) to determine whether incorporation of imaging data could improve the prediction of CVE beyond clinical cardiovascular algorithms.
4. Prevalence of Sonographic Enthesitis in Patients with Psoriasis without Arthritis and Its Association Risk Factors of Psoriatic Arthritis
Enthesitis is one of the hallmarks of psoriatic arthritis (PsA) and may be the initial site of musculoskeletal inflammation. Enthesitis affects up to 50 % of patients with PsA and is a marker of more severe disease. However, clinical evaluation of enthesitis may be difficult. Ultrasound (US) is more sensitive than physical examination in detecting enthesitis. In patients with psoriasis alone (PsC) US can detect subclinical enthesitis which may predict future development of PsA. The aim of this study was to assess the association between the severity of sonographic enthesitis and risk factors for developing PsA. These risk factors include included obesity, severity of psoriasis, nail psoriasis in addition to physically demanding occupation and the presence musculoskeletal symptoms.
5. Remission in Psoriatic Arthritis: Definition and Predictors
No validated definition of remission exists for psoriatic arthritis (PsA) to date. We previously identified 17.6% of our patients as having remission (no actively inflamed joints for 12 months). However, we did not take into account the other domains of the disease. We aimed to test the concept of remission as the absence of disease manifestations in PsA, determine the frequency of remission in our PsA cohort, and identify predictors for remission.
6. Cardiac Biomarkers and Carotid Atherosclerosis and Its Progression in Psoriatic Disease
Laboratory biomarkers indicative of cardiac ischemia or dysfunction improve cardiovascular (CV) risk stratification in the general population. Their utility in patients with psoriatic disease (PsD) is unknown. Our objective was to evaluate the levels of cardiac biomarkers in patients with PsD vs. non-psoriatic controls and to assess their association with the burden of carotid atherosclerosis and plaque progression.
7. Mortality Rates and Causes in Psoriatic Arthritis Patients
Psoriatic arthritis (PsA) is an inflammatory musculoskeletal disease that affects about 30% of psoriasis patients, and can lead to significant joint damage and disability. Results from mortality studies are inconsistent. The aims of this study were: 1) to estimate the trends in mortality rates among PsA patients over calendar time 2) to estimate cause-specific mortality rates.
8. Progression of Unilateral Grade 2 Sacroiliitis in a Psoriatic Arthritis Cohort
Axial psoriatic arthritis (axPsA) lacks a universally accepted definition. Initial studies required ≥ unilateral grade 2 sacroiliitis (Uni2SI) but recent studies have required the modified radiographic New York ankylosing spondylitis criteria (NYC) ( bilateral grade 2 or unilateral grade 3 or 4 sacroiliitis). Our aims were: 1) assess the prevalence of axial involvement in a PsA cohort according to “at least Uni2SI”, 2) assess the radiographic progression of Uni2SI, 3) identify risk factors associated with progression, 4) define axPsA.
9. A Novel Role for the Psoriatic Arthritis Impact of Disease Questionnaire
Psoriatic arthritis (PsA) is an inflammatory arthritis that occurs in about 30% of patients with Psoriasis (Ps). Recently, a new Patient Reported Outcome Measure (PROM), Psoriatic Arthritis Impact of Disease (PsAID) was specifically developed for PsA Patients. The two versions of the PsAID, PsAID-9 and PsAID-12, are scored on a Numeric Rating Scale (NRS) of 0-10. The Minimal Disease Activity (MDA) is a composite outcome measure for PsA patients, which uses the Health Assessment Questionnaire (HAQ) as one criterion. However, the HAQ does not correlate well with measures of disease activity as PsA disease duration increases, and its use in the assessment of disease activity has been questioned. Our objectives were to 1) validate the PsAID within our patient cohort, 2) determine if the PsAID can replace any of the other PROMs administered in the clinic, and 3) determine if the PsAID can replace the HAQ in the MDA.
10. Is Axial Psoriatic Arthritis Distinct from Ankylosing Spondylitis with and without Concomitant Psoriasis?
Spondyloarthritis include two major phenotypes: ankylosing spondylitis (AS) and psoriatic arthritis (PsA). 10% of AS patients have concomitant psoriasis, while 25% – 70% of PsA patients have axial disease. The question arises whether AS with concomitant psoriasis and axial PsA are essentially the same disease? The aim of this study was to compare the demographic, genetic, clinical and radiographic characteristics of patients with AS, with and without psoriasis, to axial PsA patients.