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J Dermatol. 2019 Mar;46(3):193-198. doi: 10.1111/1346-8138.14745. Epub 2019 Jan 10.

Cross-sectional multicenter observational study of psoriatic arthritis in Japanese patients: Relationship between skin and joint symptoms and results of treatment with tumor necrosis factor-α inhibitors.

Author information

1
Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
2
Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
3
Department of Dermatology, University of the Ryukyus, Graduate School of Medicine, Nishihara, Japan.
4
Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
5
Department of Dermatology, University of Miyazaki, Miyazaki, Japan.
6
Department of Dermatology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
7
Hino Dermatology Clinic, Fukutsu, Japan.
8
Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan.
9
Department of Dermatology, Kurume University School of Medicine, Kurume, Japan.
10
Iisora-Hifuka Clinic, Oita, Japan.
11
Department of Dermatology, Oita Prefectural Hospital, Oita, Japan.
12
Department of Dermatology, Faculty of Medicine, Shimane University, Izumo, Japan.
13
Department of Dermatology, Imamura General Hospital, Kagoshima, Japan.
14
Department of Dermatology, Kawasaki Medical School, Kawasaki, Japan.
15
Department of Dermatology, Onomichi General Hospital, Onomichi, Japan.
16
Division of Dermatology, Hiroshima Prefectural Hospital, Hiroshima, Japan.
17
Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Japan.
18
Department of Dermatology, Kyushu Central Hospital, Fukuoka, Japan.
19
Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
20
Department of Dermatology, Fukuyama City Hospital, Fukuyama, Japan.

Abstract

Psoriatic arthritis (PsA) is an inflammatory arthritis with as yet unclear pathophysiology. This retrospective, multicenter, cross-sectional study was conducted in 19 facilities in western Japan and aimed to identify patients' characteristics and factors that affect the results of treatment with biologic agents. Of 2116 patients with psoriasis, 285 (13.5%) had PsA. Skin manifestations preceded joint manifestations in 69.8%, the onset was simultaneous in 17.2%, whereas PsA preceded skin manifestations in 2.5%. Peripheral arthritis was most common, occurring in 73.7%, compared with axial disease in 21.8%, enthesitis in 23.5% and dactylitis in 35.4%. Patients with severe skin manifestations were significantly younger at onset (P = 0.02) and more frequently had axial disease (P < 0.01). Biologic agents were used in 206 patients (72.3%), anti-tumor necrosis factor (TNF)-α antibodies being prescribed first to 157 of them. Anti-TNF-α antibodies were continued by 105 participants and discontinued by 47, the remaining five patients being lost to follow up. Patients who discontinued anti-TNF-α antibodies were significantly older than those who continued (55 vs 51 years, P = 0.04) and significantly older at onset of joint manifestations (50 vs 44 years, P = 0.01). Multivariate analysis revealed that patients over 50 years significantly more frequently terminated anti-TNF-α antibodies (P < 0.01). In conclusion, patients with PsA and severe skin manifestations have earlier onset and axial disease, which seriously impacts on quality of life. Anti-TNF-α antibodies were generally effective enough to continue but less so in patients aged over 50 years. Further detailed research is needed.

KEYWORDS:

Japan; epidemiology; multicenter study; psoriasis; psoriatic arthritis

PMID:
30628100
DOI:
10.1111/1346-8138.14745
[Indexed for MEDLINE]

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