Psoriatic Arthritis

Psoriatic arthritis is a chronic inflammatory disease that affects the skin and joints, causing pain and disability. The disease often causes swelling of the fingers and toes;  but mainly because of joint inflammation. Although psoriatic arthritis has been associated with an enhance prevalence of obesity and being overweight; few studies have assess the relationship between weight and the severity of disease in these patients.

The results of a study present today at the Annual European Congress of Rheumatology (EULAR 2019) demonstrate; significant correlation between body mass index (BMI) and disease severity in psoriatic arthritis.

Results of this study demonstrate BMI is independently correlate to disease activity (p=0.026), patient-perceive disease impact (p<0.0001); and disability (p<0.0001). However patients with PsA classify as obese or non-obese; disease activity measure cDAPSA (range 0-154) was 33.4 vs. 27.7; patient-perceive disease impact measure PsAID-12 (range 0-10) was 6.3 vs. 5.3, and disability measure HAQ-DI (range 0-3) was 1.36 vs. 1.03 respectively.

Psoriatic arthritis in parallel to joint

“Results highlight the impact of obesity and need for lifestyle; direct approaches to manage weight in psoriatic arthritis in parallel to joint and skin focus treatments,” said Dr Stefan Siebert, Clinical Senior Lecturer in Inflammation and Rheumatology, University of Glasgow, United Kingdom.

The study include 917 patients across eight European countries as part of the PsABio study; an ongoing prospective observational study evaluating patients with PsA; receiving ustekinumab or tumor necrosis factor inhibitors. However data were collect on disease severity and impact; and analyze using multiple regression models adjust for age, sex, smoking, body surface area; c-reactive protein, disease duration and biologic treatment.

There is growing evidence describing how fat tissue acts as an active organ; involve in metabolic and inflammatory disorders. Furthermore, with fixed-dose drug regimens, as with self-inject biologics; obesity can reduce efficacy for pharmacokinetic reasons.” These factors, alongside the global epidemic of overweight and obesity, however makes research in this area of great relevance and interest.” Professor John D. Isaacs, Chairperson of the Abstract Selection Committee, EULAR

Evidence for the adipokine, adiponectin

Another study by EULAR 2019 provides evidence for the adipokine, adiponectin; in predicting the development of rheumatoid arthritis in overweight subjects. Adipokines are signaling molecules that are secrete by fat tissue and act in a similar way to hormones. Rais levels of adiponectin; a type of adipokine, have been shown in subjects with rheumatoid arthritis; however, results of this study suggest it could have a role in predicting the onset of disease.

The analysis include two studies, the first include 82 subjects with obesity and available measurements of adiponectin; before the development of rheumatoid arthritis and 410 match controls and demonstrate a 10% increase risk; of developing rheumatoid arthritis in those with raise serum adiponectin at baseline. However the second study include 88 sex- and age-match pairs and demonstrate a 20% increase risk; but only in those with a BMI greater than 25.4. Another interesting study present at EULAR 2019, look at overweight and obesity in young patients with juvenile idiopathic arthritis (JIA).

Results found the rate of being overweight; and obesity in children and adolescents with JIA is comparative to the general population. However, analysis reveal a various factors are significantly associate with being overweight in the JIA group including increasing age (OR:1.06, 95% CI:1.04-1.09), male gender (OR:1.21, 95% CI:1.04-1.44), functional limitations (OR:1.29, 95% CI:1.04-1.59), therapy with biological DMARDs (OR:1.48, 95% CI:1.22-1.80), and systemic glucocorticoids (OR:1.40, 95% CI:1.14-1.71). The implications of these findings on the long-term outcome of JIA requires further study.