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Radiological progression and predictive factors in psoriatic arthritis: insights from a decade-long retrospective cohort study

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Abstract

Objectives

Radiological alterations in psoriatic arthritis (PsA) are an established phenomenon frequently observed throughout the disease course. Our goal was to investigate the changes in the bone structure of PsA patients by conventional radiography.

Methods

This study designed as a retrospective cohort study and cross-sectional evaluation for disease activity. The disease activity and the severity of skin and nail involvement were assessed. The Simplified Psoriatic Arthritis Radiographic Score (SPARS) was used to investigate the radiological progression. Logistic regression analysis was used to determine the predictors of radiological changes.

Results

Joint space narrowing and bone proliferation in hands (p = 0.001 and p = 0.001, respectively) and joint space narrowing in feet (p = 0.047) were more common at the final evaluation than at the baseline assessment. Total scores of joint space narrowing and bone proliferation in hands and feet were higher at the last visit than at the initial assessment (p < 0.001). Male gender (p = 0.030, OR 4.32 (95%CI 1.15–16.15)], older age (for joint space narrowing [p = 0.026 OR 1.08 (95%CI 1.01–1.56)] and for proliferation [p = 0.025 OR 1.08 (95%CI 1.01–1.44)]), high Disease Activity index for Psoriatic Arthritis (DAPSA) scores at baseline [p = 0.032 OR 6.21 (95%CI 1.17–32.92)], and symmetrical polyarticular involvement at baseline [p = 0.025 OR 5.3 (95% CI 1.23–22.4)] were found as predictors of structural changes.

Conclusion

By the end of the decade, joint space narrowing and proliferation were observed to be more common than erosion. Male gender, older age, higher initial DAPSA scores, and initial polyarticular involvement were identified as predictors of radiological damage.

Key Points

• The radiological changes of Psoriatic arthritis are a well-known entity. However, studies investigating the progression of joint involvement over time are scarce.

• This study reveals that joint space narrowing and proliferation are the most prominent radiological alterations in Psoriatic Arthritis patients at the end of the decade.

• Male gender, older age, higher baseline DAPSA scores, and initial polyarticular involvement are predictive factors influencing the progression of bone destruction  in Psoriatic Arthritis patients.

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Data Availability

Data sharing encouraged and statements of data availability required (Type 3).

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Authors and Affiliations

  1. School of Medicine, Department of Internal Medicine, Division of Rheumatology, Kocaeli University, Kocaeli, Turkey

    Ozlem Ozdemir Isik, Neslihan Gokcen, Duygu Temiz Karadag, Ayten Yazici & Ayse Cefle

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  1. Ozlem Ozdemir Isik
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Contributions

OOI, NG, DTK, AY and AC contributed to the conception and design of the study. Material preparation and data collection were performed by OOI and NG. Analysis was performed by OOI and DTK. The first draft of the manuscript was written by OOI and NG. Critical review of the article finalization by AC and AY. All authors read and approved the final form.

Corresponding author

Correspondence to Ozlem Ozdemir Isik.

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Ethics approval

The study was performed according to the Declaration of Helsinki. Kocaeli  University ethical committee approved the study protocol (Date:02-May-2021, Approval Number:2021/152).

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Ozdemir Isik, O., Gokcen, N., Temiz Karadag, D. et al. Radiological progression and predictive factors in psoriatic arthritis: insights from a decade-long retrospective cohort study. Clin Rheumatol 43, 259–267 (2024). https://doi.org/10.1007/s10067-023-06839-7

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