Psoriatic arthritis (PsA) is an inflammatory disease that commonly affects patients with psoriasis. According to a study in Rheumatology and Therapy, a personal or family history of psoriasis is an important diagnostic factor for PsA. Researchers evaluated associations between history of psoriasis and clinical characteristics of PsA and found that “currently existing cutaneous lesions in patients themselves are correlated with disease activity and severity of axial joint damage, whereas family history does not have an evident impact on the disease activity of PsA.”
Co-primary investigators, Shan-Shan Li and Na Du, and colleagues from The First Affiliated Hospital of Zhengzhou University in Zhengzhou, China, enrolled 296 consecutive patients with PsA between 2019 and 2020. Participants were analyzed for clinical, biochemical, radiographic, and disease activity characteristics. Patients were stratified into three study groups based on their personal and family history of psoriasis.
Family History of Psoriasis and Disease Activity Associations
Overall, 145 of the patients had psoriasis themselves (pPsA), 96 had a family history of psoriasis (fPsA), and 55 patients had both family history and coexisting psoriasis (fPsA/PSO). The investigators reported that, “compared to fPsA/PSO, the levels of CRP, ESR, uric acid, DAPSA, BASDAI, ASDAS, and BASFI were lower in fPsA, but similar to pPsA.” Notably, sacroiliitis tended to be more severe for the fPsA/PSO group compared to the fPsA group (odds ratio [OR] = 0.508; 95% CI, 0.272–0.949; p <0.05). Additionally, no significant differences were observed in “HLA-B-27 and common inflammatory articular and extra-articular manifestations” between the three groups, or “in LEI, TJC, SJC, and DAS28CRP.”
In closing, the authors highlighted a correlation between the age of patients with psoriasis and onset of arthritis, and noted that the earliest onset of arthritis occurred in the fPsA/PSO patients (p <0.001). They ultimately advised that “careful personal and familial history taking may not only help decide the most appropriate treatments for different PsA patients but also predict the involvement of axial joint and improve prognosis.”