Psoriatic arthritis is a condition in which symptoms of arthritis commonly begin to develop after a patient has been diagnosed with psoriasis. In some cases, however, the arthritis will precede psoriasis. At first glance, the two conditions may seem unrelated – the most obvious symptoms of psoriasis include scaly rashes most frequently occurring on the elbows, knees, and scalp, while arthritis is most commonly associated with joint stiffness and pain. However, up to 30% of people with psoriasis will develop psoriatic arthritis, with about 20% of those [with psoriatic arthritis] progressing to psoriatic spondylitis – characterized by the inclusion of spinal arthritis.
New evidence, presented by Alexander Egeberg, MD, PhD, University of Copenhagen, and colleagues in the Journal of the American Academy of Dermatology suggests that patients with psoriasis or any related form of the condition, such as psoriatic arthritis, have a higher risk of experiencing a cardiovascular disease event (CVD) compared to non-afflicted individuals. The imaging and observational registry data study found that for every additional year that passes during the duration of the disease, the risk of a major adverse cardiovascular event (MACE) increases by 1%.
The first segment of the study, conducted on a population of 190 young individuals with an initial low risk of CVDs, showed that the increasing duration of psoriasis was linked to increasing vascular inflammation and thus, increasing risk for a cardiovascular issue.
The second population-based segment was carried out on all Danish citizens, 18 years and older. It was found that, over the course of 4.7 years, 152,122 out of 4,321,954 (3.5%) citizens experienced a MACE resulting in an incident rate of 7.56 per 1,000 years of age. Out of those 4,321,954 citizens, 87,161, or approximately 2%, were diagnosed with psoriasis with the MACE incident rate coming in at 10.94 per 1,000 years of age.
The studies did not account for outside factors, such as body mass index, physical activity, or eating habits, but the results were enough to conclude that having psoriasis should warrant extra precaution and screenings for cardiovascular issues. However, ongoing studies utilizing inflammation controlling biologic medications to counteract the elevated CVD and MACE risks are currently underway, bringing optimism for patients impacted with psoriasis.
Sources and further reading
Longer Psoriasis Duration May Mean Higher CVD Risk
Overview of Psoriatic Arthritis, courtesy of SAA
By:
Spondylitis Association of America