RESEARCH - The Swedish early psoriatic arthritis register - 2-year followup: comparison with early RA

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J Rheumatol. 2008 Feb 15 [Epub ahead of print]

The Swedish Early Psoriatic Arthritis Register -- 2-year Followup: A

Comparison with Early Rheumatoid Arthritis.

Lindqvist UR, Alenius GM, Husmark T, Theander E, Holmström G, Larsson PT.

From the Department of Medical Sciences, Rheumatology, University

Hospital, Uppsala; Department of Public Health and Clinical Medicine,

Rheumatology, Umeå; Department of Rheumatology, Falu Hospital, Falun;

Department of Rheumatology, University Hospital, Malmö; Spenshult

Rheumatological Hospital, Oskarström; and Karolinska University

Hospital, Stockholm, Sweden.

OBJECTIVE :Patients with symptoms and signs compatible with psoriatic

arthritis (PsA), with or without psoriasis, have been documented in

the Swedish Early Psoriatic Arthritis (SwePsA) register. Our aim was

to find markers for disease progression and to evaluate treatments for

PsA using these data. METHODS: Patients referred to rheumatology

outpatient clinics within 2 years of onset were assessed on inclusion

and at followup 2 years later. Data collection was performed according

to the program for SwePsA, and classification was as described by Moll

and and the ClASsification Criteria for Psoriatic ARthritis

(CASPAR). Remission was recorded if the patient had no tender or

swollen joints and if erythrocyte sedimentation rate (ESR) and

C-reactive protein (CRP) were within the reference range. Patients

with early rheumatoid arthritis (RA) recruited from the Swedish Early

Rheumatoid Arthritis Register (Ramona) provided comparison data.

RESULTS: One hundred thirty-five patients with PsA according to CASPAR

were assessed; 44% were classified as having mono/oligoarthritis and

47% as polyarthritis. Two patients (1%) were in remission initially,

and 23 (17%) at followup. Patients with polyarticular disease had the

highest inflammatory activity, measured by swollen and tender joint

counts, ESR, Health Assessment Questionnaire, and self-assessment by

visual analog scale of pain and global disease activity. Dactylitis

was associated with radiological findings. Compared with RA patients,

they had significantly lower CRP, ESR, and number of swollen joints (p

= 0.0003, p = 0.0026, p = 0.0380, respectively) at inclusion, but

equal numbers of tender joints and self-assessment of pain and disease

activity.

CONCLUSION: About half the patients had polyarthritis and the other

half had mono/oligoarthritis at followup after 2 years. Patients with

polyarthritis had the highest inflammatory activity. Apart from ESR,

CRP, and swollen joint count, there were no significant differences in

activity between RA and polyarticular PsA.

PMID: 18278834

http://www.ncbi.nlm.nih.gov/pubmed/18278834

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Not an MD