RT Journal Article
SR Electronic
T1 Axial Psoriatic Arthritis: Update on a Longterm Prospective Study
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2744
OP 2750
DO 10.3899/jrheum.090412
VO 36
IS 12
A1 VINOD CHANDRAN
A1 JESSICA BARRETT
A1 CATHERINE T. SCHENTAG
A1 VERNON T. FAREWELL
A1 DAFNA D. GLADMAN
YR 2009
UL http://www.jrheum.org/content/36/12/2744.abstract
AB Objective. To evaluate changes in symptoms, spinal mobility, and radiographic features in patients with axial psoriatic arthritis (AxPsA).Methods. Patients with AxPsA were identified from the University of Toronto Psoriatic Arthritis clinic database. Axial symptoms, metrology, and radiographic features at study entry were compared to 5-year and 10-year followup assessments. Data were analyzed using continuity adjusted McNemar’s test, an exact binomial test, or logistic regression.Results. Of 297 patients (mean age 42.5 yrs, PsA duration 8 yrs) in the study, 56% had axial symptoms, 43% had radiographic evidence of sacroiliitis, and 13% had syndesmophytes at entry. The number of patients with neck/back pain, neck/back stiffness, and clinical sacroiliitis declined significantly at both 5- and 10-year followup periods. There was a significant increase in the number of patients with restricted cervical spinal mobility at both 5- and 10-year visits and significant reduction in lateral flexion at both timepoints. At 5 (10) years, of those without sacroiliitis at baseline, 36.6% (51.7%) developed at least grade 2 sacroiliitis; 46.5% (52.0%) of those who presented with grade 2 progressed to a higher grade; and 15.6% (25.0%) with grade 3 progressed to grade 4 sacroiliitis. Of the patients without cervical/thoracic/lumbar syndesmophytes at study entry, 11%/16%/14% (14%/21%/20%) developed syndesmophytes in these regions at 5 (10) year followup. Similar results were obtained when analyses were restricted to patients satisfying radiographic criteria alone.Conclusion. Over a 10-year period, patients with AxPsA had improvement in neck and back pain, but lateral spinal flexion and cervical mobility deteriorated.