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Psoriatic arthritis, the importance of early treatment

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Psoriatic arthritis (PsA) affects up to one third of patients with psoriasis. Recent studies show that psoriasis treatment can change the evolution of psoriatic arthritis. Identifying the window in which to intervene to prevent PsA symptoms is therefore an important opportunity, to be seized as soon as possible. This is what is reported in an article published by Allies for Health, the portal dedicated to medical-scientific information, created by Novartis. One of the main pathological conditions associated with psoriasis is arthritis, hence the name psoriatic arthritis. If treatment is started late, the likelihood of loss of function and lifelong disability increases. Psoriatic arthritis can present with 6 clinical manifestations: peripheral arthritis, dactylitis (an inflammation of the tendon soft structures surrounding the bones), enthesitis (an inflammation of an enthesis, i.e. the site where a tendon or ligament hooks to the bone), psoriasis, nail psoriasis (psoriatic onychopathy) and inflammatory low back pain affecting the spine (axial manifestation). However, not all patients present with the 6 clinical manifestations and the same conditions may change over time. Also complicating the diagnosis is the fact that psoriatic arthritis has similarities to other rheumatological diseases. Due to the complexity of all these factors, it is understood how the early recognition of PsA in patients with psoriasis and the initiation of adequate treatment can help prevent disease progression, irreversible joint damage and consequent permanent disability, as well as improve the patient quality of life. It is not easy to define the phase that precedes the clinical manifestation of psoriatic arthritis, the article continues. There are several factors that identify patients with psoriasis who have a higher likelihood of progression to the disease, such as nail involvement, severe psoriasis and obesity. However, the preclinical stages of psoriatic arthritis remain to be clarified. These patients with clinical risk factors often have non-specific symptoms and little or no objective inflammation. In these people with psoriasis and no specific features on clinical examination, imaging (tests such as ultrasound, MRI) could play an important role in identifying subclinical inflammation and possibly existing damage. There are studies that suggest that PsA development can be predicted using imaging tools for longer (follow-up) periods, associated with other biomarkers, to accurately classify the preclinical stages of psoriatic arthritis and to identify which lesions are specifically associated with a higher risk of developing psoriatic arthritis. The full text is available at: https://www.alleatiperlasalute.it/salute-20/tritazione-precoce-dellartrite-psoriasica.

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