[18F] FDG PET/CT may be a useful adjunct in diagnosis of eosinophilic fasciitis / [18F] FDG PET/CT puede ser un complemento útil en el diagnóstico de fasciitis eosinofílica

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Registro Español de Artritis Psoriásica de Reciente Comienzo (estudio REAPSER). Objetivos y metodología / Spanish Registry of Recent-onset Psoriatic Arthritis (REAPSER study): aims and methodology

OBJETIVOS: Describir la metodología del Registro Español de Artritis Psoriásica de reciente comienzo de la Sociedad Española de Reumatología (REAPSER), así como sus fortalezas y limitaciones. El objetivo principal del proyecto es identificar factores pronósticos de la evolución clínica y radiográfica en una cohorte de pacientes que padecen artritis psoriásica (APs) diagnosticada con menos de 2 años de evolución. MATERIAL Y MÉTODO: Estudio observacional, prospectivo (2 años de seguimiento; periodicidad anual de las visitas), multicéntrico. La intención en la visita basal fue reflejar la situación del paciente antes de que la evolución de la enfermedad se viese modificada por los tratamientos pautados en los servicios de reumatología. Los pacientes fueron invitados a participar consecutivamente en una de sus visitas habituales al reumatólogo. El tamaño muestral finalmente alcanzado fue de 211 pacientes. Se recogen datos sociodemográficos; de situación laboral; historia familiar; antecedentes personales y comorbilidad; antropométricos; estilo de vida; uso de los servicios de salud; situación clínica al diagnóstico de APs; afectación articular y dolor espinal; dolor y valoración global de la enfermedad; entesitis, dactilitis y uveítis; afectación cutánea y ungueal; situación funcional y calidad de vida; evaluación radiográfica; determinaciones analíticas; tratamiento; brotes en esqueleto axial y periférico. CONCLUSIONES: El estudio REAPSER incluye una cohorte de pacientes con APs de inicio reciente reclutados antes de que la evolución de la enfermedad se viese modificada por la prescripción de FAME en los servicios de reumatología. Se espera que la información exhaustiva recogida en las visitas suponga una amplia fuente de datos para futuros análisis

AIMS: To describe the methodology of REAPSER (Spanish Registry of Recent-onset Psoriatic Arthritis), its strengths and limitations. The aim of this study is to identify prognostic factors for the clinical and radiographic course in a cohort of patients with psoriatic arthritis (PsA) diagnosed within 2 years of symptom evolution. METHODS: Multicenter, observational and prospective study (with 2-year follow-up including annual visits). Baseline visit intended to reflect patient situation before the disease course was modified by treatments prescribed in rheumatology departments. Patients were invited to participate consecutively in one of their routine visits to the rheumatologist. 211 patients were included. Following data were collected: sociodemographic variables; employment situation; family history; personal history and comorbidities; anthropometric data; lifestyle; use of healthcare services; clinical situation at the time of PsA diagnosis; joint involvement and spinal pain; pain and overall assessment; enthesitis, dactylitis and uveitis; skin and nail involvement; functional situation and quality of life; radiographic evaluation; analytical determinations; treatment; axial and peripheral flare-ups. CONCLUSIONS: The REAPSER study includes a cohort of patients with recent-onset PsA, before the disease course was modified by disease-modifying antirheumatic drugs prescribed in rheumatology departments. Exhaustive information collected in each visit is expected to be an important data source for future analysis

Spanish Registry of Recent-onset Psoriatic Arthritis (REAPSER study): Aims and methodology. / Registro Español de Artritis Psoriásica de Reciente Comienzo (estudio REAPSER). Objetivos y metodología.

AIMS: To describe the methodology of REAPSER (Spanish Registry of Recent-onset Psoriatic Arthritis), its strengths and limitations. The aim of this study is to identify prognostic factors for the clinical and radiographic course in a cohort of patients with psoriatic arthritis (PsA) diagnosed within 2years of symptom evolution. METHODS: Multicenter, observational and prospective study (with 2-year follow-up including annual visits). Baseline visit intended to reflect patient situation before the disease course was modified by treatments prescribed in rheumatology departments. Patients were invited to participate consecutively in one of their routine visits to the rheumatologist. 211 patients were included. Following data were collected: sociodemographic variables; employment situation; family history; personal history and comorbidities; anthropometric data; lifestyle; use of healthcare services; clinical situation at the time of PsA diagnosis; joint involvement and spinal pain; pain and overall assessment; enthesitis, dactylitis and uveitis; skin and nail involvement; functional situation and quality of life; radiographic evaluation; analytical determinations; treatment; axial and peripheral flare-ups. CONCLUSIONS: The REAPSER study includes a cohort of patients with recent-onset PsA, before the disease course was modified by disease-modifying antirheumatic drugs prescribed in rheumatology departments. Exhaustive information collected in each visit is expected to be an important data source for future analysis.

La talalgia en la artropatía psoriásica. Análisis de una serie de 291 pacientes / Heel pain in psoriatic arthropathy: Analysis of a series of 291 patients

Objetivo: Determinar la prevalencia de talalgia clínicamente significativa en una serie de pacientes con artritis psoriásica (APs) y analizar su asociación con otras variables de la enfermedad. Material y métodos: Estudio transversal, observacional, retrospectivo. De la cohorte de 347 pacientes afectos de APs, todos cumplían los criterios de clasificación CASPAR para APs, se seleccionaron 291 en los que estaba recogido el antecedente de talalgia clínicamente significativa. Para el análisis estadístico se ha utilizado la prueba de chi-cuadrado, el ANOVA y la prueba de regresión logística binaria. Resultados: El 35% de los pacientes presentó talalgia clínicamente significativa. La talalgia se asoció significativamente con un inicio más precoz de la enfermedad cutánea y articular, pero no con la duración de la enfermedad. También fue significativa su asociación con la dactilitis y antecedente familiar de primer grado con APs. Conclusiones: La talalgia clínicamente significativa se presentó en un tercio de los pacientes de la serie. Se asoció con dactilitis, antecedente familiar de primer grado con APs y un inicio más precoz de la enfermedad cutánea y articular

Objective: To determine the prevalence of heel pain in a series of patients with psoriatic arthritis (PsA). Material and methods: Cross-sectional, observational and retrospective study of a series of 347 patients. All patients fulfilled the CASPAR criteria for PsA and 291 had a clinically significant history of heel pain. The statistical analysis was performed using chi-square test, ANOVA and binary logistic regression. Results: Thirty-five percent of the patients had clinically significant heel pain. A significant association was established between an early onset of skin and joint involvement in the disease and the development of heel pain. However, no significant correlation was found between disease duration and the presence of heel pain. History of dactylitis and PsA in first-degree family members was also statistically associated with this complication. Conclusions: Clinically significant heel pain was recorded in one third of the patients in this series. There was a statistically significant association with dactylitis, PsA in first-degree family members and an earlier onset of joint and skin disease

Prevalence of Nasal Colonization with Staphylococcus aureus in Patients with Rheumatoid Arthritis.

Objetive: Patients with Rheumatoid Arthritis (RA) and nasal carriers of Staphylococcus aureus have an increased risk of developing infections caused by S. aureus. Our objective was to determine the prevalence of S. aureus nasal colonization in patients with RA and its relationship to RA treatments. METHODS: Two hundred and seven patients with RA and 37 healthy controls were prospectively included in a cross-sectional study. A nasal secretion sample was collected by swab from both anterior nostrils and was referred to the hospital's microbiology department for culturing. RESULTS: The mean age of the patients (168 women, 78%) was 61 ± 12 years old. The mean disease duration was 13 ± 10 years. Seventy-six percent of the patients were positive for Rheumatoid Factor (RF), and 71% were positive for Anti-citrullinated Peptides Antibodies (ACPA). Seventy percent had joint erosions. The mean DAS28 was 3.1 ± 2.2. S. aureus nasal colonization was found in 36% of the RA patients and 35% of the controls. Three patients and no controls were resistant to oxacilin/ mupirocin. The patients who were positive for ACPA had a higher prevalence of S. aureus colonization (43% vs. 17%; p < 0.05). The colonization prevalence in the patients treated with glucocorticoids was 32% (n: 133); methotrexate and/or leflunomide, 37% (n: 167); anti-TNF agents, 46% (n: 54), p < 0.05 versus patients not treated with anti-TNF agents; rituximab, 22% (n: 18); tocilizumab, 39% (n: 18). CONCLUSION: The prevalence of S. aureus nasal colonization in patients with RA does not appear to be greater than that of the general population. Anti-TNF agents might confer a higher prevalence of colonization.

Heel pain in psoriatic arthropathy: Analysis of a series of 291 patients. / La talalgia en la artropatía psoriásica. Análisis de una serie de 291 pacientes.

OBJECTIVE: To determine the prevalence of heel pain in a series of patients with psoriatic arthritis (PsA). MATERIAL AND METHODS: Cross-sectional, observational and retrospective study of a series of 347 patients. All patients fulfilled the CASPAR criteria for PsA and 291 had a clinically significant history of heel pain. The statistical analysis was performed using chi-square test, ANOVA and binary logistic regression. RESULTS: Thirty-five percent of the patients had clinically significant heel pain. A significant association was established between an early onset of skin and joint involvement in the disease and the development of heel pain. However, no significant correlation was found between disease duration and the presence of heel pain. History of dactylitis and PsA in first-degree family members was also statistically associated with this complication. CONCLUSIONS: Clinically significant heel pain was recorded in one third of the patients in this series. There was a statistically significant association with dactylitis, PsA in first-degree family members and an earlier onset of joint and skin disease.

Axial involvement according to ASAS criteria in an observational psoriatic arthritis cohort.

The definition of axial involvement in psoriatic arthritis (PsA) is still under debate. Currently, the axial spondyloarthritis (SpA) criteria defined by Assessment of Spondyloarthritis International Society (ASAS) may be the most adequate.(1) The aims of present study were to assess axial involvement according to ASAS criteria in an observational PsA cohort and define the clinical characteristics more associated with this kind of involvement. Our study included consecutive patients who had a visit in a tertiary Rheumatology centre. All patients included fulfill ClASsification criteria for Psoriatic Arthritis (CASPAR) criteria for PsA and all of them had a recent radiographic assessment of sacroiliitis. Clinical and laboratorial data were taken into account to classify patients as fulfilling or not ASAS criteria for axial SpA. Clinical and demographic data were analyzed about their association with presence of ASAS criteria of axial SpA in an univariable logistic regression analysis. Variables with a p-value <0.05 were re-tested in a multivariable logistic regression. Those variables that maintained statistical significance were tested alone in another multivariable model. Analyses were performed with IBM SPSS Statistics (version 20.0). Regarding the 233 patients included, only 42 patients (19.4%) fulfilled ASAS criteria for axial SpA. However, 22 patients had asymptomatic radiographic sacroiliitis according to modified New York criteria. The prevalence of asymptomatic sacroiliitis was 15.7% between patients without axial symptoms. In multivariable analysis, inflammatory back pain (IBP) [OR=25.111; 95% confidence interval (CI) = 8.770, 71.900, p-value <0.001], presence of HLA-B27 [OR=9.072; 95% CI=2.756, 29.860; p-value <0.001] and male gender [OR=3.767; 95% CI=1.264, 11.232; p-value = 0.017] were associated to axial involvement according to ASAS criteria. Axial SpA ASAS criteria are useful to identify axial involvement in PsA patients. This type of involvement is more common in males, in the presence of HLA-B27 and IBP. Axial disease should be systematically assessed in clinical practice, mainly in patients presenting with this clinical features.

Cardiovascular disease in immune-mediated inflammatory diseases: A cross-sectional analysis of 6 cohorts.

To analyze in several immune-mediated inflammatory diseases (IMIDs) the influence of demographic and clinical-related variables on the prevalence of cardiovascular disease (CVD), and compare their standardized prevalences.Cross-sectional study, including consecutive patients diagnosed with rheumatoid arthritis, psoriatic arthritis, psoriasis, systemic lupus erythematosus, Crohn disease, or ulcerative colitis, from rheumatology, gastroenterology, and dermatology tertiary care outpatient clinics located throughout Spain, between 2007 and 2010. Our main outcome was defined as previous diagnosis of angina, myocardial infarction, peripheral vascular disease, and/or stroke. Bivariate and multivariate logistic and mixed-effects logistic regression models were performed for each condition and the overall cohort, respectively. Standardized prevalences (in subjects per 100 patients, with 95% confidence intervals) were calculated using marginal analysis.We included 9951 patients. For each IMID, traditional cardiovascular risk factors had a different contribution to CVD. Overall, older age, longer disease duration, presence of traditional cardiovascular risk factors, and male sex were independently associated with a higher CVD prevalence. After adjusting for demographic and traditional cardiovascular risk factors, systemic lupus erythematosus exhibited the highest CVD standardized prevalence, followed by rheumatoid arthritis, psoriasis, Crohn disease, psoriatic arthritis, and ulcerative colitis (4.5 [95% confidence interval (CI): 2.2, 6.8], 1.3 [95% CI: 0.8, 1.8], 0.9 [95% CI: 0.5, 1.2], 0.8 [95% CI: 0.2, 1.3], 0.6 [95% CI: 0.2, 1.0], and 0.5 [95% CI: 0.1, 0.8], respectively).Systemic lupus erythematosus, rheumatoid arthritis, and psoriasis are associated with higher prevalence of CVD compared with other IMIDs. Specific prevention programs should be established in subjects affected with these conditions to prevent CVD.

Evaluación de una intervención sobre los factores de riesgo cardiovascular en pacientes con artritis reumatoide / Assessment of an intervention on cardiovascular risk factors in patients with rheumatoid arthritis

Objetivos: Evaluar la efectividad de una intervención sobre los factores de riesgo cardiovascular (FRCV) en pacientes con artritis reumatoide. Métodos: Tras determinar sus FRCV y su riesgo cardiovascular (RCV) mediante SCORE modificado, se entregó a los pacientes una carta dirigida a su médico de familia, en la que se solicitaba su colaboración en el control de los FRCV y se especificaba el objetivo respecto al colesterol LDL. Tres meses después se registraron las intervenciones terapéuticas realizadas y su resultado. Resultados: Se incluyeron 211 pacientes, el 29% con un alto RCV. Se realizaron nuevos diagnósticos de FRCV en 100 (47%) casos. El médico de familia cambió el tratamiento en 2/12 diabetes, 30/84 HTA, 74/167 con elevación del colesterol LDL y 21/51 hipertrigliceridemias. El porcentaje de pacientes con buen control de cada FRCV pasó: a) en HTA, del 25 al 73%; b) en elevación del colesterol LDL, del 10 al 17%; y c) en hipertrigliceridemia, del 25 al 38%. Conclusiones: Mediante esta intervención se diagnosticaron nuevos FRCV en casi la mitad de los pacientes. Su efectividad sobre el control de los FRCV fue baja (AU)

Objectives: To evaluate the effectiveness of an intervention on cardiovascular risk factors (CVRF) in patients with rheumatoid arthritis. Methods: After determining their CVRF and cardiovascular risk (CVR) by modified SCORE, we gave the patients a letter for their general practitioners in which they were requested for their cooperation in controlling CVRF and where the therapeutic goal for LDL cholesterol was specified. Three months later, any therapeutic intervention was recorded as well as the results. Results: We included 211 patients, 29% with a high CVR. There were new diagnoses of CVRF in 100 patients (47%). The general practitioner changed the treatment in 2/12 diabetes, 30/84 HBP, 74/167 with elevation of LDL cholesterol and 21/51 with hypertriglyceridemia. The percentage of patients with good control over CVRF was: a) in HBP, 25 to 73%; b) elevation of LDL cholesterol from 10 to 17%; and c) in hypertriglyceridemia, 25 to 38%. Conclusions: Through this intervention, a new CVRF was diagnosed in nearly half of the patients. The effectiveness of the intervention on CVRF was low (AU)

[Assessment of an intervention on cardiovascular risk factors in patients with rheumatoid arthritis]. / Evaluación de una intervención sobre los factores de riesgo cardiovascular en pacientes con artritis reumatoide.

OBJECTIVES: To evaluate the effectiveness of an intervention on cardiovascular risk factors (CVRF) in patients with rheumatoid arthritis. METHODS: After determining their CVRF and cardiovascular risk (CVR) by modified SCORE, we gave the patients a letter for their general practitioners in which they were requested for their cooperation in controlling CVRF and where the therapeutic goal for LDL cholesterol was specified. Three months later, any therapeutic intervention was recorded as well as the results. RESULTS: We included 211 patients, 29% with a high CVR. There were new diagnoses of CVRF in 100 patients (47%). The general practitioner changed the treatment in 2/12 diabetes, 30/84 HBP, 74/167 with elevation of LDL cholesterol and 21/51 with hypertriglyceridemia. The percentage of patients with good control over CVRF was: a) in HBP, 25 to 73%; b) elevation of LDL cholesterol from 10 to 17%; and c) in hypertriglyceridemia, 25 to 38%. CONCLUSIONS: Through this intervention, a new CVRF was diagnosed in nearly half of the patients. The effectiveness of the intervention on CVRF was low.

Bone mineral density status and frequency of osteoporosis and clinical fractures in 155 patients with psoriatic arthritis followed in a university hospital / Estado de la densidad mineral ósea y frecuencia de osteoporosis y de fracturas clínicas en 155 pacientes con artritis psoriásica evaluados en un hospital universitario

Objective: To assess the bone mineral density (BMD) and the frequency of osteoporosis and clinical fractures in a large group of Spanish patients with psoriatic arthritis (PsA). Patients and methods: BMD was determined by DXA in all the patients who were willing to participate and had peripheral PsA regularly evaluated in a tertiary university hospital. All patients underwent a physical examination and general laboratory analysis. We gathered demographic and clinical variables related with BMD and risk of fractures. We also recorded the history of clinical low impact fractures. The population of reference to calculate T-score and Z-score came from a Spanish database. Results: One hundred and fifty-five patients were included (64 postmenopausal women, 26 premenopausal women and 65 men). The clinical forms of PsA were: 46% oligoarticular and 54% polyarticular. Mean disease duration was 13.7±9.4 years and mean ESR was 21.8±13.9mm/h; 66% of patients had received glucocorticoid treatment. We found no differences in BMD status between the patients and the Spanish general population, neither in the whole series nor in each defined subgroup. Frequency of osteoporosis was 16%; it was higher in postmenopausal women (28%) than in men (9%) or premenopausal women (4%). Frequency of clinical fractures was 13%; it accounted specially in postmenopausal women

Objetivo: Analizar el estado de la densidad mineral ósea (DMO) así como la frecuencia de osteoporosis y de fracturas clínicas en una serie de pacientes con artritis psoriásica (APs). Pacientes y Método: Se determinó la DMO, mediante DXA, en todos los pacientes con APs periférica, evaluados de forma periódica en un hospital universitario, que aceptaron participar en el estudio. Se les practicó una exploración física y un estudio analítico y se recabó información acerca de variables clínicas relacionadas con la DMO y con el riesgo de fractura. Asimismo, se analizó si existía el antecedente de haber presentado una fractura de bajo impacto. El cálculo del T-score y del Z-score se realizó a partir de una base de datos de población española. Resultados: Se incluyeron 155 pacientes (64 mujeres posmenopáusicas, 26 mujeres premenopáusicas y 65 varones). En el 46% de los casos la APS adoptó un patrón oligoarticular y en el 54% poliarticular. La duración media de la enfermedad fue 13.7 ± 9.4 años, el valor medio de la VSG fue de 21.8 ± 13.9 mm/h; el 66% de los pacientes habían recibido tratamiento con glucocorticoides. No se observaron diferencias entre la DMO de los pacientes y la de la población general, ni en la globalidad de la serie, ni en ninguno de los tres grupos. La frecuencia global de osteoporosis se situó en el 16%; fue más alta en las mujeres posmenopáusicas (28%) que en los varones (9%) y que en las mujeres premenopáusicas (4%). La frecuencia de fracturas clínicas fue del 13%; acontecieron fundamentalmente en las mujeres posmenopáusicas (AU)

Specific cutaneous involvement in Whipple disease.

Cutaneous lesions in Whipple disease (WD) are infrequent, and the histological findings are usually nonspecific. Specific cutaneous lesions have rarely been described and usually involve the subcutaneous fat. We report a patient diagnosed with WD, who developed multiple small subcutaneous nodules after antibiotic treatment was administered. In addition to septal panniculitis, the cutaneous biopsy showed a mild granulomatous dermal reaction with PAS-positive macrophages characteristic of WD. A positive polymerase chain reaction in the cutaneous sample confirmed the presence of Tropheryma whipplei in the skin. Dermatopathologists should be aware that not only subcutaneous lesions but also dermal lesions may exhibit specific findings of WD.

Artritis mutilante/resortiva. Estudio de 24 pacientes de una serie de 360 artritis psoriásicas / Mutilating/resorptive arthritis. a study of 24 patients in a series of 360 patients with psoriatic arthritis

Objetivo. Describir una serie amplia de pacientes con artritis mutilante/resortiva (AM) de una población representativa de pacientes con artritis psoriásica (APs) y analizar las variables asociadas. Métodos. Estudio transversal multicéntrico que incluyó de forma consecutiva a los pacientes afectados de APs de 8 centros. A aquellos pacientes con tumefacción o deformidad de manos o pies sospechosa de se les realizó una radiografía antero-posterior. Se consideró que el paciente estaba afectado de AM si presentaba un trastorno erosivo que afectaba totalmente ambas superficies articulares. Resultados. De los 360 pacientes con APs estudiados, 24 presentaban AM (6,7%). La duración de la enfermedad fue significativamente mayor y presentaban una peor capacidad funcional, así como una mayor afección de IFD (p<0,05). En un 30% se detectaron cambios radiológicos indistinguibles de una osteoartritis nodular. Conclusiones. La AM en la APs se asocia a una peor capacidad funcional. Su posible asociación con la osteoartritis nodular de manos merece más estudios (AU)

Objective: To describe a large series of patients with mutilans/resorptive arthritis (AM) of a representative population of patients with psoriatic arthritis (PsA) and analyze the associated variables. Methods: Multicenter cross-sectional study of consecutive patients affected by PsA in 8 centers. In patients with swelling or deformity of the hands or feet we performed an anteroposterior rx. The patient was affected by AM if erosive disorder affecting both articular surfaces completely was present. Results: Of the 360 patients studied, 24 had PsA and AM (6.7%). The duration of their disease was significantly higher, and they exhibited a worse functional capacity as well as more DIP joint affection (P<.05). 30% had radiological changes indistinguishable from nodular osteoarthritis. Conclusions: AM in PA is associated with a worse functional capacity. Its possible association with nodular hand osteoarthritis deserves further study (AU)

Mutilating/resorptive arthritis. A study of 24 patients in a series of 360 patients with psoriatic arthritis.

OBJECTIVE: To describe a large series of patients with mutilans/resorptive arthritis (AM) of a representative population of patients with psoriatic arthritis (PsA) and analyze the associated variables. METHODS: Multicenter cross-sectional study of consecutive patients affected by PsA in 8 centers. In patients with swelling or deformity of the hands or feet we performed an anteroposterior rx. The patient was affected by AM if erosive disorder affecting both articular surfaces completely was present. RESULTS: Of the 360 patients studied, 24 had PsA and AM (6.7%). The duration of their disease was significantly higher, and they exhibited a worse functional capacity as well as more DIP joint affection (P<.05). 30% had radiological changes indistinguishable from nodular osteoarthritis. CONCLUSIONS: AM in PA is associated with a worse functional capacity. Its possible association with nodular hand osteoarthritis deserves further study.

Assessment of cardiovascular risk in rheumatoid arthritis: impact of the new EULAR recommendations on the score cardiovascular risk index.

To assess the impact of the application of the European League against Rheumatism (EULAR) task force recommendations in the cardiovascular (CV) risk of a series of Spanish patients diagnosed with rheumatoid arthritis (RA). Two hundred consecutive RA patients seen at the rheumatology outpatient clinics of Bellvitge Hospital, Barcelona, were studied. Information on clinical features of the disease, classic CV risk factors, and history of CV events was assessed. Both the systematic coronary risk evaluation (SCORE) CV risk index and the modified SCORE (mSCORE) according to the last EULAR recommendations were calculated. Based on the classic CV risk factors, the mean ± standard deviation SCORE was 2.1 ± 2.3% (median, 2; interquartile range [IQR], 1-3). Twenty-three (11%) patients were above the threshold of high CV risk for the Spanish population (≥5%). Following the EULAR recommendations, a change in the score was required in 119 (59%) patients. Therefore, the mean mSCORE was 2.7 ± 2.9% (median, 2; IQR, 1-3) and, due to this, 28 (14%) patients were above the threshold of high CV risk. Nine (5%) had at least one ischemic CV event. Patients with CV events were older and had more CV risk factors and higher SCORE and mSCORE than those without CV events. Although a large proportion of patients from this series fulfilled the criteria for the application of the EULAR recommendations, the final impact on the calculated CV risk was low and clinically significant in only a few patients. However, an association between the mSCORE and the presence of ischemic CV events was observed.

Relationship between psoriatic arthritis and moderate-severe psoriasis: analysis of a series of 166 psoriatic arthritis patients selected from a hospital population.

The aim of the study was to assess the prevalence of moderate to severe psoriasis (MS-P) in patients with psoriatic arthritis (PsA) and the relationship between MS-P and other variables related to arthritis. One hundred sixty-six consecutive patients with PsA periodically monitored at a university hospital's PsA unit in northeastern Spain were included in the study. Patients with psoriasis were classified as having MS-P when systemic treatment for skin was required. Clinical criteria for treatment indication was BSA >10 and/or PASI >14 and/or psoriasis affecting a very sensitive area of the body. Demographic and clinical data related to arthritis were assessed, including PsA pattern, age of onset of psoriasis and arthritis, disease activity index, and treatment required over the course of the disease. Moderate-severe psoriasis were more prevalent in women (p = 0.027). One hundred nine patients (65.7%) had psoriatic nail disease, and MS-P was more frequent in these patients (40 (77%) vs. 69 (61%), p = 0.028). Patients with spondyloarthropathy were significantly associated with MS-P (7 (16%) vs. 3 (3%), p = 0.014). No statistical association was observed between severe psoriasis and the age of onset of psoriasis or arthritis, involvement of distal interphalangeal joints, laboratory findings (HLA B27, RF), functional class, or disease activity indices. We report a high prevalence of severe psoriasis among patients with psoriatic arthritis, higher in women and patients with psoriatic nail disease and axial spondyloarthropathy.

¿Son útiles los factores pronóstico en la artritis reumatoide? / Are useful prognostic factors in rheumatoid arthritis?

La artritis reumatoide (AR) es una enfermedad inflamatoria de etiología desconocida y de predominio articular que condiciona mal pronóstico funcional y vital. En muchos pacientes el proceso inflamatorio mantenido durante años se traduce en destrucción articular e impotencia funcional a largo plazo. Los factores pronósticos (FP) son datos sociodemográficos, clínicos, analíticos y/o radiológicos presentes al inicio de la enfermedad que nos proporcionan información prospectiva de la evolución del paciente. El reto del especialista en reumatología es identificar a los pacientes que presenten signos de mal pronóstico en el inicio de la enfermedad y desarrollar una estrategia terapéutica apropiada (AU)

Rheumatoid arthritis (RA) is an inflammatory disease of unknown etiology, which predominantlyaffects joints and that confers poor functional and vital outcome. In many patients the inflammatory process is maintained for years, and results in joint destruction and long-term functional disability. Prognostic factors (PF) are demographic, clinical, laboratory and/or radiographic and should be evaluated at the onset of the disease, providing the physician prospective information on patient outcome. The challenge for the rheumatologist is to identify patients who present a poor prognosis in early rheumatoid arthritis and formulate treatment accordingly (AU)

[Are useful prognostic factors in rheumatoid arthritis?]. / Son útiles los factores pronóstico en la artritis reumatoide?

Rheumatoid arthritis (RA) is an inflammatory disease of unknown etiology, which predominantly affects joints and that confers poor functional and vital outcome. In many patients the inflammatory process is maintained for years, and results in joint destruction and long-term functional disability. Prognostic factors (PF) are demographic, clinical, laboratory and/or radiographic and should be evaluated at the onset of the disease, providing the physician prospective information on patient outcome. The challenge for the rheumatologist is to identify patients who present a poor prognosis in early rheumatoid arthritis and formulate treatment accordingly.