Comprehensive treatment of psoriatic arthritis: managing comorbidities and extraarticular manifestations

Alexis Ogdie; Sergio Schwartzman; Lihi Eder; Ajesh B Maharaj; Devy Zisman; Siba P Raychaudhuri; Soumya M Reddy; Elaine Husni

doi:10.3899/jrheum.140882

Comprehensive treatment of psoriatic arthritis: managing comorbidities and extraarticular manifestations

J Rheumatol. 2014 Nov;41(11):2315-22. doi: 10.3899/jrheum.140882.

Authors

Alexis Ogdie¹, Sergio Schwartzman¹, Lihi Eder¹, Ajesh B Maharaj¹, Devy Zisman¹, Siba P Raychaudhuri¹, Soumya M Reddy¹, Elaine Husni²

Affiliations

¹ From the University of Pennsylvania, Philadelphia, Pennsylvania; Hospital for Special Surgery, New York, New York, USA; Toronto Western Hospital, Toronto, Ontario, Canada; Nelson R. Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa, and Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Carmel Medical Center, Faculty of Medicine, Technion, Haifa, Israel; Rheumatology, VA Sacramento Medical Center; Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, UC Davis, Davis, California; Division of Rheumatology, New York University School of Medicine, New York, New York; and the Cleveland Clinic, Cleveland, Ohio, USA.A. Ogdie, MD, MSCE, University of Pennsylvania; S. Schwartzman, MD, Hospital for Special Surgery; L. Eder, MD, PhD, Toronto Western Hospital; A.B. Maharaj, MB, BS, HDipIntMed(SA), FCP(SA), Nelson R. Mandela School of Medicine, University of KwaZulu Natal and Academic Medical Center, University of Amsterdam; D. Zisman, MD, Carmel Medical Center, Faculty of Medicine, Technion; S.P. Raychaudhuri, MD, Rheumatology, VA Sacramento Medical Center; Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, UC Davis; S.M. Reddy, MD, Division of Rheumatology, New York University School of Medicine; E. Husni, MD, MPH, Cleveland Clinic.
² From the University of Pennsylvania, Philadelphia, Pennsylvania; Hospital for Special Surgery, New York, New York, USA; Toronto Western Hospital, Toronto, Ontario, Canada; Nelson R. Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa, and Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Carmel Medical Center, Faculty of Medicine, Technion, Haifa, Israel; Rheumatology, VA Sacramento Medical Center; Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, UC Davis, Davis, California; Division of Rheumatology, New York University School of Medicine, New York, New York; and the Cleveland Clinic, Cleveland, Ohio, USA.A. Ogdie, MD, MSCE, University of Pennsylvania; S. Schwartzman, MD, Hospital for Special Surgery; L. Eder, MD, PhD, Toronto Western Hospital; A.B. Maharaj, MB, BS, HDipIntMed(SA), FCP(SA), Nelson R. Mandela School of Medicine, University of KwaZulu Natal and Academic Medical Center, University of Amsterdam; D. Zisman, MD, Carmel Medical Center, Faculty of Medicine, Technion; S.P. Raychaudhuri, MD, Rheumatology, VA Sacramento Medical Center; Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, UC Davis; S.M. Reddy, MD, Division of Rheumatology, New York University School of Medicine; E. Husni, MD, MPH, Cleveland Clinic. HUSNIE@ccf.org.

PMID: 25362717
DOI: 10.3899/jrheum.140882

Abstract

Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis that can lead to decreased health-related quality of life and permanent joint damage leading to functional decline. In addition to joint and skin manifestations, both psoriasis and PsA are associated with numerous comorbidities and extraarticular/cutaneous manifestations, which may influence the physician's choice of therapy. The objectives of this review are (1) to identify comorbidities in patients with PsA based on the available evidence; (2) to examine the effects of these comorbidities or extraarticular/cutaneous manifestation on the management of patients with PsA as well as the selection of therapy; and (3) to highlight research needs around comorbidities and treatment paradigms. This review is part of a treatment recommendations update initiated by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

Keywords: AUTOIMMUNE OPHTHALMIC DISEASE; CARDIOVASCULAR DISEASE; DIABETES; METABOLIC SYNDROME; OBESITY; OSTEOPOROSIS.

Publication types

Review

MeSH terms

Arthritis, Psoriatic / diagnosis
Arthritis, Psoriatic / drug therapy*
Arthritis, Psoriatic / epidemiology*
Cardiovascular Diseases / diagnosis
Cardiovascular Diseases / epidemiology
Comorbidity
Comprehensive Health Care / methods*
Diabetes Mellitus / diagnosis
Diabetes Mellitus / epidemiology
Diabetes Mellitus / therapy
Evidence-Based Medicine
Female
Humans
Liver Diseases / diagnosis
Liver Diseases / epidemiology
Male
Obesity / diagnosis
Obesity / epidemiology
Obesity / therapy
Osteoporosis / diagnosis
Osteoporosis / epidemiology
Practice Guidelines as Topic*
Psoriasis / diagnosis
Psoriasis / drug therapy
Psoriasis / epidemiology
Randomized Controlled Trials as Topic
Renal Insufficiency, Chronic / diagnosis
Renal Insufficiency, Chronic / epidemiology
Treatment Outcome

Grants and funding

K23 AR063764/AR/NIAMS NIH HHS/United States