PSORIATIC RHEUMATISM. INFLAMMATORY ARTHROPATHY

Authors

  • Luana MACOVEI University of Medicine and Pharmacy “Grigore T. Popa”- Iaşi,
  • Isabella BRUJBU University of Medicine and Pharmacy “Grigore T. Popa”- Iaşi,

Keywords:

INFLAMMATORY ARTHROPATHY, CLINICAL MANIFESTATIONS, EARLY DIAGNOSIS, DIAGNOSTIC CRITERIA.

Abstract

Psoriatic rheumatism is an inflammatory arthropathy associated with cutaneous psoriasis that occurs mainly in adults aged between 30 and 45 years. In most cases, cutaneous phenomena precede rheumatic manifestations. Psoriatic rheumatism may begin as a monoarthritis and the diagnosis will be confirmed by the presence of psoriatic plaques or by the personal and family history of psoriasis. As a chronic proliferative epidermal disease, psoriasis is due to a genetic predisposition and it is clinically expressed following the triggering action of several factors. The onset is preceded by various events. Psoriasis is two to three times more common in patients with arthritis and about 10-20% of psoriasis patients show joint damage. Aim: The present study aims to demonstrate the clinical and biological efficacy of biotechnology-derived biologic drugs, acting as TNFα antagonists and used as backup therapy, at the same time bringing new hope for broadening and improving therapy in psoriatic arthropathy. Material and methods: The study included a total of 21 patients (13 men, 8 women) admitted in the interval 2011-2012 to the I-st Rheumatology Clinic of the Iasi Rehabilitation Hospital. The patients were older than 20 years and had one or more peripheral arthritis conditions, skin and nail lesions. Results and discussion: Based on the results, it is recommended that infliximab to be administered in patients who meet CASPAR ((Classification Criteria for Psoriatic Arthritis) diagnostic criteria, have the disease in  aggressive stage, and do not respond to treatment with methotrexate (MTX) or other disease-modifying antirheumatic drugs - DMARDs (leflunomide, sulfasalazine) administered for 12 weeks. Conclusions: Infliximab is effective in counteracting the potentially harmful elements. It reduces the number of tender and swollen joints, improves the functional capacity and the quality of life, and slows down the radiologic progression. Infliximab is well tolerated, effective, with an optimum safety profile during short-term administration in patients with active forms of psoriatic arthropathy.

Author Biographies

  • Luana MACOVEI, University of Medicine and Pharmacy “Grigore T. Popa”- Iaşi,

    Faculty of Medicine
    Discipline of Rheumatology-Balneophysiotherapy 

  • Isabella BRUJBU, University of Medicine and Pharmacy “Grigore T. Popa”- Iaşi,

    Faculty of Medicine
    Discipline of Family Medicine

References

1. Fournie A., Rhumatisme psoriasique,Rhumatol, 1968, 20: 329-334.
2. Coste F., Psoriazis Arthritis in Schoen R., Boni A., Miehlke K.Klinik der Rheumatischen Erkrakungen, Springer Verlag, Berlin-Heidelberg-New York, 1971, 240-254.
3. Abu-Shakra M., GladmanDD.,Etiopathogenesis of psoriatic arthritis.Reumatol Rev, 1993; 31: 433-458.
4. Gladman, DD, Shuckett, R, Russell, ML, et al. Psoriatic arthritis (PSA): An analysis of 220 patients. Q J Med 1987; 62: 127-132.
5. Gladman, DD, Antoni, C, Mease, P, et al. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis 2005; 64-68.
6. Hodler J, Resnik D.,Current status of imaging of articular cartilage. Skeletal Radiol 1996; 25: 703- 708.
7. Ritchlin, CT, Kavanaugh, A, Gladman, DD, et al. Treatment recommendations for psoriatic arthritis. Ann Rheum Dis 2009; 68: 1387-1392.
8. Gladman, DD, Hing, EN, Schentag, CT, Cook, RJ. Remission in psoriatic arthritis. J Rheumatol 2001; 28: 1045-1049.
9. Ali, Y, Tom, BD, Schentag, CT, et al. Improved survival in psoriatic arthritis with calendar time. Arthritis Rheum 2007; 56: 2708-2712.
10. Gladman, DD. Mortality in psoriatic arthritis. Clin Exp Rheumatol 2008; 26: S62.
11. Shbeeb, M, Uramoto, KM, Gibson, LE, et al. The epidemiology of psoriatic arthritis in Olmsted County, Minnesota, USA, 1982-1991. J Rheumatol 2000; 27: 1247-1252.
12. Goodfield, M. Skin lesions in psoriasis. Baillieres Clin Rheumatol 1994; 8: 295-299.
13. Abel, EA, DiCicco, LM, Orenberg, EK, et al. Drugs in exacerbation of psoriasis. J Am Acad Dermatol 1986; 15:1007-1011.
14. Willkens, RF, Williams, HJ, Ward, JR, et al. Randomized, double-blind, placebo controlled trial of low-dose pulse methotrexate in psoriatic arthritis. Arthritis Rheum 1984; 27: 376-3740.
15. Abu-Shakra, M, Gladman, DD, Thorne, JC, et al. Long-term methotrexate therapy in psoriatic arthritis: Clinical and radiologic outcome. J Rheumatol 1995; 22: 241-245.
16. Soriano, ER, McHugh, NJ. Therapies for peripheral joint disease in psoriatic arthritis. A systematic review. J Rheumatol 2006; 33: 1422-1426.
17. Chandran, V, Schentag, CT, Gladman, DD. Reappraisal of the effectiveness of methotrexate in psoriatic arthritis: results from a longitudinal observational cohort. J Rheumatol 2008; 35: 469-473.
18. Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H, and the CASPAR Study Group. Classification criteria for psoriatic arthritis: development of new criteria from a large interna-tional study. Arthritis Rheum 2006; 54: 2665–2673.

Additional Files

Published

2018-05-14

Issue

Section

INTERNAL MEDICINE - PEDIATRICS