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Radiographic progression in early psoriatic arthritis more severe in men than women
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Although investigators of a recently published study found radiographic progression of early psoriatic arthritis was slow in patients, they noted it occurred more quickly in men compared to women and discovered baseline damage and dactylitis were predictive of further damage.
Researchers studied 29 men and 43 women with psoriatic arthritis (PsA) who met the Classification for Psoriatic Arthritis (CASPAR) criteria. Patients had a mean age of 47.8 years and were enrolled in the Swedish Early PsA registry. Twenty-six patients had radiographs of their hands and feet at baseline and 5 years, 16 patients had radiographs of the hands and feet at 2 and 5 years, and 30 patients had images from all three time points. Median disease duration was 12 months, and disease characteristics were similar for women and men. However, men had a slightly longer disease duration and more skin involvement. Women had poorer Health Assessment Questionnaire scores.
Age was not correlated with the destruction score at baseline, and no radiographic progression was seen in 35 patients. Wassenburg scores greater than 10 were seen in one man and one woman. The mean score at baseline was 3.2 in men and 1.6 in women. Erosion scores were 1.2 in men and 0.3 in women, while proliferation scores were 1.9 for men and 1.3 for women. Foot scores were 1.04 for men and 0.28 for women, and hand scores were 2.2 for men and 1.3 for women, showing greater overall radiographic progression in men at baseline.
The mean total score at 5 years was 5.3. The mean total score in men was 8 compared to 3.4 in women. Mean erosions scores were 3.4 for mean and 0.86 for women, and proliferation mean scores were 4.6 for men and 2.6 for women. Foot scores were also higher in men compared to women, and contributed to 32% of the total score in men. However, this difference did not reach significance. – by Shirley Pulawski
Disclosure: The study was supported by grants from the Swedish Psoriasis Foundation, Skåne University Hospital and Wyeth (Pfizer).
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