Female patients with PsA have 2.3-fold increased risk for lupus
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Patients with psoriatic arthritis demonstrate a 2.3-fold increased prevalence for systemic lupus erythematosus, compared with the general population, according to data published in The Journal of Rheumatology.
“Patients with psoriasis and PsA can develop a variety of comorbidities including diabetes, hypertension, cardiovascular diseases and depression,” Danielle Korkus, of the Technion, Israel Institute of Technology, in Haifa, and colleagues wrote. “PsA patients are more affected than those with isolated psoriasis, and disease severity also increases the prevalence of comorbidities. Comorbidities, in turn, may influence the therapeutic regimen and affect treatment outcomes.”
“The presence of anti-nuclear antibodies (ANA) is one of the hallmarks of SLE,” they added. “Several studies report higher prevalence of ANA positivity in patients with psoriasis and PsA. Previous studies also report a coexistence of psoriasis and SLE, but unlike psoriasis, the coexistence of PsA and SLE has only been reported in several case reports.”
To examine the prevalence of SLE among patients with PsA, compared with the general population, Korkus and colleagues analyzed the Clalit health services database, which serves approximately 52% of the Israeli population. The researchers identified 4,836 patients with PsA in the registry from Jan. 1, 2002, to Dec. 31, 2017. They then matched these patients to 24,180 randomly selected control individuals without PsA based on age and sex as controls.
The researchers used the student’s t-test and Chi square test as appropriate in their statistical analysis. Further, they performed incidence density sampling among patients with PsA, matching as controls those without SLE to each case of PsA alongside SLE, based on age and follow-up time. Researchers also used univariate and multivariate conditional logistic regression analysis to determine which factors impact SLE development.
According to the researchers, 0.37% of patients in the PsA group and 0.15% of those in the control group were diagnosed with SLE (P = .001). Patients with SLE but without PsA demonstrated higher anti-dsDNA and anti-cardiolipin antibodies. Additionally, the use of drugs with a known potential to induce SLE was higher among those with PsA, compared with the control group. Older age at PsA diagnosis, shorter PsA duration and statin treatment were associated with the development of SLE among those with PsA.
“Our study points to an increase in prevalence of SLE among female PsA patients with patients at highest risk of SLE development being female patients with late-onset PsA, with short disease duration, and especially those of whom are on statin therapy,” Korkus and colleagues wrote. “Clinicians caring for patients with PsA and SLE should be aware of the higher prevalence of comorbid conditions in this patient population. More research is needed to understand the underlying biologic pathway which may be common to SLE and PsA.”
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