Ari Polachek

Risk of cardiovascular morbidity in patients with psoriatic arthritis: A meta-analysis of observational studies

To assess the magnitude of risk of cardiovascular and cerebrovascular morbidity in patients with psoriatic arthritis (PsA) compared with the general population through a systematic review and meta‐analysis of observational studies.

Clinical enthesitis in a prospective longitudinal psoriatic arthritis cohort: Incidence, prevalence, characteristics and outcome

To evaluate the incidence, prevalence, characteristics, disease associations, risk factors, and outcome of clinical enthesitis in patients with psoriatic arthritis (PsA).

The Development of Psoriatic Arthritis in Patients With Psoriasis Is Preceded by a Period of Nonspecific Musculoskeletal Symptoms: A Prospective Cohort Study

To assess whether the presence of nonspecific musculoskeletal symptoms, their degree, and change over time predict the development of psoriatic arthritis (PsA) in a prospective cohort of psoriasis patients without arthritis at baseline.

Defining low disease activity in systemic lupus erythematosus

To define and identify a group of systemic lupus erythematosus patients with low disease activity (LDA) and to examine whether LDA is similar to patients in remission and different from a high disease activity group (HDA) in short‐term outcomes.

Psoriatic arthritis disease activity during pregnancy and the first-year postpartum

OBJECTIVES To evaluate disease activity in the joints and skin during pregnancy and the first-year postpartum in patients with psoriatic arthritis (PsA). METHODS Women with PsA who were pregnant between 1990 and 2015 with at least 1 clinic visit during pregnancy were identified from the Toronto PsA database. The course of joint and skin disease activity was defined by the following 5 states: improvement, worsening, stable low, stable high, or a mixed. As controls, 67 nonpregnant PsA women were identified and evaluated over a similar timeframe. RESULTS Altogether, 29 PsA women with 42 pregnancies were identified. Of the 42 pregnancies, 40 (95%) resulted in normal live birth. Arthritis improved or was stable low activity in 24 (58.5%) of pregnancies. During the postpartum period, 21 (52.5%) had either improvement or stable low PsA activity, whereas 16 (40%) had either worsening or stable high disease activity. The skin activity during pregnancy either improved or stayed in a stable low state in 30 (88.2%), and in the postpartum period there was worsening in 15 (42.9%). A logistic regression analysis revealed a favourable skin disease course during the pregnancy period in the pregnant group compared to the control group (OR = 6.8, p = 0.004), but not in joint disease. CONCLUSIONS The outcome of pregnancy among patients with PsA is excellent. Arthritis activity trends toward a favourable course while the skin disease shows a favorable course during pregnancy. When compared to controls, pregnancy period has significant beneficial influence only on the skin but not on the joints in PsA.

The development of PsA in patients with psoriasis is preceded by a period of non-specific musculoskeletal symptoms: A prospective cohort study

To assess whether the presence of nonspecific musculoskeletal symptoms, their degree, and change over time predict the development of psoriatic arthritis (PsA) in a prospective cohort of psoriasis patients without arthritis at baseline.

Late onset psoriatic arthritis in a longitudinal cohort: Disease presentation, activity over time and prognosis

AIMS To evaluate disease activity of late onset psoriatic arthritis (LoPsA) patients at presentation, during follow-up, and after 5years of follow-up, compared to young onset PsA patients (YoPsA). METHODS The study included patients with PsA followed prospectively within 2years from diagnosis. Patients were divided into two groups: (1) LoPsA - defined as disease onset ≥ 50 years, (2) YoPsA - defined as disease onset < 50 years. Descriptive statistics are provided and multivariable logistic regression models were developed to compare these groups. RESULTS Five hundred and sixty-six patients were included at presentation. Regression analysis showed that the LoPsA group at presentation was characterized by: less males (OR 0.4, p = 0.001), less HLA-C*06 (OR 0.3, p = 0.005), longer psoriasis duration (OR 1.04, p = 0.0005), higher BMI (OR 1.1, p = 0.005) and higher modified Steinbrocker score (mSS) (OR 1.1, p = 0.005). Regression analysis adjusted for gender, BMI, psoriasis duration, HLA and treatments after 5years of follow-up revealed a trend toward higher adjusted mean active joint count (OR 7.98, p = 0.052) and higher mean mSS score (OR 13.39, p = 0.007) in the LoSpA group compared to the YoPsA group. During 5years of follow-up, the YoPsA patients were treated with more NSAIDs (96% vs. 88%, p = 0.04), while there were no significant differences in the DMARDs and biologic drugs. CONCLUSION The LoPsA patients at presentation are characterized by female predominance, higher BMI, more damage and less HLA-C*06. After 5years of follow-up the LoPsA patients have worse prognosis manifested by a trend toward higher disease activity burden and significantly more damage.

The Association Between HLA Genetic Susceptibility Markers and Sonographic Enthesitis in Psoriatic Arthritis

Enthesitis is an important pathophysiologic component of psoriatic arthritis (PsA). HLA genes are implicated in the pathogenesis of PsA. Little is known about the relationship between HLA genetic susceptibility markers and enthesitis in PsA patients. Our aim was to examine the association between HLA genetic susceptibility markers and sonographic enthesitis in PsA.

Sex Differences in Psychiatric Hospitalizations of Individuals With Psychotic Disorders

Abstract We aimed to evaluate the association between sex and hospitalization characteristics in psychotic disorders. We identified all acute hospitalizations, between 2010 and 2013, for psychotic disorders in patients younger than 45 and older than 55 years (n = 5411) in the hospitals database. In addition, we identified patients who were prescribed with intramuscular risperidone (n = 280) or clozapine (n = 192) at discharge. The results showed that women younger than 45 years had lower proportions of hospitalizations (33.52% vs. 66.47%) and involuntary hospitalizations (33.85% vs. 45.55%) than did men in the same age group. Women older than 55 years had higher proportions of hospitalizations (57.22% vs. 42.77%) and similar proportion of involuntary hospitalizations. Women younger than 45 years were prescribed similar doses of intramuscular risperidone and lower doses of clozapine (345.8 vs. 380.2 mg) and women older than 55 years were prescribed higher doses of intramuscular risperidone (44.8 vs. 34.4 mg/2 weeks) and clozapine (164.32 vs. 154.5 mg) than were men in the same age group. Women in the reproductive years have better hospitalization characteristics than do men on these measures.

OP0111 The association between sonographic enthesitis and radiographic joint damage in psoriatic arthritis

Background Enthesitis is a common clinical finding and a key pathogenic feature in psoriatic arthritis (PsA). Ultrasound is emerging as a preferred method to assess enthesitis. Little is known about the relation between the presence of enthesitis and the severity of joint damage in patients with PsA. Objectives Our objective was to examine the association between sonographic enthesitis and the severity of radiographic features of damage in the peripheral and axial joints in PsA. Methods A cross-sectional study was conducted in consecutive patients with PsA. The MAdrid Sonography Enthesitis Index (MASEI) scoring system was used to quantify the extent of sonographic entheseal abnormalities in 12 entheseal sites. Total MASEI was further categorized into: bone scores (enthesophytes, erosions) and soft tissue scores (structural changes, vascularization, bursitis). Radiographic joint damage in the peripheral joints and spine was assessed independently of the ultrasound results using the modified Steinbrocker score, Modified New York Criteria for sacroiliitis and the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Additionally, the presence of ankylosis, arthritis mutilans and periostitis in the hands or feet was determined. Linear and logistic regression models were used to assess the association between MASEI score and the radiographic features of joint damage after controlling for age, sex, BMI, PsA duration and the use of DMARDs and biologic medications. Results 222 patients were included (58% men) with mean (s.d.) age of 55.9 (12.9) years and PsA duration of 16.7 (12.4) years. The mean MASEI score was 15.6 (12.6). The mean modified Steinbrocker score was 18.1 (32.3), mSASSS was 1.7 (7.3) and 37% had sacroiliitis. Multivariate regression analyses found an association between higher scores of MASEI scores and peripheral joint damage: modified Steinbrocker score (β 9.26, p<0.0001), joint ankylosis (Odds Ration (OR) 2.09, p=0.0001) and arthritis mutilans (OR 1.73, p=0.005). The association between MASEI scores and periostitis was of borderline statistical significance (OR 1.29, p=0.06). Similarly, an association was found in multivariate analyses between higher MASEI scores and axial damage as measured by mSASSS (β 1.55, p≤0.0001) and sacroiliitis (OR 1.36, p=0.02). Sub-analysis showed that the MASEI bone score were more strongly associated with radiographic damage outcomes than the MASEI soft tissue score. Conclusions The severity of sonographic enthesitis is a marker of radiographic peripheral and axial joint damage in PsA. The association was found with both erosive and bone formation lesions. These findings highlight the potential role of enthesitis in the pathogenesis of articular damage in PsA. Disclosure of Interest None declared