Kobak Senol, Yildiz Fidan, Karaarslan Ahmet, Semiz Huseyin, Orman Mehmet
Istinye University Faculty of Medicine, LIV Hospital Department of Rheumatology, Istanbul Medicalpark Hospital, Department of Chest Disease Central Hospital, Department of Ortopedics Ege University Faculty of Medicine, Department of Internal Medicine Ege University Faculty of Medicine, Department of Statistics, Izmir, Turkey.
Medicine (Baltimore). 2017 Aug;96(33):e7833. doi: 10.1097/MD.0000000000007833.
Psoriatic arthritis (PsA) is a chronic inflamatory disease characterized with axial and peripheral joints involvement. It rarely affects patients older than 65 years old.The purpose of this study is to compare and evaluate the demographic, clinical and laboratory features of elderly-onset psoriatic arthritis (EOPsA) and young-onset (YOPsA) patients.A total of 180 patients diagnosed with PsA according to CASPAR criteria and followed-up in single center were included in this study. The patients with initial symptoms started after age 65 were accepted as EOPsA. Demographic, clinic, and laboratory data and the medications which the patients received were recorded and retrospectively evaluated.Nineteen (10.5%) of 180 patients were diagnosed as EOPsA, and 161 (89.5%) patients were evaluated as YOPsA. The mean patient age was 42.1years for the YOPsA group and 68.3 years for the elderly onset group. Mean duration of disease was 5.6 years for the early onset group and 1.3 years for the elderly onset group (P = .001). Fourteen (73.3%) of 19 EOPsA patients were female and 5 of them were male. Higher rates of fatique, pain scores, comorbid diseases, and acute phase reactants elevation were detected in EOPsA patients comparing to YOPsA (P = .000, P = .000, P = .001, and P = .001, respectively). YOPsA patients have more dactilitis, nail involvement, elevated PASI scores, and smoking habitus when compared with EOPsA patients (P = .019, P = .03, P = .005, P = .004, respectively). In terms of the treatment options chosen, there was no significant difference in the use of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids (CS), methotrexate (MTX), and sulfasalazine (SSL), but there was a more frequent use of anti-tumor necrosis factor-alpha in the YOPsA group.YOPsA and EOPsA patients may presented with different clinical and laboratory features. EOPsA patients are characterized with higher rates of fatigue, pain scores, comorbid diseases, and acute phase reactants and less dactilitis, nail involvement, and anti-TNF-alpha usage.
银屑病关节炎(PsA)是一种慢性炎症性疾病,其特征为累及中轴关节和外周关节。它很少影响65岁以上的患者。本研究的目的是比较和评估老年起病型银屑病关节炎(EOPsA)和年轻起病型(YOPsA)患者的人口统计学、临床和实验室特征。本研究纳入了180例根据CASPAR标准确诊并在单一中心接受随访的PsA患者。初始症状在65岁以后出现的患者被视为EOPsA。记录患者的人口统计学、临床和实验室数据以及他们接受的药物治疗,并进行回顾性评估。180例患者中有19例(10.5%)被诊断为EOPsA,161例(89.5%)患者被评估为YOPsA。YOPsA组患者的平均年龄为42.1岁,老年起病组为68.3岁。早发组的平均病程为5.6年,老年起病组为1.3年(P = 0.001)。19例EOPsA患者中有14例(73.3%)为女性,5例为男性。与YOPsA相比,EOPsA患者的疲劳、疼痛评分、合并症和急性期反应物升高的发生率更高(分别为P = 0.000、P = 0.000、P = 0.001和P = 0.001)。与EOPsA患者相比,YOPsA患者的指(趾)炎、指甲受累、PASI评分升高和吸烟习惯更为常见(分别为P = 0.019、P = 0.03、P = 0.005、P = 0.004)。在选择的治疗方案方面,非甾体抗炎药(NSAIDs)、皮质类固醇(CS)、甲氨蝶呤(MTX)和柳氮磺胺吡啶(SSL)的使用没有显著差异,但YOPsA组使用抗肿瘤坏死因子-α更为频繁。YOPsA和EOPsA患者可能表现出不同的临床和实验室特征。EOPsA患者的特征是疲劳、疼痛评分、合并症和急性期反应物的发生率较高,而指(趾)炎较少,指甲受累较少,抗肿瘤坏死因子-α的使用较少。