Zabotti Alen, De Lucia Orazio, Sakellariou Garifallia, Batticciotto Alberto, Cincinelli Gilberto, Giovannini Ivan, Idolazzi Luca, Maioli Gabriella, Tinazzi Ilaria, Aletaha Daniel, De Vita Salvatore, Marchesoni Antonio, Smolen Josef, Iagnocco Annamaria, McGonagle Dennis, Caporali Roberto
Department of Medical and Biological Science, Rheumatology Clinic, University of Udine, Udine, Italy.
Department of Specialist Medicine, Rheumatology Clinic, Azienda Sanitaria Universitaria Friuli Centrale, Piazzale S. Maria della Misericordia, 15, 33100, Udine, Italy.
Rheumatol Ther. 2021 Dec;8(4):1519-1534. doi: 10.1007/s40744-021-00378-w. Epub 2021 Oct 1.
Agreement on how to identify psoriasis (PsO) patients at risk of developing psoriatic arthritis (PsA) is lacking.
To identify predictors, risk factors and incidence rate (IR) of PsA development in PsO patients through a systematic literature review (SLR) and meta-analyses (MA).
MEDLINE, Embase, and Cochrane databases were searched. Cohort studies were used to assess the predictors, while case-control studies for PsA risk factor determination.
We screened 4698 articles for eligibility, and 110 underwent a full reading and 26 were finally included. Among skin and nail phenotypes, PsO severity and nail pitting were selected as predictors of PsA development. Furthermore, PsO patients with arthralgia (pooled RR 2.15 [1.16; 3.99]) and/or with imaging-MSK inflammation (pooled RR 3.72 [2.12; 6.51]) were at high risk of PsA. Higher categories of BMI and a family history of PsA were other predictors. In outpatient-based cohort studies, the IR of PsA per 100 patient-years varied from 1.34 to 17.4.
Despite the strength of the overall results, the heterogeneity and the number of the cohort studies could be considered a limitation.
This study provides a tentative profile of the PsO patient at risk of PsA and will help the design of PsA prevention trials.
目前对于如何识别有发展为银屑病关节炎（PsA）风险的银屑病（PsO）患者尚未达成共识。
通过系统文献综述（SLR）和荟萃分析（MA）确定PsO患者发生PsA的预测因素、风险因素和发病率（IR）。
检索MEDLINE、Embase和Cochrane数据库。队列研究用于评估预测因素，病例对照研究用于确定PsA的风险因素。
我们筛选了4698篇文章以确定其是否符合条件，110篇进行了全文阅读，最终纳入26篇。在皮肤和指甲表型中，PsO严重程度和甲凹点被选为PsA发生的预测因素。此外，有关节痛（合并RR 2.15 [1.16；3.99]）和/或有影像学肌肉骨骼炎症（合并RR 3.72 [2.12；6.51]）的PsO患者发生PsA的风险较高。较高的体重指数类别和PsA家族史是其他预测因素。在基于门诊的队列研究中，每100患者年的PsA发病率在1.34至17.4之间。
尽管总体结果有说服力，但队列研究的异质性和数量可被视为一种局限性。
本研究提供了有PsA风险的PsO患者的初步概况，将有助于PsA预防试验的设计。
