Department of Rheumatology & Clinical Immunology, UMC Utrecht, Utrecht, Netherlands
Department of Radiology, UMC Utrecht, Utrecht, Netherlands.
RMD Open. 2024 Jan 30;10(1):e003547. doi: 10.1136/rmdopen-2023-003547.
Patients with psoriatic arthritis (PsA) have an increased risk of cardiovascular disease, possibly due to a chronic inflammatory state.
The main objective of this study was to investigate the difference in vascular inflammation, measured with 18-fluorodeoxyglucose positron emission tomography/CT (PET/CT), in PsA patients and controls. We conducted a secondary analysis to assess the association between clinical parameters of disease activity with vascular inflammation in PsA.
We included a total of 75 PsA patients with active peripheral arthritis (defined as ≥2 tender and swollen joints) from an ongoing clinical trial (EudraCT 2017-003900-28) and a retrospective group of 40 controls diagnosed with melanoma, without distant metastases and not receiving immunotherapy. The main outcome measure was aortic vascular inflammation which was measured on PET/CT scans using target-to-background ratios. Clinical disease activity in PsA was assessed with joint counts, body surface area and the Disease Activity index for PsA. Laboratory assessments included C reactive protein and erythrocyte sedimentation rate.
Vascular inflammation was increased in patients with PsA in comparison with controls (mean target-to-background ratio for entire aorta, respectively, 1.63±0.17 vs 1.49±0.16; p=<0.001). This association remained significant after correction for gender, age, body mass index, mean arterial pressure and aortic calcification (p=0.002). Vascular inflammation was not associated with disease-related parameters.
Aortic vascular inflammation was significantly increased in patients with active PsA compared with controls. This evidence supports the theory that inflammation in PsA is not limited to the skin and joints but also involves the vascular system.
患有银屑病关节炎（PsA）的患者心血管疾病风险增加，这可能是由于慢性炎症状态所致。
本研究的主要目的是研究用 18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）测量的血管炎症在 PsA 患者和对照组之间的差异。我们进行了二次分析，以评估疾病活动的临床参数与 PsA 中血管炎症之间的关联。
我们纳入了来自正在进行的临床试验（EudraCT 2017-003900-28）的 75 例活动性外周关节炎（定义为≥2 个压痛和肿胀关节）的 PsA 患者和回顾性组的 40 例诊断为黑色素瘤的对照者，无远处转移且未接受免疫治疗。主要结局指标是主动脉血管炎症，通过使用靶标与背景比值的 PET/CT 扫描来测量。用关节计数、体表面积和银屑病关节炎疾病活动度指数评估 PsA 中的临床疾病活动度。实验室评估包括 C 反应蛋白和红细胞沉降率。
与对照组相比，PsA 患者的血管炎症增加（整个主动脉的平均靶标与背景比值分别为 1.63±0.17 与 1.49±0.16；p<0.001）。在校正性别、年龄、体重指数、平均动脉压和主动脉钙化后，这种关联仍然显著（p=0.002）。血管炎症与疾病相关参数无关。
与对照组相比，活动性 PsA 患者的主动脉血管炎症显著增加。这一证据支持炎症在 PsA 中不仅局限于皮肤和关节，还涉及血管系统的理论。
