Medina Gustavo A, Fenucci Maximiliano, Magri Sebastián, Abdala Marcelo, Arias Tamara, Abdala Brian, Abbas Leila, Chandran Vinod, García-Salinas Rodrigo
Rheumatology, Hospital de Clínicas, Buenos Aires University, Buenos Aires, Argentina.
Rheumatology, Hospital Cesar Milstein, Buenos Aires University, Buenos Aires, Argentina.
Ther Adv Musculoskelet Dis. 2025 Jul 10;17:1759720X251356206. doi: 10.1177/1759720X251356206. eCollection 2025.
Late-onset psoriatic arthritis (LO-PsA) has been underexplored despite its growing prevalence in aging populations. Understanding its distinct clinical presentation and treatment patterns is essential to optimize care in this subgroup.
To describe the demographic, clinical, and therapeutic features of patients with LO-PsA compared to early onset PsA (EO-PsA) using data from the Argentine RECCAPSO registry.
Ambispective, multicenter analysis with a cross-sectional evaluation.
Patients with PsA were categorized into EO-PsA (age of onset ⩽60 years) and LO-PsA (>60 years). Demographics, clinical characteristics, disease activity, and treatment variables were compared between groups using appropriate statistical tests. A multivariate logistic regression model was constructed to identify factors independently associated with LO-PsA.
A total of 271 PsA patients were included (EO-PsA: = 184; LO-PsA: = 87). LO-PsA patients had higher frequencies of hypertension (50% vs 21.4%, < 0.001), diabetes (22.1% vs 7.9%, = 0.007), and oligoarticular presentation (57.4% vs 40.5%, = 0.03), and were less likely to receive b/tsDMARDs (42.6% vs 58.7%, = 0.02). In multivariate analysis, hypertension (OR: 4.69, 95% CI: 1.83-12.03) and diabetes (OR: 14.83, 95% CI: 2.36-93.05) were independently associated with LO-PsA.
LO-PsA presents a distinct clinical profile characterized by greater comorbidity burden and lower exposure to advanced therapies. These findings highlight the need for tailored management strategies in older adults with PsA.
尽管迟发性银屑病关节炎（LO-PsA）在老年人群中的患病率不断上升，但对其研究仍不足。了解其独特的临床表现和治疗模式对于优化该亚组患者的护理至关重要。
利用阿根廷RECCAPSO注册研究的数据，描述与早发性银屑病关节炎（EO-PsA）相比，LO-PsA患者的人口统计学、临床和治疗特征。
采用横断面评估的双向多中心分析。
将银屑病关节炎患者分为EO-PsA（发病年龄≤60岁）和LO-PsA（>60岁）。使用适当的统计检验比较两组之间的人口统计学、临床特征、疾病活动度和治疗变量。构建多变量逻辑回归模型以确定与LO-PsA独立相关的因素。
共纳入271例银屑病关节炎患者（EO-PsA：=184例；LO-PsA：=87例）。LO-PsA患者高血压（50%对21.4%，<0.001）、糖尿病（22.1%对7.9%，=0.007）和少关节表现（57.4%对40.5%，=0.03）的发生率更高，接受生物制剂/靶向合成改善病情抗风湿药（b/tsDMARDs）治疗的可能性更小（42.6%对58.7%，=0.02）。多变量分析显示，高血压（比值比：4.69，95%置信区间：1.83-12.03）和糖尿病（比值比：14.83，95%置信区间：2.36-93.05）与LO-PsA独立相关。
LO-PsA具有独特的临床特征，其特点是合并症负担更重，接受先进治疗的机会更少。这些发现凸显了对老年银屑病关节炎患者采取针对性管理策略的必要性。
