Long term prognosis of psoriatic arthritis

Abstract

Psoriatic arthritis is a common inflammatory disease of peripheral and axial skeleton. Until the last two decades, there were no very effective treatments for PSA. Fortunately, in recent years, there has been a revolution in new treatments with biological drugs that lead to better control of the disease and its subsequent complications, and therefore early diagnosis is important. As a result, the following study was conducted with the aim of investigating the long-term prognosis of psoriatic arthritis in the patients of Imam Reza Hospital and the specialized clinic of Imam Reza Hospital in Tabriz. Methods: In this cohort study, 126 psoriatic arthritis patients with an average age of 38.6 ± 12.8 years were included in the study using the full number method. Based on the completion of the checklist from the patient's file and, if necessary, a telephone call to the patient, the required information includes demographic information (including age, gender, education level, age at the onset of the disease, time interval between the onset of the disease and diagnosis and treatment, duration of the disease , family history of the disease, smoking), clinical symptoms, laboratory results, and long-term follow-up results of the disease (response to initial treatment, long-term remission rate, drug-free remission rate, and psoriatic arthritis damage rate) were recorded. Long-term prognosis was evaluated based on the rate of remission and the amount of damage caused by psoriatic arthritis from the time of diagnosis to the last visit of the patient by the attending physician. Finally, the data was analyzed by SPSS statistical analysis software. Results: Plaque was the most common disease phenotype and was the most common clinical pattern of oligoarthritis. The most common musculoskeletal site involved in the affected patients was proximal interphalangeal. The follow-up period was 31 months. NSAIDs and methotrexate were the most used therapeutic drugs, respectively. At the end of an average follow-up of 31 months, 19% of patients had full compliance with treatment, 67.5% of cases were in stable remission. The average duration of recovery was 4.5 months. Recovery without medication was achieved in 5.7% of patients. In 56.6% of cases, the disease worsened after complete recovery. The result of weak joints was seen in 36 people, i.e. 28.6% of affected cases. No significant relationship was observed between age, sex, BMI, family history of psoriatic arthritis, comorbidities, delay in starting treatment, and adherence to treatment with recovery. There was a significant relationship between the clinical pattern of psoriatic arthritis and stable improvement, as well as smoking history.