Musculoskeletal ultrasound in monitoring response to apremilast in psoriatic arthritis patients: results from a longitudinal study

AbstractIntroduction/objectiveApremilast, PDE4 competitive inhibitor, has been recently introduced in the treatment of adult psoriatic arthritis (PsA) patients, but only preliminary data are available on imaging evaluation. Thus, we evaluated the response to apremilast in PsA patients by ultrasonographic (US) assessment.MethodsThirty-four patients (M/F 7/27; median age 61  years, IQR 15; median disease duration 10 years, IQR 13) treated for polyarticular involvement were longitudinally evaluated. All the patients were assessed at baseline (T0), and after 6 (T1), 12 (T2), and 24 weeks (T3) by DAS28, CDAI, SDAI, and DAPSA. At the same time-points, US assessment was performed in 22 sites (wrists, MCPs, PIPs): synovial effusion/hypertrophy and power Doppler were scored with a semi-quantitative scale (0–3). A total score, corresponding to patient’s inflammatory status, was obtained by their sum (0–198). We assessed also the presence of tenosynovitis of flex ortendons of hands ’ fingers bilaterally, registering the number of involved tendons (US-tenosynovitis score 0–10).ResultsWe found a significant reduction in the US inflammatory score values after 6  weeks (T0, median 15 (IQR 11.2); T1, 6 (10.0);P = 0.0002), confirmed at T2 (4.0 (4.0),P = 0.0002) and T3 (4.0 (6.0);P = 0.0003). Finally, US-detected tenosynovitis was observed in 44.1% of patients: a significant improvement in tenosynovitis...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research

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Abstract Psoriasis affects 1-3% of the population and up to 1/3 of psoriasis patients have underlying psoriatic arthritis (PsA)1 . Non-specific musculoskeletal complaints are even higher, being around 50%2 . Detecting early signs of PsA and early treatments are crucial to improve the outcomes to prevent progressive, damaging arthritis3 . Due to the high frequency of non-specific pain in psoriasis, it is not possible for every psoriasis patient with joint pain to be assessed by a rheumatologist. PMID: 31505032 [PubMed - as supplied by publisher]
Source: The British Journal of Dermatology - Category: Dermatology Authors: Tags: Br J Dermatol Source Type: research
AbstractTo systematically review the role of ultrasound (US) in the assessment of the joint-enthesial-nail apparatus in patients with psoriatic arthritis (PsA) or psoriasis (PSO) in terms of prevalence, diagnosis, prognosis, monitoring and treatment. A systematic literature review was conducted through medical databases (PubMed, Embase) and the grey literature up to February 2018. The main areas of application of nail US were first identified, allowing the development of research questions, which were rephrased following the PICOs methodology to develop inclusion criteria. Of the 585 studies produced by PubMed and Embase s...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
The objective of this study was to compare the clinical and ultrasonographic features of symptomatic with asymptomatic psoriatic arthritis (PsA) dactylitis.MethodsOne hundred and twenty-five hand dactylitis were evaluated in a multicenter cross-sectional study for the presence of pain, subjective functional limitation, and tenderness (4-points scale) with the calculation of a Leeds Dactylitis Index (LDI) score. Fingers were subsequently investigated using high-frequency ultrasound (US) both in gray-scale (GS) and power Doppler (PD), for the presence and grading of flexor tenosynovitis, soft tissue edema, subcutaneous PD si...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
Conclusion: MASEI demonstrates to be a reliable tool in PsA. All enthesis US Doppler definitions demonstrate to be reliable for its use in PsA with minimal differences, being PD MASEI the most sensitive in active patients. PMID: 31210075 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Rheumatology - Category: Rheumatology Authors: Tags: Scand J Rheumatol Source Type: research
CONCLUSION: A considerable number of PsA patients have clinical estimated intermediate or high risk of a fatal CV event. Carotid US study detects subclinical vascular disease and may be useful to depict the real risk. The presence of atheroma is only partially explained by the classical CV risk factors. PMID: 31203214 [PubMed - as supplied by publisher]
Source: J Rheumatol - Category: Rheumatology Authors: Tags: J Rheumatol Source Type: research
In patients with PsA involving the hands, structural alterations of the dominant hand assessed by conventional x-ray and ultrasound are associated with loss of strength measured objectively with dynamometry and greater disability also studied subjectively using the HAQ.
Source: Clinical Biomechanics - Category: Orthopaedics Authors: Source Type: research
(Wiley) Patients with psoriasis and psoriatic arthritis -- collectively termed psoriatic disease -- face increased heart risks. A new study published in Arthritis&Rheumatology indicates that ultrasound imaging of the carotid arteries can reveal the extent to which patients' arteries are clogged and also indicate their risk of experiencing future cardiovascular events.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
Authors: PMID: 31154450 [PubMed - in process]
Source: J Rheumatol - Category: Rheumatology Tags: J Rheumatol Source Type: research
Conditions:   Psoriatic Arthritis;   Psoriasis;   Enthesitis Interventions:   Biological: adalimumab;   Biological: Certolizumab;   Biological: Etanercept;   Biological: Golimumab;   Biological: Secukinumab Sponsors:   Belfast Health and Social Care Trust;   British Medical Association;   Psoriasis and Psoriatic Arthritis Alliance;   Queen's University, Belfast Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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