Exploring Peripheral Arthritis in Psoriatic Disease

In this enlightening episode of Inside GRAPPA, we delve deep into the intricate world of peripheral arthritis in psoriatic disease. Today's host, Dr. Sebastian Herrera, is joined by the esteemed Dr. Katy Leung, and Professor Oliver Fitzgerald to discuss the significance, manifestation, and management of peripheral arthritis in patients with psoriatic disease.

Dr. Herrera is a rheumatologist at Clínica Las Américas Auna and ARTMEDICA in Medellín, Colombia and also an Associate Professor of Rheumatology at Universidad CES and a member of Young GRAPPA. 

Dr. Leung is an Associate Professor at Singapore General Hospital and Duke-NUS Medical School in Singapore. Dr. Leung has interest in clinical and translational research in PsA, is the co-chair of the GRAPPA-OMERACT Outcome Measure Working group, and is also a member of the GRAPPA Education Committee. Dr. Fitzgerald is based at University College Dublin and has a major interest in clinical and translational research in PsA. More recent studies have explored genetic factors and biomarker development. Dr. Fitzgerald has been involved for many years with GRAPPA and took up the office of co-President in July 2021. He has been advocating for grant application opportunities addressing critical unmet needs in PsA for some time and this has culminated in the award of the first, significant, joint EU/industry funded Innovative Medicines Initiative (IMI) grant in PsA, the HIPPOCRATES consortium.

🗝 Key Points & Highlights:

   - Importance of Peripheral Arthritis:

• A critical manifestation in psoriatic disease, contributing to morbidity and irreversible joint damage if uncontrolled.
• Early detection and treatment are paramount to prevent long-term disability.

   - Symptoms and Manifestations:

• Peripheral arthritis often presents as the first sign, leading to joint pain, swelling, and Arthralgia.
• Studies highlight its prevalence, with erosions noted in 47% of patients within two years of symptom onset.

   - Risk Factors and Associations:

• Family history of psoriatic arthritis, severity of psoriasis, and obesity are common risk factors.
• The presence of certain genetic markers and clinical features can help predict the development of psoriatic arthritis.

   - Treatment Strategies & Recommendations:

• The episode discusses the use of conventional DMARDs like methotrexate and the divergence in treatment preferences across continents.
• TNF blockers, IL-17 blockers, IL-23 blockers, and JAK inhibitors are strongly recommended, highlighting the need for more head-to-head studies to guide treatment choices.

📚 Resources and Studies Mentioned:

• TICOPA trial & PSA SIM trial: Examining the efficacy of conventional DMARDs in peripheral arthritis.
• Presto Study: Investigating predictive factors for the onset of psoriatic arthritis.
• Hippocrates Consortium: Conducting extensive research on various treatments focusing on methotrexate, TNF inhibitors, and JAK inhibitors.

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