Disease characteristics of psoriatic arthritis patients may differ according to age at psoriasis onset: cross-sectional data from the Psoriatic Arthritis-International Database
Citation
Bilgin E, Aydin SZ, Tinazzi I, Bayindir Ö, Kimyon G, Özişler C, Doğru A, Dalkiliç E, Aksu K, Yildirim Çetin G, Yilmaz S, Solmaz D, Omma A, Can M, Küçükşahin O, Yavuz Ş, Ersözlü ED, Kiliç L, Tarhan EF, Aydin Tufan M, Akyol L, Çinar M, Erden A, Gönüllü E, Yildiz F, Bakirci S, Erbasan F, Ergülü Eşmen S, Küçük A, Tufan A, Balkarli A, Mercan R, Erten Ş, Akar S, Kaşifoğlu T, Duruöz T, Yazisiz V, Kalyoncu U. Disease characteristics of psoriatic arthritis patients may differ according to age at psoriasis onset: cross-sectional data from the Psoriatic Arthritis-International Database. Clin Exp Rheumatol. 2021 May-Jun;39(3):532-536. Epub 2020 Jun 30. PMID: 32662407.Abstract
Objectives: To explore the impact of early versus late-onset psoriasis (PsO) on the disease characteristics of psoriatic arthritis (PsA) in a large-multicentre cohort.
Methods: The data from a multicentre psoriatic arthritis database was analysed. Patients were grouped according to age at psoriasis onset (early onset; <40 years of age, late-onset; >40 years of age) and disease characteristics of the groups were compared by adjusting for BMI and PsA duration, where necessary.
Results: At the time of analyses, 1634 patients were recruited [62.8% females; early onset 1108 (67.8%); late-onset, 526 (32.2%)]. The late-onset group was more over-weight [66.8% vs. 86.8%, p<0.001; adjusted for age - aOR 1.55 (1.11-2.20; 95% CI)]. The early onset group had more scalp psoriasis at onset (56.7% vs. 43.0%, p<0.001), whereas extremity lesions were more common in the late-onset group (63.8% vs. 74.2%, p<0.001). Axial disease in males and psoriatic disease family history in females were significantly higher in the early onset group [38.0% vs. 25.4%; p=0.005; adjusted for PsA duration - aOR 1.76 (1.19-2.62; 95% CI) / 39.5% vs. 30.1%; p=0.003; OR 1.51 (1.15-1.99; 95% CI), respectively]. Psoriatic disease activity parameters, patient-physician reported outcomes and HAQ-DI scores were similar in both groups.
Conclusions: Clinical features of PsA may be affected by the age at onset of PsO. Different genetic backgrounds in early and late-onset PsO may be driving the differences in psoriasis and PsA phenotypes.
