Cross-sectional multicenter observational study of psoriatic arthritis in Japanese patients

Relationship between skin and joint symptoms and results of treatment with tumor necrosis factor-α inhibitors

Noriko Tsuruta, Yutaka Narisawa, Shinichi Imafuku, Kotaro Ito, Kazuki Yamaguchi, Takuya Miyagi, Kenzo Takahashi, Hiroko Fukamatsu, Shin Morizane, Hideki Koketsu, Michiya Yamaguchi, Ryosuke Hino, Motonobu Nakamura, Bungo Ohyama, Chika Ohata, Maki Kuwashiro, Toshihiro Sato, Kanami Saito, Sakae Kaneko, Kentaro Yonekura & 10 others Hiroaki Hayashi, Tetsuji Yanase, Kenichi Morimoto, Kazunari Sugita, Shigeto Yanagihara, Satoko Kikuchi, Chikage Mitoma, Takeshi Nakahara, Masutaka Furue, Fusako Okazaki

Research output: Contribution to journalArticle

Abstract

Psoriatic arthritis (PsA) is an inflammatory arthritis with as yet unclear pathophysiology. This retrospective, multicenter, cross-sectional study was conducted in 19 facilities in western Japan and aimed to identify patients’ characteristics and factors that affect the results of treatment with biologic agents. Of 2116 patients with psoriasis, 285 (13.5%) had PsA. Skin manifestations preceded joint manifestations in 69.8%, the onset was simultaneous in 17.2%, whereas PsA preceded skin manifestations in 2.5%. Peripheral arthritis was most common, occurring in 73.7%, compared with axial disease in 21.8%, enthesitis in 23.5% and dactylitis in 35.4%. Patients with severe skin manifestations were significantly younger at onset (P = 0.02) and more frequently had axial disease (P < 0.01). Biologic agents were used in 206 patients (72.3%), anti-tumor necrosis factor (TNF)-α antibodies being prescribed first to 157 of them. Anti-TNF-α antibodies were continued by 105 participants and discontinued by 47, the remaining five patients being lost to follow up. Patients who discontinued anti-TNF-α antibodies were significantly older than those who continued (55 vs 51 years, P = 0.04) and significantly older at onset of joint manifestations (50 vs 44 years, P = 0.01). Multivariate analysis revealed that patients over 50 years significantly more frequently terminated anti-TNF-α antibodies (P < 0.01). In conclusion, patients with PsA and severe skin manifestations have earlier onset and axial disease, which seriously impacts on quality of life. Anti-TNF-α antibodies were generally effective enough to continue but less so in patients aged over 50 years. Further detailed research is needed.

Original languageEnglish
Pages (from-to)193-198
Number of pages6
JournalJournal of Dermatology
Volume46
Issue number3
DOIs
Publication statusPublished - Mar 1 2019

Fingerprint

Psoriatic Arthritis
Multicenter Studies
Observational Studies
Tumor Necrosis Factor-alpha
Joints
Skin
Skin Manifestations
Antibodies
Therapeutics
Biological Factors
Arthritis
Lost to Follow-Up
Psoriasis
Japan
Multivariate Analysis
Cross-Sectional Studies
Quality of Life

Keywords

  • epidemiology
  • Japan
  • multicenter study
  • psoriasis
  • psoriatic arthritis

ASJC Scopus subject areas

  • Dermatology

Cite this

Cross-sectional multicenter observational study of psoriatic arthritis in Japanese patients : Relationship between skin and joint symptoms and results of treatment with tumor necrosis factor-α inhibitors. / Tsuruta, Noriko; Narisawa, Yutaka; Imafuku, Shinichi; Ito, Kotaro; Yamaguchi, Kazuki; Miyagi, Takuya; Takahashi, Kenzo; Fukamatsu, Hiroko; Morizane, Shin; Koketsu, Hideki; Yamaguchi, Michiya; Hino, Ryosuke; Nakamura, Motonobu; Ohyama, Bungo; Ohata, Chika; Kuwashiro, Maki; Sato, Toshihiro; Saito, Kanami; Kaneko, Sakae; Yonekura, Kentaro; Hayashi, Hiroaki; Yanase, Tetsuji; Morimoto, Kenichi; Sugita, Kazunari; Yanagihara, Shigeto; Kikuchi, Satoko; Mitoma, Chikage; Nakahara, Takeshi; Furue, Masutaka; Okazaki, Fusako.

In: Journal of Dermatology, Vol. 46, No. 3, 01.03.2019, p. 193-198.

Research output: Contribution to journalArticle

Tsuruta, N, Narisawa, Y, Imafuku, S, Ito, K, Yamaguchi, K, Miyagi, T, Takahashi, K, Fukamatsu, H, Morizane, S, Koketsu, H, Yamaguchi, M, Hino, R, Nakamura, M, Ohyama, B, Ohata, C, Kuwashiro, M, Sato, T, Saito, K, Kaneko, S, Yonekura, K, Hayashi, H, Yanase, T, Morimoto, K, Sugita, K, Yanagihara, S, Kikuchi, S, Mitoma, C, Nakahara, T, Furue, M & Okazaki, F 2019, 'Cross-sectional multicenter observational study of psoriatic arthritis in Japanese patients: Relationship between skin and joint symptoms and results of treatment with tumor necrosis factor-α inhibitors', Journal of Dermatology, vol. 46, no. 3, pp. 193-198. https://doi.org/10.1111/1346-8138.14745
Tsuruta, Noriko ; Narisawa, Yutaka ; Imafuku, Shinichi ; Ito, Kotaro ; Yamaguchi, Kazuki ; Miyagi, Takuya ; Takahashi, Kenzo ; Fukamatsu, Hiroko ; Morizane, Shin ; Koketsu, Hideki ; Yamaguchi, Michiya ; Hino, Ryosuke ; Nakamura, Motonobu ; Ohyama, Bungo ; Ohata, Chika ; Kuwashiro, Maki ; Sato, Toshihiro ; Saito, Kanami ; Kaneko, Sakae ; Yonekura, Kentaro ; Hayashi, Hiroaki ; Yanase, Tetsuji ; Morimoto, Kenichi ; Sugita, Kazunari ; Yanagihara, Shigeto ; Kikuchi, Satoko ; Mitoma, Chikage ; Nakahara, Takeshi ; Furue, Masutaka ; Okazaki, Fusako. / Cross-sectional multicenter observational study of psoriatic arthritis in Japanese patients : Relationship between skin and joint symptoms and results of treatment with tumor necrosis factor-α inhibitors. In: Journal of Dermatology. 2019 ; Vol. 46, No. 3. pp. 193-198.
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abstract = "Psoriatic arthritis (PsA) is an inflammatory arthritis with as yet unclear pathophysiology. This retrospective, multicenter, cross-sectional study was conducted in 19 facilities in western Japan and aimed to identify patients’ characteristics and factors that affect the results of treatment with biologic agents. Of 2116 patients with psoriasis, 285 (13.5{\%}) had PsA. Skin manifestations preceded joint manifestations in 69.8{\%}, the onset was simultaneous in 17.2{\%}, whereas PsA preceded skin manifestations in 2.5{\%}. Peripheral arthritis was most common, occurring in 73.7{\%}, compared with axial disease in 21.8{\%}, enthesitis in 23.5{\%} and dactylitis in 35.4{\%}. Patients with severe skin manifestations were significantly younger at onset (P = 0.02) and more frequently had axial disease (P < 0.01). Biologic agents were used in 206 patients (72.3{\%}), anti-tumor necrosis factor (TNF)-α antibodies being prescribed first to 157 of them. Anti-TNF-α antibodies were continued by 105 participants and discontinued by 47, the remaining five patients being lost to follow up. Patients who discontinued anti-TNF-α antibodies were significantly older than those who continued (55 vs 51 years, P = 0.04) and significantly older at onset of joint manifestations (50 vs 44 years, P = 0.01). Multivariate analysis revealed that patients over 50 years significantly more frequently terminated anti-TNF-α antibodies (P < 0.01). In conclusion, patients with PsA and severe skin manifestations have earlier onset and axial disease, which seriously impacts on quality of life. Anti-TNF-α antibodies were generally effective enough to continue but less so in patients aged over 50 years. Further detailed research is needed.",
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AU - Tsuruta, Noriko

AU - Narisawa, Yutaka

AU - Imafuku, Shinichi

AU - Ito, Kotaro

AU - Yamaguchi, Kazuki

AU - Miyagi, Takuya

AU - Takahashi, Kenzo

AU - Fukamatsu, Hiroko

AU - Morizane, Shin

AU - Koketsu, Hideki

AU - Yamaguchi, Michiya

AU - Hino, Ryosuke

AU - Nakamura, Motonobu

AU - Ohyama, Bungo

AU - Ohata, Chika

AU - Kuwashiro, Maki

AU - Sato, Toshihiro

AU - Saito, Kanami

AU - Kaneko, Sakae

AU - Yonekura, Kentaro

AU - Hayashi, Hiroaki

AU - Yanase, Tetsuji

AU - Morimoto, Kenichi

AU - Sugita, Kazunari

AU - Yanagihara, Shigeto

AU - Kikuchi, Satoko

AU - Mitoma, Chikage

AU - Nakahara, Takeshi

AU - Furue, Masutaka

AU - Okazaki, Fusako

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