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The Swedish Early Psoriatic Arthritis Register — 2-year Followup: A Comparison with Early Rheumatoid Arthritis ULLA R.C. LINDQVIST, GERD-MARIE ALENIUS, TOMAS HUSMARK, ELKE THEANDER, GUNILLA HOLMSTRÖM, and PER T. LARSSON, for the Psoriatic Arthritis Group of the Society for Rheumatology
ABSTRACT. Methods. Patients referred to rheumatology outpatient clinics within 2 years of onset were assessed on inclusion and at followup 2 years later. Data collection was performed according to the program for SwePsA, and classification was as described by Moll and Wright and the ClASsification Criteria for Psoriatic ARthritis (CASPAR). Remission was recorded if the patient had no tender or swollen joints and if erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were within the reference range. Patients with early rheumatoid arthritis (RA) recruited from the Swedish Early Rheumatoid Arthritis Register (Ramona) provided comparison data. Results. One hundred thirty-five patients with PsA according to CASPAR were assessed; 44% were classified as having mono/oligoarthritis and 47% as polyarthritis. Two patients (1%) were in remission initially, and 23 (17%) at followup. Patients with polyarticular disease had the highest inflammatory activity, measured by swollen and tender joint counts, ESR, Health Assessment Questionnaire, and self-assessment by visual analog scale of pain and global disease activity. Dactylitis was associated with radiological findings. Compared with RA patients, they had significantly lower CRP, ESR, and number of swollen joints (p = 0.0003, p = 0.0026, p = 0.0380, respectively) at inclusion, but equal numbers of tender joints and self-assessment of pain and disease activity. Conclusion. About half the patients had polyarthritis and the other half had mono/oligoarthritis at followup after 2 years. Patients with polyarthritis had the highest inflammatory activity. Apart from ESR, CRP, and swollen joint count, there were no significant differences in activity between RA and polyarticular PsA. (J Rheumatol First Release Feb 15 2008) Key Indexing Terms:
PSORIATIC ARTHRITIS
From the Department of Medical Sciences, Rheumatology, University Hospital, Uppsala; Department of Public Health and Clinical Medicine, Rheumatology, Umeå; Department of Rheumatology, Falu Hospital, Falun; Department of Rheumatology, University Hospital, Malmö; Spenshult Rheumatological Hospital, Oskarström; and Karolinska University Hospital, Stockholm, Sweden. Supported by grants from the Swedish Psoriasis Association. U.R.C. Lindqvist, MD, PhD, Department of Medical Sciences, Rheumatology, University Hospital, Uppsala; G-M. Alenius, MD, PhD, University Hospital, Department of Public Health and Clinical Medicine, Rheumatology, Umeå; T. Husmark, MD, Department of Rheumatology, Falu Hospital; E. Theander, MD, PhD, Department of Rheumatology, University Hospital, Malmö; G. Holmström, MD, Spenshult Rheumatological Hospital; P.T. Larsson, MD, PhD, Karolinska University Hospital. Address reprint requests to Dr. U. Lindqvist, Department of Medical Sciences, Rheumatology, Entrance 40, 5th floor, University Hospital, SE-751 85 Uppsala, Sweden. E-mail: Ulla.Lindqvist@medsci.uu.se Accepted for publication November 11, 2007.
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