Pulmonary Fibrosis

Research from Massachusetts General Hospital yields new data on psoriatic arthritis

"A recent study Supports the hypothesis of a common cytokine-based pathology by showing that having one AI disease significantly increased the risk of having another AI disease. Psoriasis is an AI, manifesting as a chronic inflammatory skin condition and is clearly associated with other conditions, most obviously psoriatic arthritis (PsA). We sought to examine whether patients with PsA enrolled in managed health care plans carry a higher AI disease burden than Patients with cutaneous psoriasis only (PsO). Patients 18 years or older enrolled in a health claims database were classified by two clinical subtypes: PsA and PsO. Control Subjects were matched 3:1 to patients with psoriasis on age, sex, census region, and length of previous medical insurance coverage. AI disease diagnoses were identified through International Classification of Diseases, Ninth Revision, codes. The association of other AI diseases with each psoriasis cohort was assessed using a prevalence ratio. PsO was associated with a higher prevalence ratio for the 3 gastrointestinal diseases: Crohn disease (1.6 [confidence interval {CI} 1.4-2.0]), ulcerative colitis (1.3 [CI 1.1-1.6]), and inflammatory bowel disease (1.4 [CI 1.2-1.6]). PsA was also associated with a higher prevalence ratio for the gastrointestinal diseases: Crohn disease (2.1 [CI 1.3-3.3]), ulcerative colitis (2.0 [CI 1.3-3.1]), and inflammatory bowel disease (1.8 [CI 1.3-2.5]). with PsA had an increased prevalence ratio associated with giant cell arteritis (4.8 [CI 1.5-15.7]) and Pulmonary fibrosis (1.9 [CI 1.2-3.0]). Limitations: Detection and misclassification biases may have affected these findings. These findings support the hypothesis that PsA and PsO are associated with development of other AI diseases. The data suggest that evaluating patients with psoriasis for other associated disorders in a prospective manner may be important, because they may be more likely to experience the onset of another AI disease. Treatment planning for these patients could, therefore, require the medical management of more than one AI disease," wrote M. Makredes and colleagues, Massachusetts General Hospital.

The researchers concluded: "Further, our data Suggest that PsA and PsO may be divergent in ways previously not described that could inform future research. (J Am Acad Dermatol 2009;61:405-10.)'."

Makredes and colleagues published their study in the Journal of the American Academy of Dermatology (The burden of autoimmune disease: A comparison of prevalence ratios in patients with psoriatic arthritis and psoriasis. Journal of the American Academy of Dermatology, 2009;61(3):405-410).

For additional information, contact A.B. Kimball, Massachusetts General Hospital, Dept. of Dermatology, Clinic Unit Research Trials Skin, 50 Staniford St., 240, Boston, MA 02115, USA.

Publisher contact information for the Journal of the American Academy of Dermatology is: Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA.

Keywords: United States, Boston, Autoimmune Disease, Autoimmune Disorder, Crohn Disease, Cytokines, Dermatology, Gastroenterology, Gastrointestinal, Health Insurance, Immunology, Medical Insurance, Pathology, Psoriasis, Psoriatic Arthritis, Rheumatology, Massachusetts General Hospital.

This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. Copyright 2009, Pain & Central Nervous System Week via NewsRx.com.