Axial psoriatic arthritis: update on a longterm prospective study

Area of Science:

• Rheumatology
• Orthopedics
• Immunology

Background:

• Axial psoriatic arthritis (AxPsA) is a chronic inflammatory condition affecting the spine.
• Understanding long-term disease progression is crucial for patient management.

Purpose of the Study:

• To evaluate longitudinal changes in symptoms, spinal mobility, and radiographic features in patients with AxPsA.
• To assess the 5- and 10-year outcomes of patients diagnosed with AxPsA.

Main Methods:

• Retrospective analysis of 297 patients with AxPsA from a dedicated clinic database.
• Comparison of baseline, 5-year, and 10-year follow-up data on axial symptoms, spinal mobility (metrology), and radiographic features.
• Statistical analysis using continuity adjusted McNemar's test, exact binomial test, and logistic regression.

Main Results:

• Significant decline in neck/back pain, stiffness, and clinical sacroiliitis over 10 years.
• Progressive increase in restricted cervical spinal mobility and reduced lateral flexion observed at 5 and 10 years.
• Radiographic progression of sacroiliitis and development of syndesmophytes occurred in a substantial proportion of patients over the follow-up period.

Conclusions:

• AxPsA patients show symptom improvement in pain and stiffness over a decade.
• Despite symptom improvement, spinal mobility, particularly cervical rotation and lateral flexion, deteriorates over time.
• Longitudinal assessment reveals a complex interplay of symptom improvement and functional decline in AxPsA.