Psoriatic rheumatism. Inflammatory arthropathy

Psoriatic rheumatism is an inflammatory arthropathy associated with cutaneous psoriasis that occurs mainly in adults aged between 30 and 45 years. In most cases, cutaneous phenomena precede rheumatic manifestations. Psoriatic rheumatism may begin as a monoarthritis and the diagnosis will be confirmed by the presence of psoriatic plaques or by the personal and family history of psoriasis. As a chronic proliferative epidermal disease, psoriasis is due to a genetic predisposition and it is clinically expressed following the triggering action of several factors. The onset is preceded by various events. Psoriasis is two to three times more common in patients with arthritis and about 10-20% of psoriasis patients show joint damage.

The present study aims to demonstrate the clinical and biological efficacy of biotechnology-derived biologic drugs, acting as TNFalpha antagonists and used as backup therapy, at the same time bringing new hope for broadening and improving therapy in psoriatic arthropathy.

The study included a total of 21 patients (13 men, 8 women) admitted in the interval 2011-2012 to the I-st Rheumatology Clinic of the Iasi Rehabilitation Hospital. The patients were older than 20 years and had one or more peripheral arthritis conditions, skin and nail lesions.

Based on the results, it is recommended that infliximab to be administered in patients who meet CASPAR ((Classification Criteria for Psoriatic Arthritis) diagnostic criteria, have the disease in aggressive stage, and do not respond to treatment with methotrexate (MTX) or other disease-modifying antirheumatic drugs--DMARDs (leflunomide, sulfasalazine) administered for 12 weeks.

Infliximab is effective in counteracting the potentially harmful elements. It reduces the number of tender and swollen joints, improves the functional capacity and the quality of life, and slows down the radiologic progression. Infliximab is well tolerated, effective, with an optimum safety profile during short-term administration in patients with active forms of psoriatic arthropathy.