Psoriatic arthritis and the association with cardiometabolic disease: a narrative review

Area of Science:

• Rheumatology
• Cardiology
• Metabolic Disorders

Background:

• Psoriatic arthritis (PsA) is linked to a greater burden of cardiometabolic disorders, including hypertension, dyslipidemia, diabetes, obesity, and cardiovascular disease (CVD), compared to the general population.
• These comorbidities correlate with disease severity and negatively impact treatment outcomes in PsA patients.
• Cardiovascular disease (CVD) is a primary cause of mortality in individuals with PsA.

Purpose of the Study:

• To highlight the significant association between psoriatic arthritis and cardiometabolic diseases.
• To emphasize the need for integrated management of PsA and its associated cardiometabolic comorbidities.

Main Methods:

• Comparative analysis of cardiometabolic disorder prevalence in PsA versus the general population and other inflammatory arthritides.
• Review of existing literature on the impact of comorbidities on PsA severity and treatment response.
• Exploration of potential mechanisms and trajectories of cardiometabolic comorbidities in psoriatic disease.

Main Results:

• PsA exhibits a higher incidence and prevalence of cardiometabolic comorbidities than psoriasis, rheumatoid arthritis, and other spondyloarthropathies.
• Obesity and hyperlipidemia are identified as risk factors for developing PsA.
• Cardiometabolic comorbidities in PsA are associated with increased disease severity and reduced therapeutic response.

Conclusions:

• Optimal PsA management requires addressing both the skin/joint disease and associated cardiometabolic comorbidities for improved long-term outcomes.
• Strategies for enhancing CVD screening and management in PsA include educating primary care physicians and specialists, improving interdisciplinary communication, and implementing novel care models like cardio-rheumatology clinics.