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Increased vascular inflammation on PET/CT in psoriatic arthritis patients in comparison with controls
Nienke J Kleinrensink1,2, Julia Spierings3, Harald E Vonkeman4,5
1Department of Rheumatology & Clinical Immunology, UMC Utrecht, Utrecht, Netherlands N.J.Kleinrensink-2@umcutrecht.nl.
Insights
Patients with psoriatic arthritis (PsA) show increased vascular inflammation compared to controls. This suggests PsA
Area of Science:
- Rheumatology
- Cardiology
- Nuclear Medicine
Background:
- Psoriatic arthritis (PsA) is linked to higher cardiovascular disease risk, potentially due to chronic inflammation.
- Understanding the extent of inflammation in PsA is crucial for cardiovascular risk assessment.
Purpose of the Study:
- To compare vascular inflammation levels between PsA patients and controls using 18-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT).
- To explore the relationship between PsA disease activity and vascular inflammation.
Main Methods:
- A cohort of 75 PsA patients with active peripheral arthritis and 40 controls were included.
- Aortic vascular inflammation was quantified using target-to-background ratios on PET/CT scans.
- Clinical and laboratory markers of disease activity were assessed.
Main Results:
- PsA patients exhibited significantly higher aortic vascular inflammation than controls (p<0.001).
- This finding persisted after adjusting for cardiovascular risk factors and aortic calcification (p=0.002).
- No significant association was found between vascular inflammation and clinical disease parameters.
Conclusions:
- Active PsA is associated with increased aortic vascular inflammation.
- Inflammation in PsA extends beyond the skin and joints to affect the vascular system.
- This highlights the systemic inflammatory nature of PsA and its potential cardiovascular implications.
Background:
Patients with psoriatic arthritis (PsA) have an increased risk of cardiovascular disease, possibly due to a chronic inflammatory state.
Objectives:
The main objective of this study was to investigate the difference in vascular inflammation, measured with 18-fluorodeoxyglucose positron emission tomography/CT (PET/CT), in PsA patients and controls. We conducted a secondary analysis to assess the association between clinical parameters of disease activity with vascular inflammation in PsA.
Methods:
We included a total of 75 PsA patients with active peripheral arthritis (defined as ≥2 tender and swollen joints) from an ongoing clinical trial (EudraCT 2017-003900-28) and a retrospective group of 40 controls diagnosed with melanoma, without distant metastases and not receiving immunotherapy. The main outcome measure was aortic vascular inflammation which was measured on PET/CT scans using target-to-background ratios. Clinical disease activity in PsA was assessed with joint counts, body surface area and the Disease Activity index for PsA. Laboratory assessments included C reactive protein and erythrocyte sedimentation rate.
Results:
Vascular inflammation was increased in patients with PsA in comparison with controls (mean target-to-background ratio for entire aorta, respectively, 1.63±0.17 vs 1.49±0.16; p=<0.001). This association remained significant after correction for gender, age, body mass index, mean arterial pressure and aortic calcification (p=0.002). Vascular inflammation was not associated with disease-related parameters.
Conclusions:
Aortic vascular inflammation was significantly increased in patients with active PsA compared with controls. This evidence supports the theory that inflammation in PsA is not limited to the skin and joints but also involves the vascular system.
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