Distinctive clinical patterns and management trends in late-onset psoriatic arthritis: data from Argentina's RECCAPSO...

Late-onset psoriatic arthritis (LO-PsA) has been underexplored despite its growing prevalence in aging populations. Understanding its distinct clinical presentation and treatment patterns is essential to optimize care in this subgroup.

To describe the demographic, clinical, and therapeutic features of patients with LO-PsA compared to early onset PsA (EO-PsA) using data from the Argentine RECCAPSO registry.

Ambispective, multicenter analysis with a cross-sectional evaluation.

Patients with PsA were categorized into EO-PsA (age of onset ⩽60 years) and LO-PsA (>60 years). Demographics, clinical characteristics, disease activity, and treatment variables were compared between groups using appropriate statistical tests. A multivariate logistic regression model was constructed to identify factors independently associated with LO-PsA.

A total of 271 PsA patients were included (EO-PsA: n = 184; LO-PsA: n = 87). LO-PsA patients had higher frequencies of hypertension (50% vs 21.4%, p < 0.001), diabetes (22.1% vs 7.9%, p = 0.007), and oligoarticular presentation (57.4% vs 40.5%, p = 0.03), and were less likely to receive b/tsDMARDs (42.6% vs 58.7%, p = 0.02). In multivariate analysis, hypertension (OR: 4.69, 95% CI: 1.83-12.03) and diabetes (OR: 14.83, 95% CI: 2.36-93.05) were independently associated with LO-PsA.

LO-PsA presents a distinct clinical profile characterized by greater comorbidity burden and lower exposure to advanced therapies. These findings highlight the need for tailored management strategies in older adults with PsA.