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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Axial Psoriatic Arthritis: An Evolving Concept.

Denis Poddubnyy1

  • 1Division of Rheumatology, Department of Medicine, University of Toronto and Schroeder Arthritis Institute, University Health Network, Toronto, Canada; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, Berlin, Germany.

Rheumatic Diseases Clinics of North America
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Summary

Axial psoriatic arthritis (PsA) is recognized as a distinct form of PsA. This review covers its epidemiology, pathophysiology, diagnosis, and treatment, addressing current challenges and advanced therapies.

Keywords:
Axial diseaseAxial involvementPsoriasisPsoriatic arthritisSacroiliac jointsSpine

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Area of Science:

  • Rheumatology
  • Immunology
  • Dermatology

Background:

  • Axial psoriatic arthritis (PsA) is increasingly viewed as a distinct phenotype of psoriatic arthritis.
  • Understanding its unique characteristics is crucial for effective patient management.

Purpose of the Study:

  • To review recent advancements and ongoing controversies in axial PsA.
  • To discuss challenges in diagnosis and treatment of axial PsA.
  • To present evidence for advanced therapies in axial PsA.

Main Methods:

  • Literature review of recent studies on axial PsA.
  • Analysis of epidemiological data.
  • Evaluation of current diagnostic and treatment strategies.
  • Review of evidence for biologic and targeted synthetic therapies.

Main Results:

  • Diagnostic uncertainty persists, especially with co-existing psoriasis.
  • Standardized classification criteria and outcome measures for axial PsA are lacking.
  • Evidence supports the use of IL-17, JAK, and IL-23 inhibitors.

Conclusions:

  • Axial PsA requires further research to refine diagnostic criteria and outcome measures.
  • Advanced therapies show promise for managing axial PsA.
  • Recognizing axial PsA as a distinct phenotype impacts clinical practice.