Late-onset psoriatic arthritis: data from a nationwide cross-sectional study

A proportion of patients with psoriatic arthritis (PsA) have their disease onset after the age of 60 (Late-onset PsA-LoPsA).

To examine whether this subgroup exhibits distinct characteristics, disease outcomes, and treatment patterns.

Cross-sectional, observational study.

Data were collected cross-sectionally from 805 PsA patients in a real-life, multicenter, nationwide study. Among them, we identified 130 patients (16%) with LoPsA (disease onset ⩾60 years). Univariable analyses were conducted to compare the characteristics of LoPsA with the rest of the cohort and multivariable logistic regression was performed to identify factors independently associated with LoPsA.

After controlling for potential confounders, LoPsA patients were less likely to report a family history of psoriasis (OR: 0.18, 95% CI: 0.05-0.64). At diagnosis, the LoPsA group displayed more than 2-fold higher probability of presenting with polyarthritis (OR: 2.13, 95% CI: 1.11-4.09) while during their disease course, they had a 50% lower probability of developing enthesitis (OR: 0.50, 95% CI: 0.26-0.98). Patients with LoPsA exhibited a higher rate of comorbidities such as diabetes mellitus (OR: 3.17, 95% CI: 1.56-6.43) and hypertension (OR: 4.03, 95% CI: 2.02-8.04), and were more likely to develop major adverse cardiovascular events (MACEs), (OR: 4.83, 95% CI: 1.56-14.92). There were no differences in treatment patterns, disease outcomes, and damage indices between the two patient groups.

Patients with LoPsA were more likely to present with polyarthritis, had lower odds of developing enthesitis, and were more frequently observed to have comorbidities and MACEs. Overall, their treatment patterns and disease outcomes did not differ from patients with early onset PsA.