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Psoriatic Arthritis Fast Facts

  • PsA affects between 50,000 – 156,000 people in England and Wales1
  • PsA is thought be triggered by both genetic and environmental factors4
  • Symptoms of PsA include fatigue, pain, swelling and scaly spots on the skin2


Epidemiology

· Psoriatic arthritis (PsA) affects 50,000 – 156,000 people in England and Wales1

· PsA affects both women and men and can occur at any time, most usually between the ages of 30-55 years old1

· 5-7% of the psoriasis patient population has PsA with the propensity of this increasing to 40% in those with severe psoriasis1

Symptoms of PsA

The most common symptoms include:2

· Fatigue

· Pain and swelling in the wrists, knees, ankles, fingers and toes

· Back pain

· Scaly spots on the scalp, elbows, knees and the lower end of the backbone

· Deformities of the fingernails and or toenails

Types of PsA3

Asymmetrical oligoarticular - this form causes swelling and inflammation of the fingers or toes (dactylitis)

· Symmetrical polyarthritis - this form affects several joints (poly), occurring on both sides of the body (symmetrical)

· Distal interphalangeal joint predomination (DIP) - this form affects the small joints in the fingers and toes, closest to the nails and is associated with the nails changing appearance

· Spondylitic - this form causes inflammation of the spine as well as stiffness and inflammation in the neck, lower back or sacroiliac joints

· Arthritis mutilans - this particularly-destructive form affects the small joints of the hands and feet but can also affect the spine

Types of treatment

· Phototherapy – ultraviolet light +/- sensitizing medication may be recommended for moderate psoriasis2

· Non-steroidal Anti-inflammatory Drugs (NSAIDS) - these agents help to reduce joint pain and swelling2

· Disease-modifying antirheumatic drugs (DMARDs) – these agents are used to reduce the progression of chronic forms of psoriatic arthritis when NSAIDS are ineffective2

· Biological Agents – In active and progressive cases of PsA, NICE recommends the use of TNFα inhibitors which target specific molecules, thought to be important in PsA disease progression5


References

1. National Institute of Clinical Excellence http://www.nice.org.uk/nicemedia/live/11966/40595/40595.pdf (accessed August 2012)

2. Arthritis Foundation http://www.arthritis.org/disease-center.php?disease_id=21 (accessed August 2012)

3. Psoriasis Association UK. Psoriatic Arthritis https://www.psoriasis-association.org.uk/pages/view/about-psoriasis/treatments-for-psoriatic-arthritis (accessed August 2012)

4. Friberg C. Genetic studies of psoriasis and psoriatic arthritis. The Sahlgrenska Academy at Göteborg University Göteborg, Sweden 2007

5. National Institute of Clinical Excellence http://www.nice.org.uk/usingguidance/commissioningguides/biologicaltherapies/home.jsp#fig1 (last accessed October 2012)


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