Diversity of comorbid conditions in young and middle-aged patients with psoriatic arthritis

Abstract

Aim. The aim of the study was to investigate the prevalence of comorbid conditions in young and middleaged patients with psoriatic arthritis. Material and methods. We analyzed data from the case reports of 84 patients with psoriatic arthritis for 2018-2020, among whom 39 (47,6%) were men and 45 (52,4%) were women, in a course of a cross-sectional observational study. The mean age of the patients was (42,8±10,1) years, DAPSA-18,1 (10,2; 26,7), PASI-5,3 (1,5; 10,8). Results and discussion. Comorbid conditions were observed in 68 (80,9%) patients; the mean number of comorbid conditions was 3 (1; 4). More than one comorbid condition was observed in 69% of the patients. Among transnosological conditions, cardiovascular diseases were the most frequent (40,5%), with high frequency of arterial hypertension (36,9%), atherosclerosis (20,2%), and combined cardiovascular diseases in 17,9% of patients. Osteoporosis and osteopenia (11,9%), obesity (26,2%) was also observed. Waist circumference was higher than normalvalues in 34,5% of patients, and waist-to-hip ratio was higher than normal in 57,1% of patients. Among the extra-articular manifestations, uveitis (1,2%) and Crohn’s disease (1,2%) were observed. Among chronic conditions there was a high frequency of gastrointestinal diseases (41,6%) - inflammatory diseases of upper gastrointestinal tract (27,4%), abnormality of gallbladder, biliary tract and pancreas (21,4%), alcoholic liver disease, toxic liver damage, nonalcoholic fatty liver disease (14,5%). Other musculoskeletal and connective tissue diseases unrelated to psoriasis were noted in 27,6% of patients (gout, osteoarthritis). Endocrine system diseases occurred in 19% of patients (type II diabetes mellitus, thyroid gland diseases). In 62,5% of the cases, type II diabetes mellitus was combined with increased body weight and obesity. Diseases of urogenital system were registered in 13,9% of patients, respiratory diseases such as chronic bronchitis, and bronchial asthma - in 3,6% of patients. Conclusion. A high incidence of combination of psoriatic arthritis with concomitant diseases, especially with lesions of the cardiovascular system and gastrointestinal tract diseases, has been revealed. This significantly aggravates the course of psoriatic arthritis, worsens the response to therapy, and in some cases (due to the existing contraindications) reduces the possibility of prescribing adequate therapy.