BACKGROUND: The clinical features of enthesitis in patients with psoriatic arthritis (PsA) have been reported in some Western countries, but data in China are very limited. This study aimed to describe the characteristics of enthesitis in Chinese patients with PsA and compared them with those in other cohorts. METHODS: Patients with PsA enrolled in the Chinese Registry of Psoriatic Arthritis (CREPAR) (December 2018 to June 2021) were included. Data including demographics, clinical characteristics, disease activity measures, and treatment were collected at enrollment. Enthesitis was assessed by the Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht ankylosing spondylitis enthesitis score (MASES), and Leeds enthesitis index (LEI) indices. A multivariable logistic model was used to identify factors related to enthesitis. We also compared our results with those of other cohorts. RESULTS: In total, 1074 PsA patients were included, 308 (28.7%) of whom had enthesitis. The average number of enthesitis was 3.3 ± 2.8 (range: 1.0-18.0). More than half of the patients (165, 53.6%) had one or two tender entheseal sites. Patients with enthesitis had an earlier age of onset for both psoriasis and arthritis, reported a higher proportion of PsA duration over 5 years, and had a higher percentage of axial involvement and greater disease activity. Multivariable logistic regression showed that axial involvement (odds ratio [OR] 2.21, 95% confidence interval [CI], 1.59-3.08; P <0.001), psoriasis area and severity index (PASI) (OR: 1.03, 95% CI: 1.01-1.04; P = 0.002), and disease activity score 28-C reactive protein (DAS28-CRP) (OR: 1.25, 95% CI: 1.01-1.55; P = 0.037) were associated with enthesitis. Compared with the results of other studies, Chinese patients with enthesitis had a younger age, lower body mass index (BMI), a higher rate of positive human leukocyte antigen (HLA)-B27, more frequent dactylitis, and a higher proportion of conventional synthetic disease-modifying antirheumatic drugs' (csDMARDs) use. CONCLUSIONS Enthesitis is a common condition among Chinese patients with PsA. It is important to evaluate entheses in both peripheral and axial sites.
Humans ; Arthritis, Psoriatic/drug therapy* ; East Asian People ; Enthesopathy/complications* ; Registries ; Severity of Illness Index ; Spondylarthritis/epidemiology*

Antibodies, Monoclonal, Humanized ; Arthritis, Psoriatic/drug therapy* ; China ; Humans ; Psoriasis/drug therapy* ; Severity of Illness Index ; Treatment Outcome

We report the case of a 36-year-old man with psoriatic arthritis and miliary tuberculosis, whose serum uric acid (SUA) level increased after the initiation of antituberculosis treatment, which included pyrazinamide. Most strikingly and paradoxically, the patient's SUA level increased after treatment with allopurinol. On cessation of allopurinol, his SUA level decreased substantially, and complete normalisation was observed following the discontinuation of pyrazinamide treatment.
Adult ; Allopurinol ; therapeutic use ; Arthritis, Psoriatic ; drug therapy ; Humans ; Hyperuricemia ; chemically induced ; Male ; Pyrazinamide ; adverse effects ; Treatment Outcome ; Tuberculosis, Miliary ; drug therapy ; Uric Acid ; blood

A case of juvenile psoriatic arthritis in a 12 year-old boy was reported. The patient had a history of one and half a year of bilateral heel pain, followed by pain in the right knee and ankle and right hip joint. He developed psoriatic lesions affecting his nails and skin. He had increased erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) contents. Human leukocyte antigen (HLA) B27 was detected but serum rheumatoid factor was not in the patient. A skin biopsy revealed psoriasis and ultrasonography demonstrated synovitis in right knee and ankle. Juvenile psoriatic arthritis was diagnosed based on his physical, laboratory and skin biopsy findings. A treatment with nonsteroidal anti-inflammatory drugs and sulfasalazine produced no effect. Leflunomide in conjunction with anti-TNF biologic agents (Etanercept) was administered, followed by symptomatic improvement 2 weeks later.
Arthritis, Psoriatic ; diagnosis ; drug therapy ; etiology ; Child ; Diagnosis, Differential ; Etanercept ; Humans ; Immunoglobulin G ; therapeutic use ; Male ; Receptors, Tumor Necrosis Factor ; therapeutic use ; Tumor Necrosis Factor-alpha ; antagonists & inhibitors

Humans ; Arthritis, Psoriatic/drug therapy* ; Interleukin-17 ; Interleukin Inhibitors ; Antirheumatic Agents/therapeutic use* ; Tumor Necrosis Factor-alpha/therapeutic use* ; Interleukin-23/therapeutic use*

OBJECTIVETo analyze the clinical characteristics of psoriasis arthropathy (PA) and to explore the effect of treatment by traditional Chinese medicine (TCM) syndrome differentiation and integrative medicine.

METHODSThe initiating characteristics, clinical manifestations, related laboratory and X-ray data as well as the therapeutic efficacy of syndrome dependent TCM and integrative medicine on 47 PA patients were analyzed.

RESULTSAmong all the 47 patients, 38 (80.6%) had the skin lesion revealed earlier to joint symptoms, the average time between the appearance of skin lesion and joint symptoms was 9.2 years; joint X-ray abnormality was found in 32 cases (68.1%); and psoriasis nail involvement was found in 33 cases (70.2%). Seventeen patients were treated with TCM alone and obtained satisfactory results, while the other 30 patients, were treated by integrative medicine with the dosage of medicine reduced immediately after symptoms were relieved, and finally cured or improved.

CONCLUSIONTCM and integrative medicine are effective in treating PA, with lesser side effects.

Adolescent ; Adult ; Aged ; Arthritis, Psoriatic ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Integrative Medicine ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Retrospective Studies ; Young Adult

Psoriatic arthritis is an inflammatory joint disease associated with psoriasis. Due to difficulty for early diagnosis and lack of effective therapy, the disease leads to chronic course and frequent relapse. Patients may suffer from ankylosis,disability and even death. The past treatments neither can control the disease effectively, nor be capable of inhibiting the development of structural joint damage. Based on the current psoriasis pathogenesis, novel biologics have been developed,which can aim the specific targets, resulting in more effective and safer management for psoriatic arthritis.
Adalimumab ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Arthritis, Psoriatic ; drug therapy ; etiology ; Dermatologic Agents ; therapeutic use ; Etanercept ; Humans ; Immunoglobulin G ; therapeutic use ; Receptors, Tumor Necrosis Factor ; therapeutic use ; Recombinant Fusion Proteins ; therapeutic use