Session Information
Date: Tuesday, November 15, 2016
Title: Spondylarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment - Poster III
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: To determine the characteristics of psoriatic arthritis patients(PsA) with hyperuricemia(HUC)and their outcomes especially cardiovascular(CVS) and kidney diseases.
Methods: Patients have been followed prospectively at the PsA clinic according to a standard protocol at 6-12 month intervals. We identified PsA patients with at least one visit of HUC(cases) and matched to PsA patients with normal uric acid (NUC, control) based on gender and age +/-5yrs). We defined HUC in Male> 450 mumol/L or Female > 360 mumol/L. Information collected include: demographics, education, employment history, lifestyle habits, medical history including co morbidities, medication use (all collected prospectively and stored in the clinic database). Outcomes of HUC patients especially CVS and kidney diseases after follow-up were recorded. Conditional logistic regression was performed to determine factors independent associated with HUC in PsA patients.
Results: 325 (31.9%) out of 1019 PsA patients had HUC. 318 cases were matched to 318 controls.
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Table1: characteristic of PsA patients at baseline |
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| Covariate |
NUC (n=318) |
HUC (n=318) |
p-value |
| Psoriasis duration n(%) |
20 (14.5) |
23.7 (14.1) |
0.0016 |
| PsA duration n(%) |
8.4 (8.6) |
13.9 (11.9) |
0.001 |
| Hypertension n(%) |
77 (24) |
141 (44) |
0.001 |
| Anginan(%) |
2 (1) |
10 (3) |
0.037 |
| Cardiomyopathy n(%) |
1 (0) |
1 (0) |
1 |
| Myocardial infarction n(%) |
1 (0) |
4 (1) |
0.37 |
| Congestive heart failure n(%) |
0 (0) |
4 (1) |
0.12 |
| High creatinine n(%) |
6 (2) |
26 (8) |
0.001 |
| Renal stones n(%) |
9 (3) |
28 (9) |
0.0019 |
| Diabetes n(%) |
25 (8) |
48 (15) |
0.0042 |
| Swollen joints count(SJC) mean (SD) |
0.4 (1.4) |
0.6 (1.9) |
0.21 |
| Tender joints count(SJC)mean (SD) |
2.8 (6.8) |
3 (6.3) |
0.76 |
| PASI n(%) |
3.3 (5.4) |
4.7 (7.3) |
0.0062 |
| Hypercholesterolemia n(%) |
54 (20) |
60 (20) |
1 |
| Hypertriglyceridemia n(%) |
14 (5) |
13 (4) |
0.7 |
| High Alanine transaminase (ALT) n(%) |
23(9) |
34(18) |
0.01 |
| High Aspartate transaminase (AST) n(%) |
40(14) |
70(22) |
0.01 |
| Body mass index mean (SD) |
28.5 (6.5) |
31.7 (5.7) |
0.001 |
|
PASI: Psoriasis Area and Severity Index score |
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HUC patients had longer disease duration and higher PASI than NUC patients. They had more concurrent co-morbidities including CVS diseases (hypertension and angina) and metabolic co-morbidities such as diabetes and obesity, as well as higher prevalence of kidney stones and higher serum creatinine. Only one patient with HUC was treated with allopurinol at first elevation visit and seven patients during follow-up. Over the follow-up, HUC patients developed more CVS diseases and metabolic changes especially diabetes and hypercholesterolemia. No differences in kidney disease on follow- up were noted between HUC and NUC groups.98(30.8%) of HUC patients had persistent hyperuricemia for more than 2 visits. Multivariate analysis showed an association between hyperuricemia and PsA disease duration, BMI, and high liver function test.
Conclusion: Hyperuricemia is common in PsA patients especially in those with longer disease duration and obesity. Since CVS disease is increased among HUC PsA patients, proper control of serum uric acid and metabolic diseases may play a preventive role in improving PsA outcomes.
To cite this abstract in AMA style:
ALJohani R, Polachek A, Li S, Chandran V, Gladman DD. Characteristic and Outcomes of Psoriatic Arthritis Patients with Hyperuricemia, Whether We Should Treat or Not? [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/characteristic-and-outcomes-of-psoriatic-arthritis-patients-with-hyperuricemia-whether-we-should-treat-or-not/. Accessed .« Back to ACR/ARHP Annual Meeting 2016
ACR Meeting Abstracts - https://acrabstracts.org/abstract/characteristic-and-outcomes-of-psoriatic-arthritis-patients-with-hyperuricemia-whether-we-should-treat-or-not/