ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 0501

Structural Entheseal Lesions in Psoriasis Patients Are Associated with an Increased Risk Ofprogression to Psoriatic Arthritis – A Prospective Cohort Study

David Simon1, Koray Tascilar1, Arnd Kleyer1, Sara Bayat2, Eleni Kampylafka2, Axel Hueber3, Juergen Rech1, Louis Schuster1, Klaus Engel4, Michael Sticherling2 and Georg Schett5, 1Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Bayern, Germany, 2Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany, 3Sozialstiftung Bamberg, Sektion Rheumatologie, Bamberg, Germany, 4Siemens Healthcare GmbH Digital Technology & Camp; Innovation, SHS DS DTI, Erlangen, Germany, 5Friedrich-Alexander-Universität Erlangen- Nuremberg, Erlangen, Germany

Meeting: ACR Convergence 2020

Keywords: Computed tomography (CT), Imaging, Psoriatic arthritis

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Friday, November 6, 2020

Title: Spondyloarthritis Including Psoriatic Arthritis – Diagnosis, Manifestations, & Outcomes I: Psoriatic Arthritis (0499–0503)

Session Type: Abstract Session

Session Time: 5:00PM-5:50PM

Background/Purpose: We have previously reported that the presence of musculoskeletal pain in psoriasis patients is associated with a higher risk of developing psoriatic arthritis (PsA) (1). Furthermore, a subset of psoriasis patients shows evidence for structural entheseal lesions (SEL) in their hand joints (2), sometimes also referred as “Deep Koebner Phenomenon”, which are highly specific for psoriatic disease and virtually absent in healthy controls, rheumatoid arthritis and hand osteoarthritis patients (2-4). However, it remains unclear whether SEL alone or in combination with musculoskeletal pain are associated with the development of PsA. Therefore, we aimed to test whether the presence of SEL in psoriasis patients increases the risk for progression to PsA and how this is related to the presence of musculoskeletal pain.

Methods: Psoriasis patients without evidence of PsA were enrolled in a prospective cohort study between 2011 and 2018. All patients underwent baseline assessment of SEL in their 2nd and 3rd MCP joints by high-resolution peripheral quantitative computed tomography (HR-pQCT). The risk of PsA development associated with SEL and arthralgia was explored using survival analyses and multivariable Cox regression models.

Results: 114 psoriasis patients (72 men/42 women) with a mean (SD) follow-up duration of 28.2 (17.7) months were included, 24 of whom developed PsA (9.7 /100 patient-years, 95%CI 6.2 to 14.5) during the observation period. Patients with SEL (N=41) were at higher risk of developing PsA compared to patients without such lesions (21.4/100 patient-years, 95%CI 12.5 to 34.3, HR 5.10, 95%CI 1.53 to 16.99, p=0.008) (Kaplan Meier plot A). Furthermore, while patients without arthralgia and without SEL had a very low progression rate to PsA (1/29; 3.4%), patients with arthralgia but no SEL showed higher progression (5/33; 15.2%), which was in line with previous observations (1) (Kaplan Meier plot B). Presence of SEL further enhanced the risk for progression to PsA both in the absence (6/16; 37.5%) and presence (6/14; 42.8%) of arthralgia with the highest progression rate in those subjects with both arthralgia and SEL (p< 0.001 by log rank test for trend) (Kaplan Meier plot B).

Conclusion: Presence of SEL is associated with an increased risk of developing PsA in patients with psoriasis. If used together with pain, SEL allow defining subsets of psoriasis patients with very low and very high risk to develop PsA.

References:

(1) Faustini F et al. Ann Rheum Dis. 2016;75:2068-2074

(2) Simon D et al. Ann Rheum Dis. 2016;75:660-6

(3) Finzel S et al. Ann Rheum Dis. 2011;70:122-7

(4) Finzel S et al. Arthritis Rheum. 2011;63:1231-6

(A) Kaplan-Meier plots of psoriatic arthritis-free survival by presence/absence of structural entheseal lesions (SEL) at baseline. P value by log-rank test;, (B) Kaplan-Meier plots of psoriatic arthritis-free survival by four groups; 1, no arthralgia and no SEL at baseline; 2, arthralgia but no SEL (Arthralgia only) ; 3, no arthralgia but SEL(SEL only) ; 4, arthralgia and SEL


Disclosure: D. Simon, Novartis, 8, Lilly, 5, 8, Janssen, 8, AbbVie, 5; K. Tascilar, None; A. Kleyer, Lilly, 8, Novartis, 8, BMS, 8, Sanofi, 8, Gilead, 8; S. Bayat, Novartis, 8; E. Kampylafka, Novartis, 8, Bristol-Myers-Squibb, 8, Janssen, 8; A. Hueber, Abbvie, 5, 8, BMS, 8, Gilead, 5, GSK, 5, 8, Janssen, 5, 8, Roche/Chugai, 5, Lilly, 2, 5, 8, Novartis, 2, 5, 8; J. Rech, Abbie, Biogen, BMS, Chugai, Celgene, EliLilly, Gilead, GSK, Janssen, MSD, Novartis, Roche, Sanofi, Sobi, UCB, 5, 8; L. Schuster, None; K. Engel, None; M. Sticherling, Novartis, 2, 5, 8, Abbvie, 5, 8, Celgene, 5, 8, Janssen, 5, 8, 9, Pfizer, 8, Leo, 5, 8, Lilly, 5, 8, Sanofi, 5, 8; G. Schett, None.

To cite this abstract in AMA style:

Simon D, Tascilar K, Kleyer A, Bayat S, Kampylafka E, Hueber A, Rech J, Schuster L, Engel K, Sticherling M, Schett G. Structural Entheseal Lesions in Psoriasis Patients Are Associated with an Increased Risk Ofprogression to Psoriatic Arthritis – A Prospective Cohort Study [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/structural-entheseal-lesions-in-psoriasis-patients-are-associated-with-an-increased-risk-ofprogression-to-psoriatic-arthritis-a-prospective-cohort-study/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/structural-entheseal-lesions-in-psoriasis-patients-are-associated-with-an-increased-risk-ofprogression-to-psoriatic-arthritis-a-prospective-cohort-study/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology