If you have psoriatic arthritis, the inflammatory arthritis that occurs with the chronic skin condition of psoriasis, you also are at an increased risk for other conditions — from cardiovascular disease to diabetes to eye disease.
“We know if a patient has psoriatic arthritis, it’s not just about treating the skin and the joints. It’s also diagnosing and treating the comorbidities related to the disease that they may have,” says Elaine Husni, MD, MPH, Director of Cleveland Clinic’s Arthritis and Musculoskeletal Treatment Center.
Researchers studying the conditions related to psoriatic arthritis (PsA) are raising awareness of the risks.
“Ultimately, our goal is to raise awareness in doctors and patients of what these comorbidities are. And then we want to screen for them in our patients,” Dr. Husni says.
Last summer, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) released the first guidelines advising doctors to screen patients with psoriatic arthritis for conditions that often accompany the disease.
“What really is important is to treat the patient as a whole and to say there are associated conditions that are more common with people with psoriatic arthritis. And physicians treating these patients should be made aware,” explains Dr. Husni. She led the writing group for the comorbidities section of the GRAPPA guidelines update.
If you have PsA, remember to watch for signs of other conditions. Ask your doctor about screening and proper treatment.
What other conditions could I have?
There is a significant list of comorbidities related to PsA. These include these 11 conditions:
- Cardiovascular disease (CVD), diabetes, obesity and metabolic syndrome — This list represents the most common conditions associated with PsA. “Diabetes, obesity and metabolic syndrome are all tied into the cardiovascular risk, because PsA can have a heavy inflammatory burden on the body,” Dr. Husni says.
- Inflammatory bowel diseases (IBD) – These illnesses, such as Crohn’s disease and ulcerative colitis, do have an elevated incidence in patients with PsA. Researchers are still studying the link.
- Autoimmune ophthalmic disease – Eye disease is commonly associated with PsA. Up to 25 percent of patients can get uveitis, an inflammatory condition, according to Dr. Husni. Your rheumatologist will work closely with an ophthalmologist if eye disease is present.
- Osteoporosis, fatty liver disease, chronic kidney disease, anxiety and depression — This list represents the least common conditions associated with PsA. A new medication to treat PsA called apremilast (Otezla®) it can also cause an increase in depression, Dr. Husni cautions. So it may not be the optimal choice for patients who already have anxiety or depression.
For patients, the key takeaway is to understand how comorbidities affect their PsA treatment.
“The important thing medically is that it changes the way we might treat someone,” Dr. Husni explains. “If they have PsA and IBD or PsA associated with eye disease, for example, we’re more likely to use certain types of drugs over others. It makes a difference in how we treat patients.”