Psoriatic Arthritis Flashcards
1
Q
Epidemiology
A
M=F
20-30% of people with psoriasis
More likely to have severe psoriasis, nail lesions, scalp psoriasis, intergluteal psoriasis
Only 70% of people presenting with PsA have a history of psoriasis
2
Q
Presentation
A
Involvement of DIPs Asymmetric oligoarthritis Arthritis mutilans Skin psoriasis Nail psoriasis Dactylitis
3
Q
Risk factors for progressive disease
A
Increased number of involved joints Raised ESR HLA-B27 positive DMARD failure Presence of joint damage
4
Q
Radiological changes
A
Pencil in cup deformity
5
Q
Treatment
A
NSAIDs Steroids - can cause disease flares with tapering MTX Sultasalazine Leflunomide TNF inhibitors IL-12 blockers IL-17 blockers
6
Q
IL-12 blockade
A
Ustekinumab
IL-12/23 blockade
Inhibits Th1 and Th2 pathways
Effective for spinal disease, dactylitis and enthesitis
Minimal infection risk
Slow radiographic progression
Less effective than TNF-alpha for peripheral disease
? effect on extra-articular disease
7
Q
IL-17 Blockade
A
Secukinumab
IL-17A blockade
High response rates
Highly effective for spinal disease, enthesitis and dactylitis
Not effective in IBD or uveitis
