Researchers Identify Factors Associated With Less Enthesis Inflammation in PsA

Patients with psoriatic arthritis (PsA) who avoid physical activity, are younger, and do not receive treatment with biologic medications may experience less enthesis inflammation, according to results of a new cross-sectional study.

Symptoms of enthesitis are difficult to interpret clinically. The researchers of the study sought to evaluate the associations of ultrasonography (US) changes in entheses with clinical characteristics in patients with PsA. The enthesis changes of the subset of patients aged 35 to 60 years were then compared with those of healthy participants of the same age range.

The modified Madrid Sonographic Enthesitis Index (MASEI) was used to measure inflammatory and structural enthesis changes. Associations between US scores and clinical characteristics were assessed via linear regression.

Among patients with PsA, the researchers observed a small association between higher inflammatory-modified MASEI score and older age and current use of biologics.

Patients who reported avoiding activities had significantly lower inflammatory-modified MASEI scores compared with those who did not.

The patients with PsA had similar inflammatory scores as healthy volunteers but higher structural scores.

“Within patients with PsA, avoiding physical activity, younger age, and not using biologics were associated with less enthesis inflammation,” the researchers concluded. “Patients with PsA and healthy volunteers aged 35 to 60 years displayed similar levels of inflammatory changes of the entheses, but patients had more structural damage.”

—Melinda Stevens

Reference:

Wervers K, Herrings I, Luime JJ, et al. Association of physical activity and medication with enthesitis on ultrasound in psoriatic arthritis. J Rheumatol. 2019;46:(10):1290-1294. https://doi.org/10.3899/jrheum.180782.