Systematic review and meta-analysis: risk factors for psoriatic arthritis. Part 1.

According to epidemiological and clinical studies, every fourth patient with psoriasis develops psoriatic arthritis (PsA), and in many cases there is a destructive form of arthritis that leads to disability. Late diagnosis of PsA is associated with a significant reduction in the effectiveness of therapy. Therefore, early diagnosis of this disease is so important.
Objective: to determine the methods for early detection of PsA, in particular the identification of risk factors (RFs) for its development, which will prevent the progression of the disease and the disability of patients.
Materials and methods. The literature review and meta-analysis is presented in two parts. Part 1 of the systematic review included articles on exogenous RFs for the development of PsA published over the past 10 years.
PubMed (MEDLINE), EMBASE, and Google Scholar databases were searched for articles published before March 1, 2021. We searched for currently registered trials in the registers of clinical trials of US (ClinicalTrials.gov), of China (Chinese Clinical Trial Registry) and the WHO International
Clinical Trial Registry Platform. The statistical analysis was prepared in accordance with the international guidelines for systematic reviews and meta-analysis (PRISMA) using the Statistic SPSS 26.0 program (USA).
Results and discussion. 957 articles published up to March 1, 2021 were identified. After further analysis, irrelevant articles were excluded. A total of 73 articles were included in the review and analysis, 32 of which were included in Part 1. The most common exogenous RFs are: mechanical injuries, medications, and psychotraumatic situations.
Conclusion. PsA is a multifactorial disease. Currently, a large number of exogenous RFs for the development of this disease have been established. Knowledge of RFs and the ability to recognize them will help dermatovenereologists and rheumatologists to effectively assess and predict the patient's condition. Correction of modifiable RFs, early prescription of appropriate therapy will help to reduce the number of PsA cases, the development of functional disorders and prevent the growth of disability. However, studies on the comprehensive assessment of RFs in PsA are still insufficient. Further study of methods for the early diagnosis of PsA is needed in order to optimize its treatment.

1. Boehncke WH, Schцn MP. Psoriasis. Lancet. 2015 Sep 5;386(9997):983-94. doi: 10.1016/S0140-6736(14)61909-7.

2. Chimenti MS, Caso F, Alivernini S, et al. Amplifying the concept of psoriatic arthritis: The role of autoimmunity in systemic psoriatic disease. Autoimmun Rev. 2019 Jun;18(6):565-75. doi: 10.1016/j.autrev.2018.11.007.

3. Veale DJ, Fearon U. The pathogenesis of psoriatic arthritis. Lancet. 2018 Jun 2; 391(10136):2273-84. doi: 10.1016/S0140-6736(18)30830-4.

4. Alinaghi F, Calov M, Kristensen LE, et al. Prevalence of psoriatic arthritis in patients with psoriasis: A systematic review and metaanalysis of observational and clinical studies. J Am Acad Dermatol. 2019 Jan;80(1): 251-65.e19. doi: 10.1016/j.jaad.2018.06.027.

5. Korotaeva TV, Korsakova YuL, Loginova EY, et al. Psoriatic arthritis. Clinical guidelines for diagnosis and treatment. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2018;12(2):22-35. (In Russ.).

6. Tillett W, Charlton R, Nightingale A, et al. Interval between onset of psoriasis and psoriatic arthritis comparing the UK Clinical Practice Research Datalink with a hospital-based cohort. Rheumatology (Oxford). 2017 Dec 1; 56(12):2109-13. doi: 10.1093/rheumatology/kex323.

7. Haroon M, Gallagher P, FitzGerald O. Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis. Ann Rheum Dis. 2015 Jun;74(6):1045-50. doi: 10.1136/annrheumdis-2013-204858.

8. Burgers LE, Raza K, van der Helm, van Mil AH. Window of opportunity in rheumatoid arthritis – definitions and supporting evidence: from old to new perspectives. RMD Open. 2019 Apr 3;5(1):e000870. doi: 10.1136/rmdopen-2018-000870.eCollection 2019.

9. Van Steenbergen HW, da Silva JAP, Huizinga TWJ, et al. Preventing progression from arthralgia to arthritis: targeting the right patients. Nat Rev Rheumatol. 2018 Jan;14(1): 32-41. doi: 10.1038/nrrheum.2017.185.

10. https://www.who.int/topics/risk_factors/ru/

11. Scarpa R, Del Puente A, di Girolamo C, et al. Interplay between environmental factors, articular involvement, and HLA-B27 in patients with psoriatic arthritis. Ann Rheum Dis. 1992 Jan;51(1):78-9. doi: 10.1136/ard.51.1.78.

12. De Vlam K, Gottlieb AB, Mease PJ. Current concepts in psoriatic arthritis: pathogenesis and management. Acta Derm Venereol. 2014 Nov;94(6):627-34. doi: 10.2340/00015555-1833.

13. Van Mechelen M, Lories RJ. Microtrauma: no longer to be ignored in spondyloarthritis? Curr Opin Rheumatol. 2016 Mar;28(2):176-80. doi: 10.1097/BOR.0000000000000254.

14. Pattison E, Harrison BJ, Griffiths CE, et al. Environmental risk factors for the development of psoriatic arthritis: results from a case-control study. Ann Rheum Dis. 2008 May;67(5):672-6. doi: 10.1136/ard.2007.073932.

15. Thumboo J, Uramoto K, Shbeeb MI, et al. Risk factors for the development of psoriatic arthritis: a population based nested case control study. J Rheumatol. 2002 Apr; 29(4):757-62.

16. Eder L, Law T, Chandran V, et al. Association between environmental factors and onset of psoriatic arthritis in patients with psoriasis. Arthritis Care Res (Hoboken). 2011 Aug; 63(8):1091-7. doi: 10.1002/acr.20496.

17. Schwartz J, Evers AW, Bundy C, Kimball AB. Getting under the Skin: Report from the International Psoriasis Council Workshop on the Role of Stress in Psoriasis. Front Psychol. 2016 Feb 2;7:87. doi: 10.3389/fpsyg.2016.00087.eCollection2016.

18. Trojacka E, Zaleska M, Galus R. Influence of exogenous and endogenous factors on the course of psoriasis. Pol Merkur Lekarski. 2015 Mar;38(225):169-73.

19. Eder L, Haddad A, Rosen CF, et al. The Incidence and Risk Factors for Psoriatic Arthritis in Patients With Psoriasis: A Prospective Cohort Study. Arthritis Rheumatol. 2016 Apr;68(4):915-23. doi: 10.1002/art.39494.

20. Stojanovich L. Stress and autoimmunity. Autoimmun Rev. 2010 Mar;9(5):A271-6. doi: 10.1016/j.autrev.2009.11.014.

21. Song H, Fang F, Tomasson G, et al. Association of Stress-Related Disorders With Subsequent Autoimmune Disease. JAMA. 2018 Jun 19;319(23):2388-400. doi: 10.1001/ama.2018.7028.

22. Tasdelen OY, Yurdakul FG, Duran S, Bodur H. Isotretinoin-induced arthritis mimicking both rheumatoid arthritis and axial spondyloarthritis. Int J Rheum Dis. 2015 May; 18(4):466-9. doi: 10.1111/1756-185X.12464.

23. Elnady BD, Desouky D, Elkhouly T, et al. Isotretinoin induced seronegative spondyloarthropathy: magnetic resonance imaging as diagnostic and prognostic biomarker [abstract]. Arthritis Rheum. 2017;69(Suppl. 10):1569.

24. Henning P, Conaway HH, Lerner UH. Retinoid receptors in bone and their role in bone remodeling. Front Endocrinol (Lausanne). 2015 Mar 11;6:31. doi: 10.3389/fendo.2015.00031.

25. Wu S, Han J, Qureshi AA. Use of aspirin, non-steroidal anti-inflammatory drugs, and acetaminophen (paracetamol), and risk of psoriasis and psoriatic arthritis: a cohort study. Acta Derm Venereol. 2015 Feb;95(2):217-23. doi: 10.2340/00015555-1855.

26. Li W, Han J, Choi HK, Qureshi AA. Smoking and Risk of Incident Psoriasis Among Women and Men in the United States: A Combined Analysis. Am J Epidemiol. 2012 Mar 1;175(5):402-13. doi: 10.1093/aje/kwr325. Epub 2012 Jan 12.

27. Hui M, Doherty M, Zhang W. Does smoking protect against osteoarthritis? Meta-analysis of observational studies. Ann Rheum Dis. 2011 Jul;70(7):1231-7. doi: 10.1136/ard.2010.142323.

28. Xie W, Huang H, Deng X, et al. Modifiable lifestyle and environmental factors associated with onset of psoriatic arthritis in patients with psoriasis: A systematic review and meta-analysis of observational studies. J Am Acad Dermatol. 2021 Mar;84(3):701-11. doi: 10.1016/j.jaad.2020.08.060.

29. Nguyen UDT, Zhang Y, Lu N, et al. Smoking paradox in the development of psoriatic arthritis among patients with psoriasis: a population-based study. Ann Rheum Dis. 2018 Jan;77(1):119-23. doi: 10.1136/annrheumdis-2017-211625.

30. Eder L, Shanmugarajah S, Thavaneswaran A, et al. The association between smoking and the development of psoriatic arthritis among psoriasis patients. Ann Rheum Dis. 2012 Feb;71(2):219-24. doi: 10.1136/ard.2010.147793.

31. Green A, Shaddick G, Charlton R, et al; PROMPT study group. Modifiable risk factors and the development of psoriatic arthritis in people with psoriasis. Br J Dermatol. 2020 Mar;182(3):714-20. doi: 10.1111/bjd.18227.

32. Maciejewska-Radomska A, Szczerkowska-Dobosz A, Rebala K, et al. Frequency of streptococcal upper respiratory tract infections and HLA-Cw*06 allele in 70 patients with guttate psoriasis from northern Poland. Postepy Dermatol Alergol. 2015 Dec;32(6): 455-8. doi: 10.5114/pdia.2014.40982