Systematic review and meta-analysis: risk factors for psoriatic arthritis. Part 2

Psoriasis (PsO) is a chronic immune-mediated disease, in the pathogenesis of which various risk factors (RFs) and genetic predisposition play an important role. The complex interaction of genetic and trigger factors leads to the development of autoimmune and autoinflammatory reactions. Every fourth patient with skin PsO develops psoriatic arthritis (PsA), which, progressing and left untreated, can cause irreversible functional disorders, which necessitates early diagnosis of this disease.

Objective: to identify endogenous risk factors for the development of PsA.

Material and methods. We searched PubMed (MEDLINE), EMBASE, and Google Scholar databases for articles on endogenous risk factors for the development of PsA that were published over the past 10 years (until 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). Meta-analysis was prepared using RevMan 5 software.

Results and discussion. Part 2 of the systematic review included 56 articles on endogenous risk factors for the development of PsA. When preparing a meta-analysis, a statistically significant increase (1.68 times) in the risk of developing PsA in the presence of psoriatic lesions of the scalp was noted (95% confidence interval, CI 1.09–2.61). There was no statistically significant increase in the risk of developing PsA in the presence of inverse PsO. The mean PASI was significantly higher (mean difference 2.64; 95% CI 1.37–3.91) in patients with PsA compared with patients without this disease. Mean duration of illness was also longer (mean difference 2.64 years; 95% CI 1.34–4.50) in patients with PsA than in patients with PsO.

Conclusion: PsO and PsA are multifactorial diseases. RFs not only affect their development, but also determine the characteristics of the clinical course, severity, and the presence of complications. Understanding the risk factors of the development of PsA is important for assessing the prognosis, timely diagnosis, and early initiation of therapy, which will prevent severe forms of the disease and disability in patients.

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