Psoriatic Arthritis
Conditions
Keywords
Erosions, Onycholysis, HR-pQCT, Psoriatic arthritis
Brief summary
Nearly 30% of patients with cutaneous psoriasis (PsO) developed psoriatic arthritis (PsA). Among these patients 20 % will have severe destructive arthritis. The risk of developing PsA is significantly higher in patients with nail involvement (OR = 2.24; 95% CI \[1.26-3.98\]). The risk is particularly high for the peripheral form of PsA and onycholysis (OR=2.80; 95% CI \[1.34-5.85\]). Thus the investigators wanted to test the hypothesis that onycholysis, in patients without PsA, is a potential clinical marker of subclinical distal enthesopathy and, by extension, of bone micro-structural alterations. Patients and Methods The investigators will recruit 4 groups of subjects: 1. Patients with peripheral PsA, 2. Patients with psoriatic nail onycholysis, 3. Patients with PsO only 4. Healthy match control subjects. The investigators will assess the presence of enthesopathy by ultrasonography and bone structural damages (by HR-pQCT) in all subjects at baseline and 4 years.
Interventions
RADIATIONHR-pQCT High resolution peripheral quantitative CT-scan
HR-pQCT is a powerful device providing low dose irradiation already used in bone field. It is a high resolution tool (voxel size=82µm) that the investigators adapted to look after the distal joint involved by onycholysis. An anteroposterior scout view is used to define the region of interest (ROI), which spanned from the top of the distal phalange to the distal part of the intermediate phalange in order to contain the distal joint of the target finger. Images are then analysed for erosions, osteophytes and volumetric bone mineral density.
Sponsors
Hospices Civils de Lyon
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* adults over 18 years and until 65 years * both gender * covered by the French National Insurance * subjects entering one of the 4 groups.
Exclusion criteria
* Treatment by biological agents are an
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| distal phalangeal bone erosion of the 2 index fingers of the hand | at baseline and after 4 years of follow-up | assessment by HR-pQCT |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| enthesopathy of the 2 index fingers of the hand | at baseline and after 4 years of follow-up | assessment by ultrasonography |
| Rheumatoid factors | Biomarkers are assessed at baseline | — |
Countries
France
Contacts
Primary ContactCyrille Confavreux, MD PHD
Backup ContactCéline Coutisson, clinical research assistant
Outcome results
None listed