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The impact of concomitant diffuse idiopathic skeletal hyperostosis on the achievement of minimal disease activity in subjects with psoriatic arthritis

  • Original Article - Observational Research
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Abstract

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by ossification of different entheses. Psoriatic arthritis (PsA) is a seronegative spondyloarthritis associated with psoriasis. Given the possible overlap of the two diseases, we assessed whether DISH presence may affect PsA clinical outcomes. Also, predictors of DISH presence in the cohort were investigated. Consecutive PsA patients from two Italian Rheumatology Research Units were enrolled. Subjects were splitted into two groups, according to the current treatment (TNF-α blockers or traditional DMARDs). All patients underwent a rheumatologic examination, blood sample collections and spine radiographs. Information about traditional vascular risk factors was recorded. In each patient, the presence of minimal disease activity was evaluated and the presence of DISH was established according to the Resnick and Niwayama criteria. Among the 80 enrolled subjects (57.5 % men, mean age 56.5 ± 11.1 years), the overall prevalence of DISH was 30.0 %. Patients with DISH were older, with higher BMI and waist circumference. DISH subjects showed worsen BASMI, HAQ and ESR. In a multivariate regression model, BASMI was a significant predictor of DISH presence (OR 3.027, 95 % CI 1.449–6.325, p = 0.003). The prevalence of MDA was lower in DISH patients than in no-DISH (16.7 vs 41.1 %, p = 0.041), and the presence of DISH was a predictor of not achieving MDA (OR 3.485, 95 % CI 1.051–11.550, p = 0.041). PsA subjects with DISH showed worsen indices of spine mobility and articular function and lower prevalence of minimal disease activity than no-DISH patients.

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References

  1. Mader R, Buskila D, Verlaan JJ, Atzeni F, Olivieri I, Pappone N et al (2013) Developing new classification criteria for diffuse idiopathic skeletal hyperostosis: back to square one. Rheumatology (Oxford) 52(2):326–330

    Article  Google Scholar 

  2. Mader R, Sarzi-Puttini P, Atzeni F, Olivieri I, Pappone N, Verlaan JJ et al (2009) Extraspinal manifestations of diffuse idiopathic skeletal hyperostosis [review]. Rheumatology (Oxford) 48:1478–1481

    Article  Google Scholar 

  3. Russolillo A, Iervolino S, Peluso R, Lupoli R, Di Minno A, Pappone N et al (2013) Obesity and psoriatic arthritis: from pathogenesis to clinical outcome and management. Rheumatology (Oxford) 52(1):62–67

    Article  CAS  Google Scholar 

  4. Olivieri I, D’Angelo S, Palazzi C, Padula A, Mader R, Khan MA (2009) Diffuse idiopathic skeletal hyperostosis: differentiation from ankylosing spondylitis. Curr Rheumatol Rep 11(5):321–328

    Article  PubMed  Google Scholar 

  5. Haddad A, Thavaneswaran A, Toloza S, Chandran V, Gladman DD (2013) Diffuse idiopathic skeletal hyperostosis in psoriatic arthritis. J Rheumatol 40(8):1367–1373

    Article  PubMed  Google Scholar 

  6. Di Minno MN, Peluso R, Iervolino S, Lupoli R, Russolillo A, Tarantino G et al (2012) Hepatic steatosis, carotid plaques and achieving MDA in psoriatic arthritis patients starting TNF-α blockers treatment: a prospective study. Arthritis Res Ther 14(5):R211

    Article  PubMed Central  PubMed  Google Scholar 

  7. Di Minno MN, Iervolino S, Peluso R, Di Scarpa R, Minno G, CaRRDs Study Group (2011) Carotid intima-media thickness in psoriatic arthritis: differences between tumor necrosis factor-α blockers and traditional disease-modifying antirheumatic drugs. Arterioscler Thromb Vasc Biol 31(3):705–712

    Article  PubMed  Google Scholar 

  8. Di Minno MN, Tufano A, Guida A, Di Capua M, De Gregorio AM et al (2011) Abnormally high prevalence of major components of the metabolic syndrome in subjects with early-onset idiopathic venous thromboembolism. Thromb Res 127(3):193–197

    Article  PubMed  Google Scholar 

  9. Baraliakos X, Listing J, Rudwaleit M, Haibel H, Brandt J, Sieper J et al (2007) Progression of radiographic damage in patients with ankylosing spondylitis: defining the central role of syndesmophytes. Ann Rheum Dis 66:910–915

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Zincarelli C, Iervolino S, Di Minno MN, Miniero E, Rengo C, Di Gioia L et al (2012) Diffuse idiopathic skeletal hyperostosis prevalence in subjects with severe atherosclerotic cardiovascular diseases. Arthritis Care Res (Hoboken) 64(11):1765–1769

    Article  Google Scholar 

  11. Pappone N, Lubrano E, Esposito-del Puente A, D’Angelo S, Di Girolamo C, Del Puente A (2005) Prevalence of diffuse idiopathic skeletal hyperostosis in a female Italian population. Clin Exp Rheumatol 23:123–124

    CAS  PubMed  Google Scholar 

  12. Olivieri I, Vitali C, Gemignani G, Pasero G (1989) Concomitant ankylosing spondylitis and DISH. J Rheumatol 16:1170–1172

    CAS  PubMed  Google Scholar 

  13. Rillo OL, Scheines EJ, Moreno C, Barreira JC, Porrini AA, Maldonado Cocco JA (1989) Coexistence of diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis. Clin Rheumatol 8:499–503

    Article  CAS  PubMed  Google Scholar 

  14. Di Minno MN, Iervolino S, Lupoli R, Russolillo A, Coppola A, Peluso R et al (2012) Cardiovascular risk in rheumatic patients: the link between inflammation and atherothrombosis. Semin Thromb Hemost 38(5):497–505

    Article  PubMed  Google Scholar 

  15. Di Minno MN, Peluso R, Iervolino S, Lupoli R, Russolillo A, Scarpa R et al (2013) Obesity and the prediction of minimal disease activity: a prospective study in psoriatic arthritis. Arthritis Care Res (Hoboken) 65(1):141–147

    Article  Google Scholar 

  16. Di Minno MN, Peluso R, Iervolino S, Lupoli R, Russolillo A, Scarpa R, CaRRDs Study Group (2014) Weight loss and achievement of minimal disease activity in patients with psoriatic arthritis starting treatment with tumour necrosis factor α blockers. Ann Rheum Dis 73(6):1157–1162

    Article  PubMed Central  PubMed  Google Scholar 

  17. Peluso R, Cafaro G, Di Minno A, Iervolino S, Ambrosino P, Lupoli G et al (2013) Side effects of TNF-α blockers in patients with psoriatic arthritis: evidences from literature studies. Clin Rheumatol 32:743–753

    Article  PubMed  Google Scholar 

  18. Iervolino S, Di Minno MN, Peluso R, Lofrano M, Russolillo A, Di Minno G et al (2012) Predictors of early minimal disease activity in patients with psoriatic arthritis treated with tumor necrosis factor-α blockers. J Rheumatol 39:568–573

    Article  PubMed  Google Scholar 

  19. di Girolamo C, Pappone N, Rengo C, Miniero E, Crisci C, Olivieri I (2001) Intervertebral disc lesions in diffuse idiopathic skeletal hyperostosis (DISH). Clin Exp Rheumatol. 19(3):310–312

    PubMed  Google Scholar 

  20. Olivieri I, D’Angelo S, Palazzi C, Padula A (2013) Spondyloarthritis and diffuse idiopathic skeletal hyperostosis: two different diseases that continue to intersect. J Rheumatol 40:1251–1253

    Article  PubMed  Google Scholar 

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    Authors and Affiliations

    1. Rheumatology and Rehabilitation Research Unit, “Salvatore Maugeri” Foundation I.R.C.C.S. Scientific Institute of Telese Terme, Via Bagni Vecchi 1, Telese Terme, BN, Italy

      Nicola Pappone, Salvatore Iervolino & Carmela Zincarelli

    2. Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy

      Matteo Nicola Dario Di Minno, Roberta Lupoli & Rosario Peluso

    3. Rheumatic Diseases Unit, Ha’Emek Medical Center, Afula, Israel

      Reuven Mader

    Authors
    1. Nicola Pappone
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    2. Matteo Nicola Dario Di Minno
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    3. Salvatore Iervolino
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    4. Roberta Lupoli
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    5. Reuven Mader
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    6. Carmela Zincarelli
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    7. Rosario Peluso
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    Correspondence to Salvatore Iervolino.

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    Nicola Pappone and Matteo Nicola Dario Di Minno contributed equally to this paper.

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    Pappone, N., Di Minno, M.N.D., Iervolino, S. et al. The impact of concomitant diffuse idiopathic skeletal hyperostosis on the achievement of minimal disease activity in subjects with psoriatic arthritis. Rheumatol Int 35, 2041–2046 (2015). https://doi.org/10.1007/s00296-015-3303-4

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    • DOI: https://doi.org/10.1007/s00296-015-3303-4

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