Skip to main content
Log in

Analysis by Age Group of Disease Outcomes in Patients with Psoriatic Arthritis: A Cross-Sectional Multicentre Study

  • Original Research Article
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

Objectives

Elderly psoriatic arthritis (PsA) patients may show greater inflammatory activity and worse prognoses than patients of other ages. However, these patients may be at risk of receiving fewer systemic treatments. In this report, we have analysed disease outcomes in PsA by age groups.

Methods

This cross-sectional, multicentre study included 227 PsA patients under biological and non-biological systemic therapies. The study population was divided into four categories by age: < 40, 40‒49, 50‒65 and > 65 years. Physical functioning, disease activity, remission rates and disease impact were compared.

Results

Thirty-one patients (13.7%) were under 40 years, 26.9% (n = 61) were 40–49 years, 26.4% (n = 60) were 50–65 years and 33.0% (n = 75) were patients > 65 years. Compared with the other age groups, disease duration was significantly higher in subjects older than 65 years (p < 0.001). Only 8% of patients older than 65 years received corticosteroids compared with 29% of patients aged < 40 years, 13.1% of patients aged 40–49 years and 26.7% of patients aged 50–65 years (p = 0.007). Similarly, only 36% of patients over 65 years of age received a biological therapy compared with between 51.6 and 59% for the other age groups (p = 0.036). However, remission rates were not statistically different between groups. Disease-associated physical disability was similar among groups. Compared with patients aged < 40 years, more patients > 65 years achieved low disease impact (10.7% vs 37.7%, respectively; p < 0.05).

Conclusions

Fewer older patients received corticosteroids and biological therapy. However, disease outcomes were similar or even better compared with those observed in younger patients. Therefore, treatment strategies for older patients with PsA should be similar to those offered to younger individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ritchlin CT, Colbert RA, Gladman DD. Psoriatic arthritis. N Engl J Med. 2017;376:957–70.

    Article  Google Scholar 

  2. Wilson FC, Icen M, Crowson CS, McEvoy MT, Gabriel SE, Kremers HM. Time trends in epidemiology and characteristics of psoriatic arthritis over 3 decades: a population-based study. J Rheumatol. 2009;36:361–7.

    Article  Google Scholar 

  3. Liew JW, Ramiro S, Gensler LS. Cardiovascular morbidity and mortality in ankylosing spondylitis and psoriatic arthritis. Best Pract Res Clin Rheumatol. 2018;32:369–89.

    Article  Google Scholar 

  4. Henseler T, Christophers E. Psoriasis of early and late onset: characterization of two types of psoriasis vulgaris. J Am Acad Dermatol. 1985;13:450–6.

    Article  CAS  Google Scholar 

  5. Olivieri I, Pipitone N, D’ Angelo S, Padula A, Salvarani C. Late-onset rheumatoid arthritis and late-onset spondyloarthritis. Clin Exp Rheumatol. 2009;27(4 Suppl 55):S139–45.

    CAS  PubMed  Google Scholar 

  6. Queiro R, Tejon P, Alonso S, Coto P. Age at disease onset: a key factor for understanding psoriatic disease. Rheumatology (Oxford). 2014;53:1178–85.

    Article  CAS  Google Scholar 

  7. Caso F, Tasso M, Chimenti MS, Navarini L, Perricone C, Girolimetto N, et al. Late-onset and elderly psoriatic arthritis: clinical aspects and management. Drugs Aging. 2019. https://doi.org/10.1007/s40266-019-00688-3.

    Article  PubMed  Google Scholar 

  8. Queiro R, Cañete JD, Montilla C, Abad M, Montoro M, Gómez S, et al. MAAPS study group. Minimal disease activity and impact of disease in psoriatic arthritis: a Spanish cross-sectional multicenter study. Arthritis Res Ther. 2017;19(1):72.

    Article  Google Scholar 

  9. Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H, CASPAR Study Group. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum. 2006;54:2665–73.

    Article  Google Scholar 

  10. Pincus T, Summey JA, Soraci SA Jr, Wallston KA, Hummon NP. Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assessment Questionnaire. Arthritis Rheum. 1983;26:1346–53.

    Article  CAS  Google Scholar 

  11. Schoels MM, Aletaha D, Alasti F, Smolen JS. Disease activity in psoriatic arthritis (PsA): defining remission and treatment success using the DAPSA score. Ann Rheum Dis. 2016;75:811–8.

    Article  Google Scholar 

  12. Gossec L, de Wit M, Kiltz U, Braun J, Kalyoncu U, Scrivo R, et al. A patient-derived and patient-reported outcome measure for assessing psoriatic arthritis: elaboration and preliminary validation of the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire, a 13-country EULAR initiative. Ann Rheum Dis. 2014;73:1012–9.

    Article  Google Scholar 

  13. Punzi L, Pianon M, Rossini P, Schiavon F, Gambari PF. Clinical and laboratory manifestations of elderly onset psoriatic arthritis: a comparison with younger onset disease. Ann Rheum Dis. 1999;58:226–9.

    Article  CAS  Google Scholar 

  14. Kobak S, Yildiz F, Karaarslan A, Semiz H, Orman M. Characteristics of Turkish patients with elderly onset psoriatic arthritis: a retrospective cohort study. Medicine (Baltimore). 2017;96(33):e7833.

    Article  Google Scholar 

  15. Polachek A, Al-Johani R, Li S, Ye JY, Chandran V, Gladman D. Late onset psoriatic arthritis in a longitudinal cohort: disease presentation, activity over time and prognosis. Semin Arthritis Rheum. 2019;48:834–9.

    Article  Google Scholar 

  16. Rea IM, Gibson DS, McGilligan V, McNerlan SE, Alexander HD, Ross OA. Age and age-related diseases: role of inflammation triggers and cytokines. Front Immunol. 2018;9:586.

    Article  Google Scholar 

  17. Patel P, Rosen CF, Chandran V, Ye YJ, Gladman DD. Addressing comorbidities in psoriatic disease. Rheumatol Int. 2018;38:219–27.

    Article  Google Scholar 

  18. Queiro R, Cañete JD. Impact of cardiovascular risk factors on the achievement of therapeutic goals in psoriatic arthritis: is there any association? Clin Rheumatol. 2018;37:661–6.

    Article  Google Scholar 

  19. Costa L, Lubrano E, Ramonda R, Chimenti MS, Vezzù M, Perrotta FM, et al. Elderly psoriatic arthritis patients on TNF-α blockers: results of an Italian multicenter study on minimal disease activity and drug discontinuation rate. Clin Rheumatol. 2017;36:1797–802.

    Article  Google Scholar 

Download references

Acknowledgements

MAAPs (Minimal Activity in Psoriatic Arthritis) Study Group: J.D. Cañete (H. Clinic, Barcelona, Spain); C. Montilla (HU. Salamanca, Salamanca, Spain); M.A. Abad (H. Virgen del Puerto, Plasencia, Spain); S. Gómez (Pfizer Medical Department, Madrid, Spain); M. Montoro (Pfizer Medical Department, Madrid, Spain); A. Cabez (Pfizer Medical Department, Madrid, Spain); J.C. Torre Alonso (H. Monte Naranco, Oviedo, Spain); J.A. Román-Ivorra [Hospital Universitario (HU) La Fe, Valencia, Spain]; J. Sanz (HU Puerta de Hierro, Madrid, Spain); J. Salvatierra (HU San Cecilio, Granada, Spain); J. Calvo-Alén (HU Sierrallana, Torrelavega, Spain); A. Sellas (Vall d’Hebron, Barcelona, Spain); F.J. Rodriguez (Santa Lucia, Cartagena, Spain); A. Bermúdez (Virgen de la Arrixaca, Murcia, Spain); M. Romero (Complejo hospitalario Jaén, Spain); M. Riesco (Rheumatology H. Juan Ramón Jiménez, Huelva, Spain); J.C. Cobeta (H. Royo Villanova, Zaragoza, Spain); F. Medina (H. Puerta del Mar, Cádiz, Spain); A. Aragón (H. Getafe, Madrid, Spain); M.L. García (HU Basurto, Bilbao, Spain); A. Urruticoechea (H. Can Misses, Ibiza, Spain); C.M. González (HU Gregorio Marañón, Madrid, Spain); E. Judez (HU, Albacete, Spain); B. González (HU Nta. Sra de la Candelaria, Tenerife, Spain); P. Fernández (HU 12 de Octubre, Madrid, Spain); L. Pantoja (H. del Bierzo, Leon, Spain); R. Morlá (H. Sant Pau y Sta. Tecla, Tarragona, Spain).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rubén Queiro.

Ethics declarations

Funding

The MAAPS study was funded by Pfizer.

Conflict of interest

RQ, EP, LC, SA, LA and MA declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Queiro, R., Pardo, E., Charca, L. et al. Analysis by Age Group of Disease Outcomes in Patients with Psoriatic Arthritis: A Cross-Sectional Multicentre Study. Drugs Aging 37, 99–104 (2020). https://doi.org/10.1007/s40266-019-00724-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40266-019-00724-2

Navigation