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Komorbiditäten der Arthritis psoriatica

Comorbidities in psoriatic arthritis

  • Leitthema
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Zusammenfassung

Die Arthritis psoriatica tritt fast ausschließlich zusammen mit der Psoriasis (der Haut) auf. Zwangsläufig finden sich daher mit Psoriasis vergesellschaftete Erkrankungen, sog. Komorbiditäten, auch bei Patienten mit Arthritis psoriatica. Zu den relevantesten Komorbiditäten zählen kardiovaskuläre Erkrankungen sowie deren Risikofaktoren, speziell Rauchen und Adipositas bzw. das metabolische Syndrom. Darüber hinaus sind psychische Erkrankungen und Osteoporose zu berücksichtigen. Zumindest zwischen Psoriasis/Arthritis psoriatica und kardiovaskulären Erkrankungen bestehen nicht nur epidemiologische, sondern auch pathophysiologische Verbindungen. Für den behandelnden Arzt ist es wichtig, dieses komplexe Neben- und Miteinander mehrerer Erkrankungen im Blick zu behalten, um im Einzelfall zu einer optimalen Therapieentscheidung zu gelangen. Dies wird noch dadurch erschwert, als die Behandlung von Komorbiditäten zu Komedikation führt, die ebenfalls Einfluss auf die jeweilige Therapieentscheidung hat.

Abstract

Psoriatic arthritis occurs almost exclusively together with psoriasis (of the skin). Thus, psoriasis-associated diseases or comorbidities are also seen in psoriatic arthritis patients. Among the clinically most relevant comorbidities are cardiovascular diseases and their risk factors, namely smoking, obesity and the metabolic syndrome. Moreover, psychological conditions and osteoporosis should also be considered. The link between psoriasis, psoriatic arthritis and its comorbidities has been established based on epidemiological studies; however, at least for the cardiovascular comorbidities, the association can be explained based on novel insights into the pathogenesis of atherosclerosis. For the practising physician it is important to take into account the aspect of comorbidity to come to an optimal treatment decision in each individual case. Clinical decision-making is complicated further by the fact that comorbidity necessitates comedication which again influence the choice of treatment.

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Literatur

  1. Abuabara K, Azfar RS, Shin DB et al (2010) Cause-specific mortality in patients with severe psoriasis: a population-based cohort study in the U.K. Br J Dermatol 163:586–592

    Article  PubMed  CAS  Google Scholar 

  2. Attia EA, Khafagy A, Abdel-Raheem S et al (2011) Assessment of osteoporosis in psoriasis with and without arthritis: correlation with disease severity. Int J Dermatol 50:30–35

    Article  PubMed  Google Scholar 

  3. Boehncke WH, Bürger C, Boehncke S (2009) Komorbiditäten der Psoriasis. Hautarzt 60:116–121

    Article  PubMed  Google Scholar 

  4. Boehncke S, Thaci D, Beschmann H et al (2007) Psoriasis patients show signs of insulin resistance. Br J Dermatol 157:1249–1251

    Article  PubMed  CAS  Google Scholar 

  5. Boehncke WH, Boehncke S, Schoen MP (2010) Managing comorbid disease in patients with psoriasis. Br Med J 340:200–203

    Article  Google Scholar 

  6. Boehncke WH, Boehncke S, Tobin AM, Kirby B (2011) The „psoriatic march“: a concept of how severe psoriasis may drive cardiovascular comorbidity. Exp Dermatol 20:303–307

    Article  PubMed  Google Scholar 

  7. Borman P, Babaoglu S, Gur G et al (2008) Bone mineral density and bone turnover in patients with psoriatic arthritis. Clin Rheumatol 27:443–447

    Article  PubMed  Google Scholar 

  8. Burmester GR, Mease P, Dijkmans PA et al (2009) Adalimumab safety and mortality rates from global clinical trials of six immune-mediated inflammatory diseases. Ann Rheum Dis 68:1863–1869

    Article  PubMed  CAS  Google Scholar 

  9. Dauden E, Castaneda S, Suarez C et al (2012) Clinical practice guideline for an integrated approach to comorbidity in patients with psoriasis. J Eur Acad Dermatol Venereol (im Druck)

  10. Eder L, Zisman D, Barzlai M et al (2008) Subclinical atherosclerosis in psoriatic arthritis: a case-control study. J Rheumatol 35:877–882

    PubMed  Google Scholar 

  11. Eder L, Jayakar J, Pollock R et al (2012) Serum adipokines in patients with psoriatic arthritis and psoriasis alone and their correlation with disease activity. Ann Rheum Dis (im Druck)

  12. Frediani B, Allegri A, Falsetti P et al (2001) Bone mineral density in patients with psoriatic arthritis. J Rheumatol 28:138–143

    PubMed  CAS  Google Scholar 

  13. Gerdes S, Zahl VA, Knopf H et al (2008) Comedication related to comorbidities: a study in 1203 hospitalized patients with severe psoriasis. Br J Dermatol 159:1116–1123

    PubMed  CAS  Google Scholar 

  14. Gisondi P, Tessari G, Conti A (2007) Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study. Br J Dermatol 157:68–73

    Article  PubMed  CAS  Google Scholar 

  15. Hansson GI (2005) Inflammation, atherosclerosis and coronary artery disease. N Engl J Med 52:1685–1695

    Article  Google Scholar 

  16. Harrison BJ, Hutchinson CE, Adams J et al (2002) Assessing periarticular bone mineral density in patients with early psoriatic arthritis or rheumatoid arthritis. Ann Rheum Dis 61:1007–1011

    Article  PubMed  CAS  Google Scholar 

  17. Jamnitski A, Symmonds D, Peters MJL et al (2013) Cardiovascular comorbidities in patients with psoriatic arthritis: a systematic review. Ann Rheum Dis 72:211–216

    Article  PubMed  Google Scholar 

  18. Kimball AB, Gladman D, Gelfand JM et al (2008) National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening. J Am Acad Dermatol 58:1031–1042

    Article  PubMed  Google Scholar 

  19. Ludwig RJ, Herzog C, Rostock A et al (2007) Psoriasis: a pssible riks factor for development of coronary arter calcification. Br J Dermatol 156:271–276

    Article  PubMed  CAS  Google Scholar 

  20. Mallbris L, Akre O, Granath F et al (2004) Increased risk for cardiovascular mortality in psoriasis in-patients but not in outpatients. Eur J Epidemiol 19:225–230

    Article  PubMed  Google Scholar 

  21. Mallbris L, Granath F, Hamsten A, Stahle M (2006) Psoriasis is associated with lipid abormalities at the onset of skin disease. J Am Acad Dermatol 54:614–621

    Article  PubMed  Google Scholar 

  22. Rohekar S, Tom BD, Hassa A et al (2008) Prevalence of malignancy in psoriatic arthritis. Arthritis Rheum 58:82–87

    Article  PubMed  Google Scholar 

  23. Spadaro A, Scrivo R, Spinelli FR, Valesini G (2009) Monitoring biological therapies in psoriatic arthritis. J Rheumatol Suppl 83:69–70

    Article  PubMed  Google Scholar 

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Interessenkonflikt

Interessenkonflikt. W.-H. Boehncke erhielt Honorare als Referent anlässlich von durch pharmazeutsche Firmen finanzierten Symposien sowie als Teilnehmer von Advisory Boards: Abbvie, Biogen Idec, Janssen, Lilly, MSD, Novartis, Leo und Pfizer. Darüber hinaus erhielt er Forschungsmittel von folgenden Firmen: Baxter, Biogen Idec, Janssen und Leo. S. Boehncke erklärt, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Service de Dermatologie et Vénérologie et Département de Pathologie et Immunologie, Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, 12, Genève 4, Schweiz

    W.-H. Boehncke

  2. Service d’Endocrinologie, Diabétologie, Hypertension et Nutrition, Hôpitaux Universitaires de Genève, -, Genève , Schweiz

    S. Boehncke

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  1. W.-H. Boehncke
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Correspondence to W.-H. Boehncke.

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Boehncke, WH., Boehncke, S. Komorbiditäten der Arthritis psoriatica . Z. Rheumatol. 72, 779–783 (2013). https://doi.org/10.1007/s00393-013-1189-7

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  • DOI: https://doi.org/10.1007/s00393-013-1189-7

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