Key Findings

Sonographic enthesitis has been identified as a potential marker of radiographic joint damage in PsA. In addition, the relationship between HLA genetic susceptibility markers has been examined, with HLA-B27 being associated with more severe sonographic enthesitis in PsA. Through international initiatives, future steps include the development of sonographic scoring systems in PsA.

An additional field of research is the epidemiology of psoriatic disease, with an emphasis on the pre-clinical phases of PsA. These studies have suggested that a preclinical phase, characterized by non-specific musculoskeletal systems (e.g. joint pain, fatigue), exists in PsA patients prior to the diagnosis of the disease. Other risk factors, such as smoking, severe psoriasis, nail pitting and uveitis, have shown to be predictive of the development of PsA in patients with psoriasis. 

These studies contributed to a growing body of knowledge about cardio-metabolic diseases in psoriatic patients. A significant proportion of patients with PsA were found to develop cardiovascular events, such as heart attack and stroke, during the course of their disease. Increased cardiovascular risk is associated with a combination of traditional cardiovascular risk factors and disease activity. Importantly, general risk prediction algorithms, such as the Framingham Risk Score, were found to underestimate risk and subclinical atherosclerosis in patients with psoriatic disease.

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Council of Academic Hospitals of Ontario (CAHO)