PMID- 35501145
OWN - NLM
STAT- MEDLINE
DCOM- 20221025
LR  - 20221222
IS  - 1499-2752 (Electronic)
IS  - 0315-162X (Linking)
VI  - 49
IP  - 9
DP  - 2022 Sep
TI  - Dactylitis Is Associated With More Severe Axial Joint Damage and Higher Disease 
      Activity in Axial Psoriatic Arthritis.
PG  - 1012-1019
LID - 10.3899/jrheum.220098 [doi]
AB  - OBJECTIVE: To investigate the association of dactylitis with disease activity and 
      the severity of damage detected by radiography in patients with axial psoriatic 
      arthritis (axPsA). METHODS: Patients with axPsA who met the Classification 
      Criteria for Psoriatic Arthritis were recruited. Clinical data, radiographic 
      changes, and disease activity in patients with axPsA with or without dactylitis 
      were compared using t tests, Mann-Whitney U tests, or Kruskal-Wallis tests for 
      continuous variables. Chi-square or Fisher exact tests were used for categorical 
      variables, and logistic regression analysis was performed to evaluate the 
      association between dactylitis and damage detected by radiography. RESULTS: A 
      total of 186 patients with axPsA were analyzed and dichotomized according to the 
      presence or absence of dactylitis. Patients with dactylitis, as compared to those 
      without dactylitis, had higher C-reactive protein (P = 0.004), erythrocyte 
      sedimentation rate (P = 0.006), neutrophil-to-lymphocyte ratio (P = 0.04), and 
      platelet-to-lymphocyte ratio (P = 0.02). In addition, patients with dactylitic 
      axPsA, as compared to patients with nondactylitic axPsA, had higher tender joint 
      counts, swollen joint counts, Disease Activity Index for Psoriatic Arthritis 
      (DAPSA) scores, and Health Assessment Questionnaire scores (P < 0.001). Patients 
      with axPsA who had dactylitis, as compared to those who did not, also had higher 
      values for the Disease Activity Score in 28 joints, Ankylosing Spondylitis 
      Disease Activity Score, Bath Ankylosing Spondylitis Functional Index, and Bath 
      Ankylosing Spondylitis Disease Activity Index (P < 0.05), while fewer of these 
      patients met the criteria for minimal disease activity and low disease activity 
      (P < 0.05). Consistently, they had more severe damage as detected by radiography 
      (P < 0.05), higher sacroiliac scores (odds ratio [OR] 2.08, 95% CI 1.14-3.79; P = 
      0.02), and a more significant reduction in bone mass density (OR 2.42, 95% CI 
      1.34-4.37; P = 0.003). No statistical differences were observed regarding HLA-B27 
      and the Leeds Enthesitis Index between these 2 groups of patients. Notably, only 
      half of the patients with dactylitic axPsA had inflammatory back pain. 
      CONCLUSION: Our study demonstrated that patients with axPsA who had dactylitis 
      had higher disease activity and more severe joint damage compared to those 
      without dactylitis. Careful examination and proper management of axial 
      involvement are recommended.
CI  - Copyright (c) 2022 by the Journal of Rheumatology.
FAU - Li, Shan-Shan
AU  - Li SS
AUID- ORCID: 0000-0002-0216-9171
AD  - S.S. Li, MD, N. Du, MD, S.H. He, MD, X. Liang, MD, T.F. Li, MD, PhD, Department 
      of Rheumatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 
      China.
FAU - Du, Na
AU  - Du N
AD  - S.S. Li, MD, N. Du, MD, S.H. He, MD, X. Liang, MD, T.F. Li, MD, PhD, Department 
      of Rheumatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 
      China.
FAU - He, Shi-Hao
AU  - He SH
AUID- ORCID: 0000-0002-9062-2422
AD  - S.S. Li, MD, N. Du, MD, S.H. He, MD, X. Liang, MD, T.F. Li, MD, PhD, Department 
      of Rheumatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 
      China.
FAU - Liang, Xu
AU  - Liang X
AD  - S.S. Li, MD, N. Du, MD, S.H. He, MD, X. Liang, MD, T.F. Li, MD, PhD, Department 
      of Rheumatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 
      China.
FAU - Li, Tian-Fang
AU  - Li TF
AUID- ORCID: 0000-0002-3039-8676
AD  - S.S. Li, MD, N. Du, MD, S.H. He, MD, X. Liang, MD, T.F. Li, MD, PhD, Department 
      of Rheumatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 
      China. tfli@zzu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220502
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
RN  - 0 (HLA-B27 Antigen)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Humans
MH  - *Arthritis, Psoriatic/complications/diagnostic imaging
MH  - *Spondylitis, Ankylosing/complications
MH  - HLA-B27 Antigen
MH  - C-Reactive Protein/metabolism
MH  - Severity of Illness Index
OTO - NOTNLM
OT  - axial
OT  - dactylitis
OT  - disease activity index
OT  - psoriatic arthritis
OT  - radiographic damage
EDAT- 2022/05/03 06:00
MHDA- 2022/10/26 06:00
CRDT- 2022/05/02 21:45
PHST- 2022/04/20 00:00 [accepted]
PHST- 2022/05/03 06:00 [pubmed]
PHST- 2022/10/26 06:00 [medline]
PHST- 2022/05/02 21:45 [entrez]
AID - jrheum.220098 [pii]
AID - 10.3899/jrheum.220098 [doi]
PST - ppublish
SO  - J Rheumatol. 2022 Sep;49(9):1012-1019. doi: 10.3899/jrheum.220098. Epub 2022 May 
      2.