Recent data published in Arthritis Research & Therapy suggest that the presence of psoriatic arthritis (PsA) acts as a strong enhancer of age-related catabolic bone damage, whereas the presence of enthesiophytes, as a sign of anabolic bone damage, is less age related, depending primarily on the duration of PsA.

The investigators conducted a cross-sectional analysis of 3 groups of patients, including those with PsA, those with psoriasis, and controls. They sought to compare the extent of bone erosions and enthesiophytes in patients with PsA, individuals with psoriasis, and healthy controls; to evaluate the effect of age and disease duration on the development of enthesiophytes and bone erosions; and to define the effect of bone erosions and enthesiophytes on physical function. Data from patients with PsA, those with psoriasis, and controls were analyzed using high-resolution peripheral quantitative computed tomography. The extent of enthesiophytes and bone erosions was plotted based on age, duration of PsA, and duration of psoriasis. Demographic and disease-specific data, including physical function using a health assessment questionnaire, were obtained.

Data from 203 patients were analyzed, of whom 101 had PsA, 55 had psoriasis, and 47 were healthy controls. Those with PsA had significantly more (P =.002) and larger (P =.003) bone erosions and enthesiophytes (P <.001) compared with patients with psoriasis and healthy controls. Although the presence of bone erosions in patients with psoriasis and controls did not differ, and enthesiophytes were more common among those with psoriasis vs healthy controls. The presence of bone erosions but not enthesiophytes demonstrated strong age dependency in all 3 groups. Moreover, enthesiophytes were influenced mostly by the duration of psoriasis and PsA. Compared with bone erosions, the presence of enthesiophytes was linked to poorer physical function.

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The investigators concluded that based on the current study findings, enthesiophytes affect physical function in patients with PsA, underscoring the need for early therapeutic intervention in this population to limit the burden of bone damage.

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Simon D, Kleyer A, Faustini F, et al. Simultaneous quantification of bone erosions and enthesiophytes in the joints of patients with psoriasis or psoriatic arthritis – effects of age and disease duration.  Arthritis Res Ther. 2018;20(1):203.