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Psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: a population-based study
OBJECTIVES: Imaging studies in patients with cutaneous psoriasis have demonstrated asymptomatic bone and tendon changes, commonly of the foot and ankle. We sought to determine if patients with cutaneous psoriasis have an increased risk of clinically significant foot and ankle tendinopathy or entheso...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976107/ https://www.ncbi.nlm.nih.gov/pubmed/29862046 http://dx.doi.org/10.1136/rmdopen-2018-000668 |
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author | Lewinson, Ryan T Vallerand, Isabelle A Parsons, Laurie M LaMothe, Jeremy M Frolkis, Alexandra D Lowerison, Mark W Kaplan, Gilaad G Patten, Scott B Barnabe, Cheryl |
author_facet | Lewinson, Ryan T Vallerand, Isabelle A Parsons, Laurie M LaMothe, Jeremy M Frolkis, Alexandra D Lowerison, Mark W Kaplan, Gilaad G Patten, Scott B Barnabe, Cheryl |
author_sort | Lewinson, Ryan T |
collection | PubMed |
description | OBJECTIVES: Imaging studies in patients with cutaneous psoriasis have demonstrated asymptomatic bone and tendon changes, commonly of the foot and ankle. We sought to determine if patients with cutaneous psoriasis have an increased risk of clinically significant foot and ankle tendinopathy or enthesopathy compared with the general population. METHODS: Patients with cutaneous psoriasis and a general population cohort were identified in The Health Improvement Network, a general practice medical records database from the UK. All patients with psoriatic arthritis were excluded. Cox proportional-hazards models (α=0.05) estimated the HR for development of foot and ankle tendinopathy or enthesopathy among patients with psoriasis, with adjustment for numerous covariates. RESULTS: In total, 78 630 patients with cutaneous psoriasis and 5 983 338 persons from the general population were identified. In an unadjusted model, patients with cutaneous psoriasis had a 25% increased risk of developing foot and ankle tendinopathy or enthesopathy compared with the general population (HR 1.25, 95% CI 1.20 to 1.30, p<0.0001). The HR remained unchanged and statistically significant after adjusting for covariates, and in sensitivity analyses. CONCLUSIONS: These data suggest that patients with psoriasis can have foot and ankle tendinopathy or enthesopathy without having psoriatic arthritis, presenting a diagnostic challenge to physicians. Further research is needed to elucidate mechanisms contributing to this increased risk. |
format | Online Article Text |
id | pubmed-5976107 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-59761072018-06-01 Psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: a population-based study Lewinson, Ryan T Vallerand, Isabelle A Parsons, Laurie M LaMothe, Jeremy M Frolkis, Alexandra D Lowerison, Mark W Kaplan, Gilaad G Patten, Scott B Barnabe, Cheryl RMD Open Psoriatic Arthritis OBJECTIVES: Imaging studies in patients with cutaneous psoriasis have demonstrated asymptomatic bone and tendon changes, commonly of the foot and ankle. We sought to determine if patients with cutaneous psoriasis have an increased risk of clinically significant foot and ankle tendinopathy or enthesopathy compared with the general population. METHODS: Patients with cutaneous psoriasis and a general population cohort were identified in The Health Improvement Network, a general practice medical records database from the UK. All patients with psoriatic arthritis were excluded. Cox proportional-hazards models (α=0.05) estimated the HR for development of foot and ankle tendinopathy or enthesopathy among patients with psoriasis, with adjustment for numerous covariates. RESULTS: In total, 78 630 patients with cutaneous psoriasis and 5 983 338 persons from the general population were identified. In an unadjusted model, patients with cutaneous psoriasis had a 25% increased risk of developing foot and ankle tendinopathy or enthesopathy compared with the general population (HR 1.25, 95% CI 1.20 to 1.30, p<0.0001). The HR remained unchanged and statistically significant after adjusting for covariates, and in sensitivity analyses. CONCLUSIONS: These data suggest that patients with psoriasis can have foot and ankle tendinopathy or enthesopathy without having psoriatic arthritis, presenting a diagnostic challenge to physicians. Further research is needed to elucidate mechanisms contributing to this increased risk. BMJ Publishing Group 2018-05-21 /pmc/articles/PMC5976107/ /pubmed/29862046 http://dx.doi.org/10.1136/rmdopen-2018-000668 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Psoriatic Arthritis Lewinson, Ryan T Vallerand, Isabelle A Parsons, Laurie M LaMothe, Jeremy M Frolkis, Alexandra D Lowerison, Mark W Kaplan, Gilaad G Patten, Scott B Barnabe, Cheryl Psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: a population-based study |
title | Psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: a population-based study |
title_full | Psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: a population-based study |
title_fullStr | Psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: a population-based study |
title_full_unstemmed | Psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: a population-based study |
title_short | Psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: a population-based study |
title_sort | psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: a population-based study |
topic | Psoriatic Arthritis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976107/ https://www.ncbi.nlm.nih.gov/pubmed/29862046 http://dx.doi.org/10.1136/rmdopen-2018-000668 |
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