Axial Psoriatic Arthritis and Corticosteroids

May 16, 2018

Findings from the first study to compare the therapeutic response to corticosteroids in axial psoriatic arthritis and ankylosing spondylitis.

Reference1. Haroon M, Ahmad M, Baig MN, et al. Inflammatory back pain in psoriatic arthritis is significantly more responsive to corticosteroids compared to back pain in ankylosing spondylitis: a prospective, open-labelled, controlled pilot study. Arthritis Res Ther. 2018 Apr 17;20:73. doi:10.1186/s13075-018-1565-4.

Haroon and colleagues¹ in Ireland found that corticosteroids work significantly better on inflammatory back pain in patients with psoriatic arthritis than in those with ankylosing spondylitis.

Thumb through the slides to learn more about the study and for take-home points for physicians.

Photo credit: ©Mirana/Shutterstock.com

Nearly a third of patients with psoriasis who attend dermatology clinics have undiagnosed psoriatic arthritis (PsA). PsA has been associated with joint erosions even after treatment with disease-modifying antirheumatic drugs (DMARDs).

Assessments included spinal pain score (numerical rating scale, 0-10), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Ankylosing Spondylitis Quality of Life (ASQoL), Ankylosing Spondylitis Disease Activity Score (ASDAS), patient global assessment (numeric rating scales, 0-10), number of swollen joints (66/68-joint score), and number of tender entheseal sites (Leeds Enthesitis Index).

When subjects with AS were compared with controls at week 2 of the corticosteroid challenge, there was minimal improvement in ASDAS (1.02 ± 0.30 vs 0.81 ± 0.25, P = .077), but at week 4 there were no significant improvement in ASDAS (0.76 ± 0.27 vs 0.74 ± 0.22, P = .79).

The bottom line: Corticosteroids are far more effective in treating inflammatory back pain in patients with axial PsA than in patients with AS.