Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Spinal Diseases: HELP
Articles by Nehal N. Mehta
Based on 10 articles published since 2010
(Why 10 articles?)
||||

Between 2010 and 2020, Nehal Mehta wrote the following 10 articles about Spinal Diseases.
 
+ Citations + Abstracts
1 Guideline Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. 2019

Elmets, Craig A / Leonardi, Craig L / Davis, Dawn M R / Gelfand, Joel M / Lichten, Jason / Mehta, Nehal N / Armstrong, April W / Connor, Cody / Cordoro, Kelly M / Elewski, Boni E / Gordon, Kenneth B / Gottlieb, Alice B / Kaplan, Daniel H / Kavanaugh, Arthur / Kivelevitch, Dario / Kiselica, Matthew / Korman, Neil J / Kroshinsky, Daniela / Lebwohl, Mark / Lim, Henry W / Paller, Amy S / Parra, Sylvia L / Pathy, Arun L / Prater, Elizabeth Farley / Rupani, Reena / Siegel, Michael / Stoff, Benjamin / Strober, Bruce E / Wong, Emily B / Wu, Jashin J / Hariharan, Vidhya / Menter, Alan. ·University of Alabama, Birmingham, Alabama. · Central Dermatology, St. Louis, Missouri. · Mayo Clinic, Rochester, Minnesota. · University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. · National Psoriasis Foundation, Portland, Oregon. · National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland. · University of Southern California, Los Angeles, California. · Department of Dermatology, University of California San Francisco School of MedicineSan Francisco, California. · Medical College of Wisconsin, Milwaukee, Wisconsin. · Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, New York. · University of Pittsburgh, Pennsylvania. · University of California San Diego, San Diego, California. · Baylor Scott and White, Dallas, Texas. · University Hospitals Cleveland Medical Center, Cleveland, Ohio. · Massachusetts General Hospital, Boston, Massachusetts. · Department of Dermatology, Henry Ford Hospital, Detroit, Michigan. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Dermatology and Skin Surgery, Sumter, South Carolina. · Colorado Permanente Medical Group, Centennial, Colorado. · University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. · Icahn School of Medicine at Mount Sinai, New York, New York. · Emory University School of Medicine, Atlanta, Georgia. · University of Connecticut, Farmington, Connecticut; Probity Medical Research, Waterloo, Canada. · San Antonio Uniformed Services Health Education Consortium, Joint-Base San Antonio, Texas. · Dermatology Research and Education Foundation, Irvine, California. · American Academy of Dermatology, Rosemont, Illinois. Electronic address: vhariharan@aad.org. ·J Am Acad Dermatol · Pubmed #30772097.

ABSTRACT: Psoriasis is a chronic, inflammatory, multisystem disease that affects up to 3.2% of the US population. This guideline addresses important clinical questions that arise in psoriasis management and care, providing recommendations on the basis of available evidence.

2 Editorial Underestimation of Risk of Carotid Subclinical Atherosclerosis by Cardiovascular Risk Scores in Patients with Psoriatic Arthritis: How Far Are We from the Truth? 2018

Belur, Agastya D / Mehta, Nehal N. ·Lasker Clinical Investigator, Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. · Lasker Clinical Investigator, Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. nehal.mehta@nih.gov. ·J Rheumatol · Pubmed #29419446.

ABSTRACT: -- No abstract --

3 Review Psoriasis. 2016

Greb, Jacqueline E / Goldminz, Ari M / Elder, James T / Lebwohl, Mark G / Gladman, Dafna D / Wu, Jashin J / Mehta, Nehal N / Finlay, Andrew Y / Gottlieb, Alice B. ·Tufts University School of Medicine, Boston, Massachusetts, USA. · Tufts Medical Center, Department of Dermatology, Boston, Massachusetts, USA. · Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA. · Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA. · Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. · University of Toronto, Toronto, Ontario, Canada. · Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada. · Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA. · National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. · Department of Dermatology and Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK. · Department of Dermatology, New York Medical College, 40 Sunshine Cottage Rd, Valhalla, New York 10595, USA. ·Nat Rev Dis Primers · Pubmed #27883001.

ABSTRACT: Psoriasis is a chronic, immune-mediated disorder with cutaneous and systemic manifestations and substantial negative effects on patient quality of life. Psoriasis has a strong, albeit polygenic, genetic basis. Whereas approximately half of the accountable genetic effect of psoriasis maps to the major histocompatibility complex, >70 other loci have been identified, many of which implicate nuclear factor-κB, interferon signalling and the IL-23-IL-23 receptor axis. Psoriasis pathophysiology is characterized by abnormal keratinocyte proliferation and immune cell infiltration in the dermis and epidermis involving the innate and adaptive immune systems, with important roles for dendritic cells and T cells, among other cells. Frequent comorbidities are rheumatological and cardiovascular in nature, in particular, psoriatic arthritis. Current treatments for psoriasis include topical agents, photo-based therapies, traditional systemic drugs and biologic agents. Treatments can be used in combination or as monotherapy. Biologic therapies that target specific disease mediators have become a mainstay in the treatment of moderate-to-severe disease, whereas advances in the treatment of mild-to-moderate disease have been limited.

4 Article Cardiovascular Diseases in Psoriasis and Psoriatic Arthritis. 2019

Eder, Lihi / Dey, Amit / Joshi, Aditya A / Boehncke, Wolf-Henning / Mehta, Nehal N / Szentpetery, Agnes. ·From the Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; Laboratory of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, Maryland, USA; Division of Dermatology and Venereology, Geneva University Hospitals, and Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland; Department of Rheumatology, Uppsala University Hospital, Uppsala, Sweden. Lihi.EDER@wchospital.ca. · L. Eder, MD, PhD, Women's College Research Institute, Women's College Hospital, University of Toronto; A. Dey, MD, Laboratory of Inflammation and Cardiometabolic Diseases, NHLBI, NIH; A.A. Joshi, MD, Laboratory of Inflammation and Cardiometabolic Diseases, NHLBI, NIH; W.H. Boehncke, MD, Professor and Chair, Division of Dermatology and Venereology, Geneva University Hospitals, and Department of Pathology and Immunology, University of Geneva; N.N. Mehta, MD, MSCE, Laboratory of Inflammation and Cardiometabolic Diseases, NHLBI, NIH; A. Szentpetery, MD, PhD, Department of Rheumatology, Uppsala University Hospital. Lihi.EDER@wchospital.ca. · From the Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; Laboratory of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, Maryland, USA; Division of Dermatology and Venereology, Geneva University Hospitals, and Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland; Department of Rheumatology, Uppsala University Hospital, Uppsala, Sweden. · L. Eder, MD, PhD, Women's College Research Institute, Women's College Hospital, University of Toronto; A. Dey, MD, Laboratory of Inflammation and Cardiometabolic Diseases, NHLBI, NIH; A.A. Joshi, MD, Laboratory of Inflammation and Cardiometabolic Diseases, NHLBI, NIH; W.H. Boehncke, MD, Professor and Chair, Division of Dermatology and Venereology, Geneva University Hospitals, and Department of Pathology and Immunology, University of Geneva; N.N. Mehta, MD, MSCE, Laboratory of Inflammation and Cardiometabolic Diseases, NHLBI, NIH; A. Szentpetery, MD, PhD, Department of Rheumatology, Uppsala University Hospital. ·J Rheumatol Suppl · Pubmed #31154400.

ABSTRACT: Patients with psoriatic disease have an increased risk of developing cardiovascular (CV) events. Recent advances in imaging and biomarker research provide insights into the underlying mechanisms that link these conditions. Here, we summarize recent work in this field that was presented at the July 2018 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) annual meeting in Toronto, Ontario, Canada. The presentations highlighted recent data about the association between psoriasis and vascular inflammation, the use of coronary angiogram to investigate CV outcomes, new approaches for CV risk stratification, and the shared pathomechanisms of psoriasis and atherosclerosis.

5 Article Coronary artery plaque characteristics and treatment with biologic therapy in severe psoriasis: results from a prospective observational study. 2019

Elnabawi, Youssef A / Dey, Amit K / Goyal, Aditya / Groenendyk, Jacob W / Chung, Jonathan H / Belur, Agastya D / Rodante, Justin / Harrington, Charlotte L / Teague, Heather L / Baumer, Yvonne / Keel, Andrew / Playford, Martin P / Sandfort, Veit / Chen, Marcus Y / Lockshin, Benjamin / Gelfand, Joel M / Bluemke, David A / Mehta, Nehal N. ·Section of Inflammation and Cardiometabolic Disease, National Heart, Lung, and Blood Institute; National Institutes of Health, Bethesda, MD, USA. · DermAssociates, Silver Spring, MD, USA. · Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA. · Department of Radiology, University of Wisconsin, Madison, WI, USA. ·Cardiovasc Res · Pubmed #30721933.

ABSTRACT: AIMS: The use of biologic therapy has increased over the past decade well beyond primary autoimmune diseases. Indeed, a recent trial using an anti-IL-1beta antibody reduced second myocardial infarction (MI) in those who have had MI. Psoriasis is a chronic inflammatory disease often treated with biologics when severe, is associated with increased risk of MI, in part driven by high-risk coronary plaque phenotypes by coronary computed tomography angiography (CCTA). We hypothesized that we would observe a reduction in inflammatory-driven phenotypes of coronary plaque, including non-calcified coronary plaque burden and lipid-rich necrotic core in those treated with biologic therapy after one-year compared with non-biologic therapy. METHODS AND RESULTS: In a prospective, observational study, 290 participants were recruited from 1 January 2013 through 31 October 2018 with 215 completing one-year follow-up. Of the 238, 121 consecutive participants who were biologic treatment naïve at baseline were included. A blinded reader (blinded to patient demographics, visit and treatment) quantified total coronary plaque burden and plaque subcomponents (calcified and non-calcified) in the three main coronary vessels >2 mm using dedicated software (QAngio, Medis, Netherlands). Psoriasis patients were middle-aged [mean (standard deviation) age, 50.5 (12.1) years], mostly male (n = 70, 58%) with low cardiovascular risk by Framingham score [median (interquartile range, IQR), 3 (1-6)] and had moderate to severe skin disease at baseline [median (IQR) Psoriasis Area Severity Index, PASI, 8.6 (5.3-14.0)]. Biologic therapy was associated with a 6% reduction in non-calcified plaque burden (P = 0.005) reduction in necrotic core (P = 0.03), with no effect on fibrous burden (P = 0.71). Decrease in non-calcified plaque burden in the biologic treated group was significant compared with slow plaque progression in non-biologic treated (Δ, -0.07 mm2 vs. 0.06 mm2; P = 0.02) and associated with biologic treatment beyond adjustment for traditional cardiovascular risk factors (β = 0.20, P = 0.02). CONCLUSION: In this observational study, we demonstrate that biologic therapy in severe psoriasis was associated with favourable modulation of coronary plaque indices by CCTA. These findings highlight the importance of systemic inflammation in coronary artery disease and support the conduct of larger, randomized trials.

6 Article Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review. 2018

Ford, Adam R / Siegel, Michael / Bagel, Jerry / Cordoro, Kelly M / Garg, Amit / Gottlieb, Alice / Green, Lawrence J / Gudjonsson, Johann E / Koo, John / Lebwohl, Mark / Liao, Wilson / Mandelin, Arthur M / Markenson, Joseph A / Mehta, Nehal / Merola, Joseph F / Prussick, Ronald / Ryan, Caitriona / Schwartzman, Sergio / Siegel, Evan L / Van Voorhees, Abby S / Wu, Jashin J / Armstrong, April W. ·Keck School of Medicine, University of Southern California, Los Angeles. · National Psoriasis Foundation, Portland, Oregon. · Psoriasis Treatment Center of Central New Jersey, East Windsor. · Department of Dermatology, University of California San Francisco. · Department of Pediatrics, University of California San Francisco. · Department of Dermatology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York. · New York Medical College at Metropolitan Hospital, New York. · Hudson Dermatology, Somers, New York. · Department of Dermatology, George Washington University School of Medicine, Washington, DC. · Department of Dermatology, University of Michigan, Ann Arbor. · Icahn School of Medicine at Mount Sinai, New York, New York. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Hospital for Special Surgery, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York. · National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. · Brigham and Women's Hospital, Harvard University, Boston, Massachusetts. · Blackrock Clinic, Dublin, Ireland. · Arthritis and Rheumatism Associates, PC, Rockville, Maryland. · Georgetown University School of Medicine, Washington, DC. · Department of Dermatology, Eastern Virginia Medical School, Norfolk. · Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California. ·JAMA Dermatol · Pubmed #29926091.

ABSTRACT: Importance: Psoriasis is a chronic, inflammatory skin disease and has significant associated morbidity and effect on quality of life. It is important to determine whether dietary interventions help reduce disease severity in patients with psoriatic diseases. Objective: To make evidence-based dietary recommendations for adults with psoriasis and/or psoriatic arthritis from the Medical Board of the National Psoriasis Foundation. Evidence Review: We used literature from prior systematic reviews as well as additional primary literature from the MEDLINE database from January 1, 2014, to August 31, 2017, that evaluated the impact of diet on psoriasis. We included observational and interventional studies of patients with psoriasis or psoriatic arthritis. The quality of included studies was assessed using the Newcastle-Ottawa scale for observational studies and the Cochrane Risk of Bias Tool for interventional studies. We made evidence-based dietary recommendations, which were voted on by the National Psoriasis Foundation Medical Board. Findings: We identified 55 studies meeting the inclusion criteria for this review. These studies represent 77 557 unique participants of which 4534 have psoriasis. Based on the literature, we strongly recommend dietary weight reduction with a hypocaloric diet in overweight and obese patients with psoriasis. We weakly recommend a gluten-free diet only in patients who test positive for serologic markers of gluten sensitivity. Based on low-quality data, select foods, nutrients, and dietary patterns may affect psoriasis. For patients with psoriatic arthritis, we weakly recommend vitamin D supplementation and dietary weight reduction with a hypocaloric diet in overweight and obese patients. Dietary interventions should always be used in conjunction with standard medical therapies for psoriasis and psoriatic arthritis. Conclusions and Relevance: Adults with psoriasis and/or psoriatic arthritis can supplement their standard medical therapies with dietary interventions to reduce disease severity. These dietary recommendations from the National Psoriasis Foundation Medical Board will help guide clinicians regarding the utility of dietary interventions in adults with psoriatic diseases.

7 Article Risk of venous thromboembolism in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a general population-based cohort study. 2018

Ogdie, Alexis / Kay McGill, Neilia / Shin, Daniel B / Takeshita, Junko / Jon Love, Thorvardur / Noe, Megan H / Chiesa Fuxench, Zelma C / Choi, Hyon K / Mehta, Nehal N / Gelfand, Joel M. ·Division of Rheumatology, Department of Medicine, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, White Building, Room 5024, 3400 Spruce St, Philadelphia, PA, USA. · Division of Rheumatology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. · Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, South Tower, 7th Floor, 3400 Civic Center Blvd, Philadelphia, PA, USA. · Department of Dermatology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. · Division of Rheumatology/Department of Medicine, Faculty of Medicine, University of Iceland, Reykjavik, Iceland. · Department of Science, Landspitali University Hospital, Reykjavik, Iceland. · Division of Rheumatology and Allergy/Immunology, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 165, Boston, MA, USA. · Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, 10 Center Drive, Bethesda, MD, USA. · Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, 8th Floor, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, USA. ·Eur Heart J · Pubmed #28444172.

ABSTRACT: Aims: To determine the risk of venous thromboembolism (VTE) defined as the combined endpoint of deep venous thrombosis (DVT) and pulmonary embolism (PE) among patients with psoriatic arthritis (PsA), psoriasis and rheumatoid arthritis (RA) compared with population controls. Methods and results: A cohort study was conducted in a primary care medical record database in the UK with data from 1994-2014 among patients with PsA, RA, or psoriasis. Cox proportional hazards models were used to calculate the relative hazards for DVT, PE, and VTE. An interaction with disease modifying anti-rheumatic drugs (DMARD) was hypothesized a priori and was significant. Patients with PsA (n = 12 084), RA (n = 51 762), psoriasis (n = 194 288) and controls (n = 1 225 571) matched on general practice and start date were identified. Patients with RA (with and without a DMARD prescription) and patients with mild psoriasis had significantly elevated risks of VTE (HR 1.35, 1.29, and 1.07, respectively) after adjusting for traditional risk factors. Severe psoriasis and PsA prescribed a DMARD had an elevated but not statistically significant risk for VTE. Findings were similar for DVT. The age-and-sex-adjusted risk of PE was elevated in RA, severe psoriasis and PsA patients prescribed a DMARD. Conclusion: While systemic inflammation is a risk factor for VTE, the risk of VTE compared with controls is different among patients with three different inflammatory disorders: RA, PsA, and psoriasis.

8 Article Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. 2015

Ogdie, Alexis / Yu, YiDing / Haynes, Kevin / Love, Thorvardur Jon / Maliha, Samantha / Jiang, Yihui / Troxel, Andrea B / Hennessy, Sean / Kimmel, Steven E / Margolis, David J / Choi, Hyon / Mehta, Nehal N / Gelfand, Joel M. ·Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA. · Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. · University of Iceland, Reykjavik, Iceland. · New York University School of Medicine, New York, NY, USA. · Division of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Department of Medicine, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Center for Therapeutic Effectiveness Research, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Department of Dermatology, Center for Clinical Epidemiology and Biostatistics, Center for Dermatoepidemiology and Translation, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Section of Rheumatology and the Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA. · Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA. · Department of Dermatology, Center for Clinical Epidemiology and Biostatistics, Center for Dermatoepidemiology and Translation, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. ·Ann Rheum Dis · Pubmed #25351522.

ABSTRACT: OBJECTIVES: We aimed to quantify the risk of major adverse cardiovascular events (MACE) among patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA) and psoriasis without known PsA compared with the general population after adjusting for traditional cardiovascular risk factors. METHODS: A population-based longitudinal cohort study from 1994 to 2010 was performed in The Health Improvement Network (THIN), a primary care medical record database in the UK. Patients aged 18-89 years of age with PsA, RA or psoriasis were included. Up to 10 unexposed controls matched on practice and index date were selected for each patient with PsA. Outcomes included cardiovascular death, myocardial infarction, cerebrovascular accidents and the composite outcome (MACE). Cox proportional hazards models were used to calculate the HRs for each outcome adjusted for traditional risk factors. A priori, we hypothesised an interaction between disease status and disease-modifying antirheumatic drug (DMARD) use. RESULTS: Patients with PsA (N=8706), RA (N=41 752), psoriasis (N=138 424) and unexposed controls (N=81 573) were identified. After adjustment for traditional risk factors, the risk of MACE was higher in patients with PsA not prescribed a DMARD (HR 1.24, 95% CI 1.03 to 1.49), patients with RA (No DMARD: HR 1.39, 95% CI 1.28 to 1.50, DMARD: HR 1.58, 95% CI 1.46 to 1.70), patients with psoriasis not prescribed a DMARD (HR 1.08, 95% CI 1.02 to 1.15) and patients with severe psoriasis (DMARD users: HR 1.42, 95% CI 1.17 to 1.73). CONCLUSIONS: Cardiovascular risk should be addressed with all patients affected by psoriasis, PsA or RA.

9 Article Psoriatic arthritis and sacroiliitis are associated with increased vascular inflammation by 18-fluorodeoxyglucose positron emission tomography computed tomography: baseline report from the Psoriasis Atherosclerosis and Cardiometabolic Disease Initiative. 2014

Rose, Shawn / Dave, Jenny / Millo, Corina / Naik, Haley B / Siegel, Evan L / Mehta, Nehal N. · ·Arthritis Res Ther · Pubmed #25078679.

ABSTRACT: INTRODUCTION: Psoriasis and psoriatic arthritis (PsA) increase cardiovascular disease (CVD) risk, but surrogate markers for CVD in these disorders are inadequate. Because the presence of sacroiliitis may portend more severe PsA, we hypothesized that sacroiliitis defined by computed tomography (CT) would be associated with increased vascular inflammation defined by 18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), which is an established measure of CVD. METHODS: Participants (n = 65) underwent whole-body FDG-PET/CT. Metabolic activity of the aorta was measured using the maximal standardized uptake value (SUVmax), a measure of atherosclerotic plaque activity. The primary outcome was aortic vascular inflammation. Linear regression (with β-coefficients (β) and P-values reported for PsA and sacroiliitis) was used to adjust for CVD risk factors to determine associations of PsA or sacroiliitis with vascular inflammation. Likelihood ratio testing was performed to evaluate the contribution of sacroiliitis to vascular disease estimation compared to the effects of PsA and traditional CVD risk factors. RESULTS: Vascular inflammation (measured as SUVmax) was greater (P < 0.001) in patients with sacroiliitis (mean ± SD = 7.33 ± 2.09) defined by CT compared to those without sacroiliitis (6.39 ± 1.49, P = 0.038). There were associations between PsA and aortic inflammation (β = 0.124, P < 0.001) and between sacroiliitis and aortic inflammation (β = 0.270, P < 0.001) after adjusting for CVD risk factors. Sacroiliitis predicted vascular inflammation beyond PsA and CVD risk factors (χ2 = 124.6, P < 0.001). CONCLUSIONS: Sacroiliitis is associated with increased vascular inflammation detected by FDG-PET/CT, suggesting that sacroiliac joint disease may identify patients at greater risk for CVD. Large, ongoing prospective studies are required to confirm these findings.

10 Article Prevalence and treatment patterns of psoriatic arthritis in the UK. 2013

Ogdie, Alexis / Langan, Sinéad / Love, Thorvardur / Haynes, Kevin / Shin, Daniel / Seminara, Nicole / Mehta, Nehal N / Troxel, Andrea / Choi, Hyon / Gelfand, Joel M. ·Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 8 Penn Tower, 1 Convention Ave, Philadelphia, PA 19104, USA. alexis.ogdie@uphs.upenn.edu ·Rheumatology (Oxford) · Pubmed #23221331.

ABSTRACT: OBJECTIVES: The objectives of this study were to determine the prevalence of PsA in The Health Improvement Network (THIN), a large population-based medical records database in the UK, to examine factors associated with prevalent PsA among patients with psoriasis and to describe the use of DMARDs in patients with PsA. METHODS: Two cohorts were derived from THIN to examine the prevalence of PsA in a cross-sectional study among all patients aged 18-90 years and among a subcohort of 4900 psoriasis patients aged 45-65 years. Prescription codes were used to describe therapies after the diagnosis of PsA. Associations for prevalent PsA among psoriasis patients were assessed using logistic regression analysis. RESULTS: Among 4.8 million patients in THIN between the ages of 18 and 90 years, 9045 patients had at least one medical code for PsA, giving an overall prevalence of 0.19% (95% CI 0.19%, 0.19%). Of those patients, 45.9% with PsA have been prescribed DMARDs. Among the 4064 confirmed psoriasis patients, the prevalence of PsA was 8.6% (95% CI 7.7%, 9.5%). PsA was more prevalent among patients with severe psoriasis [odds ratio (OR) 3.34; 95% CI 2.40, 4.65], obesity (OR 1.77; 95% CI 1.30, 2.41) and duration of psoriasis for ≥10 years (OR 7.42; 95% CI 3.86, 14.25) in the fully adjusted model. CONCLUSION: The prevalence of PsA in THIN is consistent with previous population-based estimates. Limitations include a definition of PsA based on a diagnostic code rather than Classification Criteria for Psoriatic Arthritis (CASPAR) criteria. Given the large population of PsA patients, THIN is an important resource for the study of PsA.