MetS and Radiographic Damage in PsA: Is There a Link?

TOPLINE:

In patients with psoriatic arthritis (PsA), metabolic syndrome (MetS) was associated with degenerative and metabolic changes in the spine and entheses but not with more severe peripheral or axial radiographic damage.

METHODOLOGY:

• Researchers assessed 1422 patients with PsA (mean age, 44.43 years; 55.5% men) who were prospectively followed between 1978 and 2024 at the University of Toronto PsA Clinic. Patients were evaluated according to a standard protocol every 6-12 months.
• The patients underwent radiographic assessment of the peripheral joints and spine at baseline and every 2 years.
• The presence of syndesmophytes, atlantoaxial subluxation, degenerative disc disease, calcaneal spurs, and diffuse idiopathic skeletal hyperostosis was also recorded.

TAKEAWAY:

• Overall, 28.1% of patients had MetS at baseline, and 58.79% ever had a record of MetS over the median follow-up period of 10.59 years.
• Significant associations were observed between MetS and plantar and/or Achilles calcaneal spurs (odds ratio [OR], 2.32; 95% CI, 1.69-3.18), diffuse idiopathic skeletal hyperostosis (OR, 2.00; 95% CI, 1.28-3.13), and degenerative disc disease (OR, 1.51; 95% CI, 1.11-2.04).
• However, MetS was not associated with peripheral damage (assessed as the radiographic damaged joint count) or axial damage (assessed as the presence of sacroiliitis or syndesmophytes).

IN PRACTICE:

“These imaging changes, while not being inherent radiographic features of PsA, may have untoward impacts on patient symptoms and quality of life,” the authors wrote.

SOURCE:

This study was led by Fadi Kharouf, MD, who is affiliated with the Gladman-Krembil Psoriatic Arthritis Research Program at the Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, and the University of Toronto, both located in Toronto, Ontario, Canada. It was published online on March 2, 2025, in Arthritis Care & Research.

LIMITATIONS:

This study had a retrospective design and was conducted at a single center, which may have affected the generalizability of the findings.

DISCLOSURES:

The Gladman-Krembil Psoriatic Arthritis Research Program was funded by the Schroeder Arthritis Institute and a grant from the Krembil Foundation. Two authors reported receiving grants from the Krembil Foundation and consulting fees from various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.