Oxford Textbook of Psoriatic Arthritis (Oxford Textbooks in Rheumatology)

 

Description:

 

 

Psoriatic arthritis, or PsA, is now acknowledged the second most prevalent and important inflammatory arthropathy worldwide. The addition of this new textbook on PsA is a fitting and important inclusion to the Oxford Textbooks in Rheumatology series, written to reflect the significant advances in the field in recent years. With the recent advances in the understanding of pathogenesis, and the development of novel therapies, the Oxford Textbook of Psoriatic Arthritis provides a comprehensive overview of the disease. Each chapter is written by leading clinicians and scientists in the field of psoriatic arthritis, to provide a contemporary view of PsA, and a look into the future directions of research. Covering everything from epidemiology and diagnosis to genetics and pathology, detailed sections on treatment and outcomes provide an invaluable resource for the clinician. The book is also highly illustrated with both clinical images such as x-rays and histological photographs to aid clinical knowledge, and diagrams of the immunology and genetics that underlie the disease. Practical and all-inclusive, with summary boxes to distil the most important information, the Oxford Textbook of Psoriatic Arthritis will prove an invaluable resource for rheumatologists, dermatologists, trainees, and all members of the multidisciplinary team who are interested in recent advances in PsA.

 

 

Table of Contents:

 

 

List of contributors

Abbreviations

Introduction

1 Introduction

Epidemiology

2 Epidemiology of psoriasis

Prevalence

Incidence

Principal causes

Environmental and behavioural risk factors

Natural history and prognosis

Comorbid diseases in psoriasis

Cardiometabolic disease

Malignancy

Gastrointestinal disease

Inflammatory bowel disease

Psychiatric disorders

Chronic kidney disease

Other emerging comorbidities

3 Epidemiology of psoriatic arthritis

Introduction

Epidemiology

Screening

Conclusion

Pathogenesis

4 Overview of psoriatic arthritis pathogenesis

Introduction

Is psoriatic arthritis an autoimmune disease or autoinflammatory disease?

Aetiology of psoriatic arthritis

Immunogenetics

Environmental factors

Inflammatory process in psoriatic disease: the histopathology of psoriatic arthritis

Synovitis

Synovial fluid

Enthesitis

Osteitis and juxta-articular bone involvement

Bone remodelling in PsA: specific tissue responses in PsA

Cellular and molecular compartments involved in psoriatic arthritis

Cellular compartment

Molecular compartment

Conclusion

5 Genetics of psoriasis

Impact of psoriasis

Genetic epidemiology of psoriasis

Historical aspects of psoriasis genetics

HLA association studies

Linkage studies

Psoriasis genetics in the 21st century

DNA sequencing

Microarray-based genotyping

HLA associations in psoriasis—what do they mean?

Participation of multiple HLA alleles

HLA-B amino acid 45 distinguishes PsA from PsC

Altered regulation of HLA-C*06

Presentation of other antigens by HLA-C*06

Future genetic studies of psoriasis: Challenges and opportunities

Summary

6 Genetics of psoriatic arthritis

Introduction

Genetic epidemiology of PsA

Genetics of PsA

MHC genetics

Genetic heterogeneity within the overall psoriasis or psoriatic disease phenotype

Genetic heterogeneity of psoriatic arthritis

Architecture and function of HLA molecules encoded by susceptibility alleles

Interval between the onset of psoriasis and the development of PsA

Relationship of PsA allelic heterogeneity to PsA phenotypic heterogeneity

Axial involvement in psoriatic arthritis is more strongly associated with HLA-B*08 rather than HLA-B*27

Genotypic associations of other clinical features of the heterogeneous PsA phenotype

Genotypic contributions to phenotype assessed by propensity analysis

Limitations and future directions

Implication of genetic and phenotypic heterogeneity on personalized medicine

Potential impact of genotypic and phenotypic heterogeneity on psoriatic arthritis classification, diagnosis criteria, and therapeutic trials

Non-MHC genetics

Barrier integrity

Innate immunity

Antigen presentation

Adaptive immunity

7 Immunology and cytokine pathways

Introduction

Cytokine networks

Cellular composition of PsA synovial pathology

Enthesitis in spondyloarthritis

Serum markers of immune activity

New concepts of pathogenesis

The innate immune system

Innate and adaptive immune cells in psoriatic arthritis

γδ T cells

NK cells

Innate lymphoid cells

MAIT cells

Dendritic cells

CD4 cells

CD8 cells

Conclusion

8 Mechanisms of bone destruction and proliferation in psoriatic arthritis

Introduction

Basics of bone development, growth, and homeostasis

Structural damage in psoriatic arthritis

The anatomic basis of bone destruction and remodelling in psoriatic arthritis

The molecular basis of tissue destruction and remodelling in psoriatic arthritis

Joint destruction

New bone formation and ankylosis

Clinical relevance of joint destruction and remodelling

Therapeutic strategies

Conclusion

Clinical features

9 Psoriasis: skin and nails

Clinical features

Inverse psoriasis

Sebopsoriasis

Palmoplantar psoriasis and Palmoplantar pustulosis

Nail psoriasis

Ethnicity

Gender

Pathophysiology

Genetics of psoriasis

Environmental factors

Human immunodeficiency virus infection

Medications

Anti-TNF biologics

Psychological distress

Ultraviolet radiation/sunlight

Physical trauma

Cigarette smoking

Alcohol misuse

Obesity and metabolic syndrome

Cardiovascular disease

Measurement of psoriasis severity and outcome measures

10 Peripheral arthritis

Introduction

Symmetrical polyarthritis

Asymmetrical oligoarthritis

Distal interphalangeal arthritis

Arthritis mutilans

Psoriatic arthritis ‘sine psoriasis’

Laboratory tests and imaging for diagnosis

Differential diagnosis

Prognosis

11 Enthesitis

Definition, clinical evaluation and differential diagnosis

Definition, clinical relevance and prevalence

Clinical evaluation, including outcome measures

Differential diagnosis

Pathogenesis

Linking enthesitis and synovitis: the synovial-entheseal complex

Immunogenetics of PsA enthesitis

Immunopathology of human enthesitis

Animal models of enthesitis

Imaging modalities

Ultrasound findings in patients with psoriasis only: the preclinical phase of PsA?

Treatment

Research agenda

12 Dactylitis

Introduction

Clinical aspects

Imaging

Clinimetric assessment

Therapy

13 Axial disease

Introduction

Clinical manifestations of axial PsA

Imaging of axial PsA

Diagnosis of axial PsA (including differential diagnosis)

Treatment of axial PsA

Conclusion

14 Extra-articular, extra-skin disease

Introduction

Ophthalmological manifestations

Uveitis: background, (differential) diagnosis and prevalence

Uveitis: clinical manifestations

Uveitis: treatment

Gastrointestinal manifestations

Inflammatory bowel disease: clinical manifestations

Inflammatory bowel disease: treatment

Conclusion

15 Co-morbidities

Introduction

Cardiovascular diseases

Conventional cardiovascular diseases

Cardiovascular morbidity

Obesity

Depression

Autoimmune ophthalmic disease

Malignancy

Inflammatory bowel disease

Burden of inflammation and co-morbidities

Screening and treating co-morbidities

The impact of comorbidities

Conclusions

Imaging

16 Plain radiography

Introduction

Historical perspective and the role of plain radiography in defining psoriatic arthritis

Radiographic features of peripheral psoriatic arthritis

Articular erosion

Extra-articular erosions

Osteolysis and psoriatic arthritis mutilans

Osteoproliferation (juxtaarticular/ periosteal) and ankylosis

Radiographic features of psoriatic spondyloarthritis

History of psoriatic spondyloarthritis

Prevalence and associations of psoriatic spondyloarthritis

Distribution and distinguishing features of psoriatic spondyloarthritis and ankylosing spondylitis

Measurement of radiographic outcome in psoriatic arthritis

Measures of peripheral radiographic damage

Outcome measurement in psoriatic spondyloarthritis

Natural history/prognosis

17 Use of ultrasound in psoriatic arthritis

Introduction

Enthesitis

Sonographic indices

Nail disease

Synovitis

Dactylitis

Conclusion

18 MRI

Introduction

History of MRI and psoriatic arthritis

MRI interpretation considerations

Evaluation of different joints in psoriatic arthritis

Knee joint and other large joints

Imaging of hand metacarpophalangeal and proximal interphalangeal joints

Imaging of hand distal interphalangeal joint disease

DIP joint disease in psoriatic arthritis and osteoarthritis

The nail

Dactylitis

The SAPHO syndrome

Spine and sacroiliac joints

The sacroiliac joint

The foot

Other manifestations

Measuring MRI changes

Other MRI techniques

Summary

19 Assessment of joint and bone structure in PsA patients: Using high-resolution computed tomography

Introduction

Local bone erosions in PsA

Enthesiophyte formation in PsA

Systemic bone loss in PsA

Summary

Diagnosis and classification

20 Diagnosis and classification criteria

The difference between diagnosis and classification

Clues to the diagnosis of psoriatic arthritis in a clinical setting

Symptoms and signs

Predictors of PsA within psoriasis patients

Investigations—blood tests and imaging

Historical development of classification criteria for psoriatic arthritis

Moll and Wright

Later modifications

The development of the CASPAR criteria

Accuracy of the CASPAR criteria in established and early disease

Accuracy in development

Testing in prospective studies of established disease

Retrospective application in registries

Use in early disease study

Proposed modifications to the CASPAR criteria

Psoriatic arthritis and axial/peripheral spondyloarthritis

Psoriatic arthritis within the umbrella of spondyloarthritides

Axial and peripheral spondyloarthritides classification criteria

Direct comparison of peripheral spondyloarthritides criteria and CASPAR criteria in psoriatic arthritis

Subtypes of psoriatic arthritis

Classical subtypes proposed by Moll and Wright

Proposed modifications to subtypes

Evolution in subtypes over time

Future evolution of PsA classification criteria

GRAPPA project to define the inflammatory musculoskeletal stem of CASPAR

Outcome and biomarkers

21 The clinical course and outcome of psoriatic arthritis

Introduction

Disease onset and pattern of presentation and progression

Mild non-erosive PsA

Progressive destructive PsA

Spondylitis

Dactylitis and enthesitis

Outcomes of PsA

Remission and minimal disease activity state

Peripheral joint damage

HLA alleles and disease outcome

Physical functioning and work disability

Economic considerations

Mortality

Summary

22 Biomarkers of psoriatic arthritis outcomes

Introduction

Definition and biomarker categorization

Biomarkers of psoriatic arthritis

Serum/plasma protein soluble biomarkers

Tissue protein biomarkers

Biomarkers from synovial fluid

Genomic markers

Transcriptomic markers

Cellular biomarkers

Imaging biomarkers

Challenges in bringing biological markers to clinical practice

Conclusions and future directions

Domains, instruments, and composite scores

23 Domains and instruments

Introduction

Musculoskeletal domains

Skin and nail domains

Patient reported outcome and imaging domains

Present and future directions

Instruments

Peripheral joints

Spine

Sacroiliac joint assessment

Back movements

Finger to floor distance

Schober test

Spine lateral flexion

Cervical flexion–extension and rotation

Other measurements related to spondylitis

Enthesitis

Dactylitis

Skin

Nails

24 Patient-reported outcome measures in psoriatic arthritis

Introduction

Importance of PROs in rheumatology and their advantages as outcome measures

PRO assessment historically in rheumatology

PROs as valid outcomes

Domains of health assessed by PROs in PsA

The PsA OMERACT core set

Domains of health reported in recently published studies of PsA

Domains of health important for PsA patients—qualitative aspects

Specific PROs for PsA

The PsAQoL questionnaire

The PsAID questionnaire

Widely-used PROs in PsA

Single questions used in PsA

Assessment of functional capacity

Generic quality of life measured by the Medical Outcomes Study Short Form-36 (SF36)

Fatigue

Conclusions

25 Composite scores in psoriatic arthritis

Introduction

What are composite scores?

History of composite scores in psoriatic arthritis clinical trials

Utility of composite scores

The GRAPPA composite index study

Response measures

American College of Rheumatology response criteria

Psoriatic arthritis response criteria, PsARC

Psoriatic arthritis Joint Activity Index, PsAJAI

Minimal disease activity, MDA

Composite disease activity measures

Disease activity score for 28 joints (DAS28)

Disease activity for psoriatic arthritis, DAPSA

Composite psoriatic disease activity index, CPDAI

GRAPPA composite score, GRACE

Psoriatic arthritis Disease Activity Score, PASDAS

Comparative studies and overall assessment

Conclusions and future considerations

Treatment

26 Psoriasis treatment

Introduction

Topical therapy

Phototherapy and photochemotherapy

Systemic therapy

Methotrexate

Acitretin

Cyclosporine

Apremilast

Biological therapy

TNF inhibitors

Ustekinumab

Combination therapy

New biological therapies

IL-17 inhibitors

IL-23 inhibitors

Conclusion

27 Approach to management and symptomatic (including non-pharmacologic) management of psoriatic arthritis

General approach to the management of psoriatic arthritis

Symptoms in psoriatic arthritis

Nonsteroidal anti-inflammatory drugs

Intra-articular and soft tissue injections of steroids

Rehabilitation and physical therapy

Surgical management

Summary

28 Synthetic DMARDs

Introduction

sDMARDs as a treatment option for peripheral arthritis

Methotrexate

Leflunomide

Sulfasalazine

Cyclosporin

Apremilast

Responses to treatment of additional musculoskeletal manifestations

Enthesitis

Dactylitis

sDMARDs in axial PsA

Effects of sDMARDs on skin psoriasis in PsA patients

Plaque psoriasis in PsA patients

Nail psoriasis

Effects on extra-musculoskeletal manifestations and comorbidities in PsA patients

Combination therapy with other sDMARDs or with biologicals

sDMARD treatment in patients planning to have children

29 Biologic DMARDs (TNF inhibitors)

Introduction

Traditional DMARDs and PsA: unmet needs

Rationale for the use of TNF inhibitors in PsA

Clinical trial data

Evidence for the efficacy of TNF inhibitors in PsA

Etanercept (Enbrel®)

Infliximab (Remicade®)

Adalimumab (Humira®)

Golimumab (Simponi®)

Certolizumab pegol (Cimzia®)

Safety and tolerability

Current recommendations and clinical practice guidelines

GRAPPA recommendations

EULAR recommendations

General consensus: when to use TNF inhibitors in PsA

Novel treatment concepts involving the use of TNF inhibitors

Early intervention in PsA

Targeted therapy in PsA

Benefits of tight control in PsA

TNF inhibitor switching

Tapering therapy in controlled disease

Combination therapy

Alternative treatment options for treatment failures

Conclusion

30 Biologic treatments for psoriatic arthritis apart from TNF inhibition

Introduction

Targeting the Th17 cell axis in PsA

IL-12/23 inhibition

Ustekinumab

IL-17 inhibition

Secukinumab

Ixekizumab

Brodalumab

Dual TNF and IL-17 inhibitor

IL-23 inhibitors

Guselkumab

Tildrakizumab

Risankizumab

Co-stimulatory blockade modulating T lymphocyte function

Abatacept

IL-6 inhibition

Clazakizumab

B lymphocyte inhibition

Conclusion

31 Small molecules in the treatment of psoriatic arthritis

Introduction

Current treatment landscape

Molecules approved or in phase III trials in PsA

Apremilast

JAK/STAT inhibitors

Fumaric acid esters

Molecular pathways under exploration

Ponesimod

Voclosporin

Molecules postulated to have promise, that were tested but failed

Apilimod

A3 adenosise receptors agonists

Protein kinase C inhibitors

Possible future targets RORγt inhibitors

Conclusion

32 Treatment algorithm and treat to target

Treatment algorithms

Step up vs Step down approaches

Does early treatment improve outcome?

Treat to target

EULAR review of treating to target in SpA

Deciding on a target for treatment in PsA

Potential targets in PsA

The Tight Control of PsA study (TICOPA)

What about comorbidities and other related conditions?

How should these treatment algorithms be adopted in clinical practice?

Future directions

33 Recent progress in psoriatic arthritis and areas for further research

Research agenda

Index

 

An aparitie	18 July 2018
Autor	Oliver FitzGerald, Dafna Gladman
Dimensiuni	227 x 280 x 19 mm
Editura	Oxford University Press
Format	Hardcover
ISBN	9780198737582
Limba	Engleza
Nr pag	336