252 The prevalence of axial involvement in psoriasis or psoriatic arthritis: a systematic review and meta-analysis

Sze, Jeeu Teck; Packham, Jonathan C; Konstantinou, Kika; Blagojevic-Bucknall, Milica; Stynes, Siobhán

Abstract

Background: A significant proportion of patients with psoriasis (PsO) or psoriatic arthritis (PsA) have axial involvement which is associated with more severe peripheral arthritis in PsA. Historically, methods for recognition of axial involvement in psoriatic disease (AxPsA) have varied as different definitions have been used to define axial disease. This is the first attempt to derive a robust prevalence estimate of AxPsA in adult patients with PsO or PsA fulfilling the ClASsification for Psoriatic ARthritis (CASPAR) criteria, and explore variation in prevalence by criteria used to define AxPsA.

Methods: Five electronic databases were searched using a search strategy combining key words and related database-specific subject terms to identify relevant cross-sectional, case-control or longitudinal studies published since the introduction of the CASPAR criteria in 2006. Prevalence figures and 95% confidence intervals (CIs) were extracted or calculated. Included articles were assessed for risk of bias by two independent reviewers. The Cochran Q statistic was used to assess the presence of heterogeneity. Furthermore, I2 statistic was calculated to examine the proportion of variation in the study estimates that could be explained by heterogeneity. Meta-analyses were undertaken using random-effects models.

Results: Twenty-two articles met the eligibility criteria. In patients with established PsA, prevalence estimates for radiographic sacroiliitis ranged from 11% to 46%. The random-effects pooled prevalence was 29% (95% CIs: 24-35) (Table). When only studies defining sacroiliitis using the modified New York criteria (mNYc) for ankylosing spondylitis (AS) and at low risk of bias were pooled, prevalence increased to 33% (95% CIs: 29-37) with reduced but still significant heterogeneity. It was possible to stratify prevalence of radiographic sacroiliitis by sex in five studies. Prevalence was higher for men in all studies with male-to-female prevalence ratios ranging from 1.28 to 2.03. In PsO patients, the prevalence of radiographic sacroiliitis was much lower than in PsA, including two studies reporting mNYc defined sacroiliitis prevalence of 2.8% and 6.0%.

Citation

Sze, J. T., Packham, J. C., Konstantinou, K., Blagojevic-Bucknall, M., & Stynes, S. (2019). 252 The prevalence of axial involvement in psoriasis or psoriatic arthritis: a systematic review and meta-analysis. Rheumatology, 58(Supplement_3), https://doi.org/10.1093/rheumatology/kez107.068

• Journal Article Type: Conference Paper
• Conference Name: British Society for Rheumatology Annual Conference 2019
• Online Publication Date: Apr 12, 2019
• Publication Date: Apr 1, 2019
• Deposit Date: Jun 28, 2023
• Journal: Rheumatology
• Print ISSN: 1462-0324
• Electronic ISSN: 1462-0332
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 58
• Issue: Supplement_3
• DOI: https://doi.org/10.1093/rheumatology/kez107.068
• Keywords: Pharmacology (medical); Rheumatology