rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2022-445-449rsp-3197Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHВлияние возраста начала псориаза на частоту и клинические характеристики псориатического артрита (по данным регистра пациентов с псориазом РОДВК)Influence of age of onset of psoriasis on prevalence and clinical characteristics of psoriatic arthritis (according to the registry of patients with psoriasis)https://orcid.org/0000-0002-7625-0503КубановА. А.KubanovA. A.

107076, Москва, ул. Короленко, 3, стр. 6

107076, Moscow, Korolenko str., 3, building 6

https://orcid.org/0000-0002-0662-2682БогдановаЕ. В.BogdanovaE. V.

107076, Москва, ул. Короленко, 3, стр. 6

107076, Moscow, Korolenko str., 3, building 6

bogdanova@cnikvi.ruФГБУ «Государственный научный центр дерматовенерологии и косметологии» Минздрава РоссииРоссияState Scientific Center for Dermatovenereology and CosmetologyRussian Federation202206092022604445449Copyright © Кубанов А.А., Богданова Е.В., 20222022Кубанов А.А., Богданова Е.В.Kubanov A.A., Bogdanova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3197

Имеются указания на наличие клинических, иммунологических и генетических различий между пациентами с ранним и поздним началом псориаза. Сравнительные исследования клинических характеристик псориатического артрита (ПсА) в зависимости от возраста начала псориаза крайне малочисленны.

Цель исследования – сравнить частоту и клинические характеристики псориатического артрита у больных, включенных в регистр пациентов с псориазом Российского общества дерматовенерологов и косметологов (РОДВК), в зависимости от возраста начала псориаза (кожных проявлений).

Материалы и методы

Материалы и методы. В исследование включено 3 227 пациентов в возрасте 18 лет и старше с псориазом. Сравнение клинических характеристик ПсА в зависимости от возраста начала псориаза было проведено по данным обследования 916 пациентов с псориазом и ПсА.

Для сравнения количественных переменных использовали U-критерий. Для выявления зависимости между качественными переменными использовали критерий χ2 ; рассчитывали отношение шансов и 95%-й доверительный интервал, в том числе с поправкой на другие независимые переменные.

Результаты

Результаты. У большей части пациентов (73%) псориаз манифестировал в возрасте ≤40 лет. ПсА на момент включения в регистр был диагностирован у 31,7% пациентов с ранним (в возрасте ≤40 лет) и у 19,5% – с поздним (после 40 лет) началом псориаза (р=0,0005).

Вероятность наличия ПсА у пациентов с поздним началом псориаза (ПНП) была почти в 2 раза ниже, чем при раннем начале псориаза (РНП) (р=0,0005). При введении поправки на пол и возраст вероятность наличия ПсА среди пациентов с ПНП была в 4 раза ниже, чем среди пациентов с РНП (р=0,0005). Однако при введении поправки на пол и продолжительность псориаза статистическая значимость различий терялась. Для пациентов с РНП характерно более частое, чем при ПНП, поражение позвоночника (32,1% и 20,5% соответственно; р=0,003) и мелких суставов стоп (59,7% и 51,5% соответственно; р=0,048). Статистическая значимость различий по частоте поражения позвоночника сохранялась при введении поправок на другие независимые переменные.

Выводы

Выводы. РНП ассоциировано с более частым развитием аксиальных изменений при ПсА. 

Сlinical, immunological and genetic differences between patients with early and late onset psoriasis are reported. Comparative studies of clinical characteristics of psoriatic arthritis according to age of psoriasis onset (skin manifestation) are lacking.

Aim – to compare the prevalence and clinical characteristics of psoriatic arthritis depending on age of psoriasis onset (skin manifestation) in patients included to the psoriasis patient registry of Russian Society of Dermatovenereologists and Cosmetologists.

Materials and methods

Materials and methods. Prevalence of psoriatic arthritis in 3,227 patients with psoriasis aged 18 years and older was calculated. Comparison of the clinical characteristics of psoriatic arthritis according to the age of onset of psoriasis was performed on 916 patients with psoriasis and psoriatic arthritis.

The U-test was used to compare quantitative variables. To identify the association between qualitative variables, the χ2 test was used; odds ratio and 95% confidence interval were calculated, unadjusted and adjusted for other independent variables.

Results

Results. In the majority of patients (73%), psoriasis manifested before the age of 40. Psoriatic arthritis at the time of inclusion to the registry was diagnosed in 31.7% of patients with early onset psoriasis and in 19.5% of patients with late onset psoriasis (p=0.0005).

The odds of having psoriatic arthritis were almost two times lower in patients with late onset psoriasis (p=0.0005). When adjusted for sex and age, the odds of having psoriatic arthritis among patients with late onset psoriasis became 4 times lower than in patients with early onset psoriasis (p=0.0005). However, when adjusted for sex and duration of psoriasis, the odds ratio lost its statistical significance.

The axial involvement (32.1% vs 20.5%; p=0.003) and the involvement of foot joints (59.7% vs 51.5%; p=0.048) was more likely in patients with early onset psoriasis. The odds ratio for axial involvement was still statistically significant when adjusted for other independent variables.

Conclusions

Conclusions. Age of onset of psoriasis before 40 years of age is associated with more frequent axial involvement in psoriatic arthritis.

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The authors declare that there are no conflicts of interest present.