TY - JOUR
T1 - Patients with psoriatic arthritis have higher levels of FeNO than those with only psoriasis, which may reflect a higher prevalence of a subclinical respiratory involvement
AU - Damiani, Giovanni
AU - Pacifico, Alessia
AU - Rizzi, Maurizio
AU - Santus, Pierachille
AU - Bridgewood, Charlie
AU - Bragazzi, Nicola Luigi
AU - Adawi, Mohammed
AU - Watad, Abdulla
N1 - <p>Funding Information:<br/>GD is supported by the P50 AR 070590 01A1 National Institute of Arthritis and Musculoskeletal and Skin Diseases.</p><p>Publisher Copyright:<br/>© 2020, International League of Associations for Rheumatology (ILAR).</p><p>Copyright:<br/>Copyright 2020 Elsevier B.V., All rights reserved.</p>
PY - 2020
Y1 - 2020
N2 - Background: Psoriatic arthritis (PsA) patients are often affected by numerous comorbidities. However, contrasting results have been reported with regard to the respiratory involvement in PsA patients. The aim of this study was to evaluate the presence of subclinical airway inflammation in non-smoking PsA patients compared to patients with only psoriasis using the fraction of exhaled nitric oxide (FeNO) as an indirect marker of airway inflammation. Methods: The study included 164 non-smoking psoriatic patients (Psoriasis Area of Severity Index or PASI score ' 10): 82 with and 82 without PsA, who underwent FeNO tests at different flow rates (30, 50, 100, 200 mL/s). PsA patients were evaluated with Disease Activity in PSoriatic Arthritis Score (DAPSA). Both study groups were compared in terms of FeNO values and its association with the PASI score. The correlations between the variables were evaluated by means of Pearson’s coefficient. Results: Patient with PsA had higher levels of FeNO than those with psoriasis but without arthritis (at 30 mL/s, 71.09 ± 18.40 ppb vs 66.88 ± 19.12 ppb (NS); at 50 mL/s, 36.61 ± 9.30 ppb vs 30.88 ± 9.73 ppb (p ' 0.001); at 100 mL/s, 19.09 ± 4.66 ppb vs 16.63 ± 4.90 ppb (p ' 0.001); and at 200 mL/s, 10.88 ± 2.53 ppb vs 9.43 ± 2.55 ppb (p ' 0.001), respectively). PASI score correlated to FeNO only in psoriatic patients without arthritis. However, CASPAR index correlated with FeNO (FeNO30: r = 0.81, p ' 0.001; FeNO50: r = 0.84, p ' 0.001; FeNO100: r = 0.71, p ' 0.001; FeNO200: r = 0.58, p ' 0.001). DAPSA was also correlated with FeNO to all flows (FeNO30: r = 0.43, p ' 0.001; FeNO50: r = 0.33, p ' 0.001; FeNO100: r = 0.34, p ' 0.001; FeNO200: r = 0.25, p ' 0.001). Conclusions: PsA patients seem to have more commonly subclinical airway inflammation than those with only psoriasis. Further studies are needed to replicate these findings.Key Points• Fraction of exhaled nitric oxide (FeNO) is a useful device to detect and monitor airway inflammation not only in asthma but also in systemic inflammatory diseases such as psoriatic arthritis and psoriasis.• Clinicians should be aware to check respiratory diseases in patients with psoriatic arthritis.
AB - Background: Psoriatic arthritis (PsA) patients are often affected by numerous comorbidities. However, contrasting results have been reported with regard to the respiratory involvement in PsA patients. The aim of this study was to evaluate the presence of subclinical airway inflammation in non-smoking PsA patients compared to patients with only psoriasis using the fraction of exhaled nitric oxide (FeNO) as an indirect marker of airway inflammation. Methods: The study included 164 non-smoking psoriatic patients (Psoriasis Area of Severity Index or PASI score ' 10): 82 with and 82 without PsA, who underwent FeNO tests at different flow rates (30, 50, 100, 200 mL/s). PsA patients were evaluated with Disease Activity in PSoriatic Arthritis Score (DAPSA). Both study groups were compared in terms of FeNO values and its association with the PASI score. The correlations between the variables were evaluated by means of Pearson’s coefficient. Results: Patient with PsA had higher levels of FeNO than those with psoriasis but without arthritis (at 30 mL/s, 71.09 ± 18.40 ppb vs 66.88 ± 19.12 ppb (NS); at 50 mL/s, 36.61 ± 9.30 ppb vs 30.88 ± 9.73 ppb (p ' 0.001); at 100 mL/s, 19.09 ± 4.66 ppb vs 16.63 ± 4.90 ppb (p ' 0.001); and at 200 mL/s, 10.88 ± 2.53 ppb vs 9.43 ± 2.55 ppb (p ' 0.001), respectively). PASI score correlated to FeNO only in psoriatic patients without arthritis. However, CASPAR index correlated with FeNO (FeNO30: r = 0.81, p ' 0.001; FeNO50: r = 0.84, p ' 0.001; FeNO100: r = 0.71, p ' 0.001; FeNO200: r = 0.58, p ' 0.001). DAPSA was also correlated with FeNO to all flows (FeNO30: r = 0.43, p ' 0.001; FeNO50: r = 0.33, p ' 0.001; FeNO100: r = 0.34, p ' 0.001; FeNO200: r = 0.25, p ' 0.001). Conclusions: PsA patients seem to have more commonly subclinical airway inflammation than those with only psoriasis. Further studies are needed to replicate these findings.Key Points• Fraction of exhaled nitric oxide (FeNO) is a useful device to detect and monitor airway inflammation not only in asthma but also in systemic inflammatory diseases such as psoriatic arthritis and psoriasis.• Clinicians should be aware to check respiratory diseases in patients with psoriatic arthritis.
KW - Psoriasis
KW - Airway inflammation
KW - CASPAR
KW - FeNO
KW - PASI
KW - Psoriatic arthritis
U2 - 10.1007/s10067-020-05050-2
DO - 10.1007/s10067-020-05050-2
M3 - Article
VL - 39
SP - 2981
EP - 2988
JO - Clinical Rheumatology
JF - Clinical Rheumatology
SN - 0770-3198
IS - 10
ER -