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Risk Factors of Gladman et al for Mortality in Patients with Psoriatic Arthritis

Purpose: To identify mortality risk factors in a patient with psoriatic arthritis.

Description

Gladman et al identified risk factors associated with an increased likelihood of death in patients with psoriatic arthritis. This can help identify those patients who might benefit from more aggressive management. The authors are from Toronto, Hamilton and Waterloo in Canada and London in England.


Risk factors for mortality:

(1) previous active and severe disease, as indicated by medication use (NSAIDs, corticosteroids, methotrexate, azathioprine, gold, chloroquine, retinoic acid derivatives, etc.) prior to the initial clinic visit for psoriatic arthritis

(2) an elevated erythrocyte sedimentation rate (ESR > 15 mm/h)

(3) presence of severe radiologic damage (>= 5 joints affected)

 

Protective factors:

(1) presence of nail lesions (either pits or oncholysis

 

Risk Factor

Relative Risk

95% Confidence Interval

prior medication use

1.83

0.93 – 3.60

elevated ESR

3.77

1.31 – 10.83

radiologic damage

3.88

1.32 – 11.35

nail lesions present

0.33

0.14 – 0.76

from Table 4, page 1107


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Specialty

Objective

ICD-10