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Nearly 30% of patients with cutaneous psoriasis (PsO) developed psoriatic arthritis (PsA). Among these patients 20 % will have severe destructive arthritis. The risk of developing PsA is significantly higher in patients with nail involvement (OR = 2.24; 95% CI [1.26-3.98]). The risk is particularly high for the peripheral form of PsA and onycholysis (OR=2.80; 95% CI [1.34-5.85]).
Thus the investigators wanted to test the hypothesis that onycholysis, in patients without PsA, is a potential clinical marker of subclinical distal enthesopathy and, by extension, of bone micro-structural alterations.
Patients and Methods
The investigators will recruit 4 groups of subjects:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with peripheral PsA |
| ||
| Patients with psoriatic nail onycholysis |
| ||
| Patients with PsO only |
| ||
| Healthy match control subjects |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HR-pQCT High resolution peripheral quantitative CT-scan | Radiation | HR-pQCT is a powerful device providing low dose irradiation already used in bone field. It is a high resolution tool (voxel size=82µm) that the investigators adapted to look after the distal joint involved by onycholysis. An anteroposterior scout view is used to define the region of interest (ROI), which spanned from the top of the distal phalange to the distal part of the intermediate phalange in order to contain the distal joint of the target finger. Images are then analysed for erosions, osteophytes and volumetric bone mineral density. |
| Measure | Description | Time Frame |
|---|---|---|
| distal phalangeal bone erosion of the 2 index fingers of the hand | assessment by HR-pQCT | at baseline and after 4 years of follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| enthesopathy of the 2 index fingers of the hand | assessment by ultrasonography | at baseline and after 4 years of follow-up |
| Rheumatoid factors | Biomarkers are assessed at baseline |
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Inclusion Criteria:
Exclusion Criteria:
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PSUPSO is a prospective study. Diagnosis of PsA is based on the CASPAR criteria (Taylor 2006). PASI, NAPSI and NAPSI target are recorded. PsO patients are gender and age matched with onycholysis patients patients.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Cyrille Confavreux, MD PHD | Contact | (0)4 72 11 74 79 | +33 | cyrille.confavreux@chu-lyon.fr |
| Céline Coutisson, clinical research assistant | Contact | (0)4 72 11 74 46 | +33 | centre.prevention@wanadoo.fr |
| Name | Affiliation | Role |
|---|---|---|
| Cyrille Confavreux, MD PHD | Hospices Civils de Lyon, France | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre des Métastases Osseuses (CEMOS) Pavillon F - Rhumatology Hôpital Edouard Herriot, 5 place d'Arsonval | Recruiting | Lyon | 69003 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32885241 | Derived | Villani AP, Boutroy S, Coutisson C, Carlier MC, Barets L, Marotte H, Richert B, Chapurlat RD, Jullien D, Confavreux CB. Distal phalangeal bone erosions observed by HR-pQCT in patients with psoriatic onycholysis. Rheumatology (Oxford). 2021 Mar 2;60(3):1176-1184. doi: 10.1093/rheumatology/keaa415. |
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| ID | Term |
|---|---|
| D015535 | Arthritis, Psoriatic |
| D054039 | Onycholysis |
| ID | Term |
|---|---|
| D025242 | Spondylarthropathies |
| D025241 | Spondylarthritis |
| D013166 | Spondylitis |
| D013122 | Spinal Diseases |
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Urine Serum and plasma Whole blood
|
| D001847 |
| Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D011565 | Psoriasis |
| D017444 | Skin Diseases, Papulosquamous |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D009260 | Nail Diseases |