Skip to main content
Erschienen in: Zeitschrift für Rheumatologie 1/2012

01.01.2012 | Leitthema

Diagnostik und Therapie der frühen Psoriasis-Arthritis

verfasst von: Dr. M. Köhm, F. Behrens

Erschienen in: Zeitschrift für Rheumatologie | Ausgabe 1/2012

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die frühzeitige Diagnose der Psoriasis-Arthritis ist von großer Bedeutung. Entgegen älteren Einschätzungen verläuft die Psoriasis-Arthritis häufig bereits zu Beginn der Erkrankung erosiv. Meist ist eine Diagnosestellung durch die Diversität der Symptome bei früher Psoriasis-Arthritis eingeschränkt, das typische Leitsymptom fehlt. Da die meisten Patienten, die eine Psoriasis-Arthritis entwickeln, bereits an einer Psoriasis leiden, ist die interdisziplinäre Zusammenarbeit mit den Dermatologen von tragender Bedeutung, um eine frühe Diagnose zu ermöglichen. Screening-Werkzeuge, wie Fragebögen, ermöglichen bereits in der hausärztlichen oder dermatologischen Praxis die Selektion von Psoriasis-Patienten mit hohem Risiko für das Vorliegen einer Psoriasis-Arthritis. Gerade mit Einführung der CASPAR-Kriterien zur Klassifikation der Psoriasis-Arthritis konnte die Diagnosestellung vereinfacht werden. Therapieempfehlungen wurden durch die Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) erarbeitet. Dabei spielen DMARD- und Biologika-Therapien eine wesentliche Rolle für das Erreichen einer Krankheitskontrolle.
Literatur
1.
Zurück zum Zitat Behrens F (2009) Psoriasisarthritis In: Boehncke WH, Kaufmann R (Hrsg) Evidenz-basierte Therapie der Psoriasis – Schwerpunkt Biologics, Kapitel 5. Uni-Med, Bremen, S 140 Behrens F (2009) Psoriasisarthritis In: Boehncke WH, Kaufmann R (Hrsg) Evidenz-basierte Therapie der Psoriasis – Schwerpunkt Biologics, Kapitel 5. Uni-Med, Bremen, S 140
2.
Zurück zum Zitat Chandran V, Schentag CT, Gladman DD (2007) Sensitivity of the classification of psoriatic arthritis criteria in early psoriatic arthritis. Arthritis Rheum 57(8):1560–1563PubMedCrossRef Chandran V, Schentag CT, Gladman DD (2007) Sensitivity of the classification of psoriatic arthritis criteria in early psoriatic arthritis. Arthritis Rheum 57(8):1560–1563PubMedCrossRef
3.
Zurück zum Zitat Chandran V, Gottlieb A, Cook RJ et al (2009) International multicenter psoriasis and psoriatic arthritis reliability trial for the assessment of skin, joints, nails, and dactylitis. Arthritis Rheum 61(9):1235–1242PubMedCrossRef Chandran V, Gottlieb A, Cook RJ et al (2009) International multicenter psoriasis and psoriatic arthritis reliability trial for the assessment of skin, joints, nails, and dactylitis. Arthritis Rheum 61(9):1235–1242PubMedCrossRef
4.
Zurück zum Zitat Dominguez PL, Husni ME, Holt EW et al (2009) Validity, reliability, and sensitivity-to- change properties of the psoriatic arthritis screening and evaluation questionnaire. Arch Dermatol Res 301(8):573–579PubMedCrossRef Dominguez PL, Husni ME, Holt EW et al (2009) Validity, reliability, and sensitivity-to- change properties of the psoriatic arthritis screening and evaluation questionnaire. Arch Dermatol Res 301(8):573–579PubMedCrossRef
5.
Zurück zum Zitat Erdem CZ, Tekin NS, Sarikaya S et al (2008) MR imaging features of foot involvement in patients with psoriasis. Eur J Radiol 67:521–525PubMedCrossRef Erdem CZ, Tekin NS, Sarikaya S et al (2008) MR imaging features of foot involvement in patients with psoriasis. Eur J Radiol 67:521–525PubMedCrossRef
6.
Zurück zum Zitat Farber E, Nall M (1998) Epidemiology: natural history and genetics. In: Roenigk H, Maibach H (Hrsg) Psoriasis. Marcel Dekker, New York, S 107–158 Farber E, Nall M (1998) Epidemiology: natural history and genetics. In: Roenigk H, Maibach H (Hrsg) Psoriasis. Marcel Dekker, New York, S 107–158
7.
Zurück zum Zitat Gladman DD, Shuckett R, Russell ML et al (1987) Psoriatic arthritis (PsA) – an analysis of 220 patients. Q J Med 62:127–141PubMed Gladman DD, Shuckett R, Russell ML et al (1987) Psoriatic arthritis (PsA) – an analysis of 220 patients. Q J Med 62:127–141PubMed
8.
Zurück zum Zitat Gladman DD, Schentag CT, Tom BD et al (2009) Development and initial validation of a screening questionnaire for psoriatic arthritis: the Toronto Psoriatic Arthritis Screen (ToPAS). Ann Rheum Dis 68(4):497–501PubMedCrossRef Gladman DD, Schentag CT, Tom BD et al (2009) Development and initial validation of a screening questionnaire for psoriatic arthritis: the Toronto Psoriatic Arthritis Screen (ToPAS). Ann Rheum Dis 68(4):497–501PubMedCrossRef
9.
Zurück zum Zitat Gladman DD, Mease PJ, Choy EH et al (2010) Risk factors for radiographic progression in psoriatic arthritis: subanalysis of the randomized controlled trial ADEPT. Arthritis Res Ther 12(3):R113PubMedCrossRef Gladman DD, Mease PJ, Choy EH et al (2010) Risk factors for radiographic progression in psoriatic arthritis: subanalysis of the randomized controlled trial ADEPT. Arthritis Res Ther 12(3):R113PubMedCrossRef
10.
Zurück zum Zitat Gladman DD, Thavaneswaran A, Chandran V et al (2011) Do patients with psoriatic arthritis who present early fare better than those presenting later in the disease? Ann Rheum Dis 70(12):2152–2154PubMedCrossRef Gladman DD, Thavaneswaran A, Chandran V et al (2011) Do patients with psoriatic arthritis who present early fare better than those presenting later in the disease? Ann Rheum Dis 70(12):2152–2154PubMedCrossRef
11.
Zurück zum Zitat Gottlieb A, Menter A, Mendelsohn A et al (2009) Ustekinumab, a human interleukin 12/23 monoclonal antibody, for psoriatic arthritis: randomised, double-blind, placebo-controlled, crossover trial. Lancet 373(9664):633–640PubMedCrossRef Gottlieb A, Menter A, Mendelsohn A et al (2009) Ustekinumab, a human interleukin 12/23 monoclonal antibody, for psoriatic arthritis: randomised, double-blind, placebo-controlled, crossover trial. Lancet 373(9664):633–640PubMedCrossRef
12.
Zurück zum Zitat Härle P, Hartung W, Lehmann P et al (2010) Detection of psoriasis arthritis with the GEPARD patient questionnaire in a dermatologic outpatient setting. Z Rheumatol 69(2):157–160, 162–163PubMedCrossRef Härle P, Hartung W, Lehmann P et al (2010) Detection of psoriasis arthritis with the GEPARD patient questionnaire in a dermatologic outpatient setting. Z Rheumatol 69(2):157–160, 162–163PubMedCrossRef
13.
Zurück zum Zitat Harty L, Veale DJ (2010) How early should psoriatic arthritis be treated with a TNF-blocker? Curr Opin Rheumatol 22(4):393–396PubMedCrossRef Harty L, Veale DJ (2010) How early should psoriatic arthritis be treated with a TNF-blocker? Curr Opin Rheumatol 22(4):393–396PubMedCrossRef
14.
Zurück zum Zitat Hellgren L (1969) Association between rheumatoid arthritis and psoriasis in total populations. Acta Rheumatol Scand 15:316–326PubMed Hellgren L (1969) Association between rheumatoid arthritis and psoriasis in total populations. Acta Rheumatol Scand 15:316–326PubMed
15.
Zurück zum Zitat Ibrahim GH, Buch MH, Lawson C et al (2009) Evaluation of an existing screening tool for psoriatic arthritis in people with psoriasis and the development of a new instrument: the Psoriasis Epidemiology Screening Tool (PEST) questionnaire. Clin Exp Rheumatol 27(3):469–474PubMed Ibrahim GH, Buch MH, Lawson C et al (2009) Evaluation of an existing screening tool for psoriatic arthritis in people with psoriasis and the development of a new instrument: the Psoriasis Epidemiology Screening Tool (PEST) questionnaire. Clin Exp Rheumatol 27(3):469–474PubMed
16.
Zurück zum Zitat Kane D, Stafford L, Bresnihan B et al (2003) A prospective, clinical and radiological study of early psoriatic arthritis: an early synovitis clinic experience. Rheumatology (Oxford) 42:1460–1468 Kane D, Stafford L, Bresnihan B et al (2003) A prospective, clinical and radiological study of early psoriatic arthritis: an early synovitis clinic experience. Rheumatology (Oxford) 42:1460–1468
17.
Zurück zum Zitat Mease P, Genovese MC, Gladstein G et al (2011) Abatacept in the treatment of patients with psoriatic arthritis: results of a six-month, multicenter, randomized, double- blind, placebo-controlled, phase II trial. Arthritis Rheum 63(4):939–948PubMedCrossRef Mease P, Genovese MC, Gladstein G et al (2011) Abatacept in the treatment of patients with psoriatic arthritis: results of a six-month, multicenter, randomized, double- blind, placebo-controlled, phase II trial. Arthritis Rheum 63(4):939–948PubMedCrossRef
19.
Zurück zum Zitat Offidani A, Cellini A, Valeri G et al (1998) Subclinical joint involvements in psoriasis: magnetic resonance imaging and x-ray findings. Acta Derm Venereol 78(6):463–465PubMedCrossRef Offidani A, Cellini A, Valeri G et al (1998) Subclinical joint involvements in psoriasis: magnetic resonance imaging and x-ray findings. Acta Derm Venereol 78(6):463–465PubMedCrossRef
20.
Zurück zum Zitat Radtke M, Reich K, Blome C et al (2009) Prevalence and clinical features of psoriatic arthritis and joint complaints in 2009 patients with psoriasis: results of a German national survey. J Eur Acad Dermatol Venereol 23:683–691PubMedCrossRef Radtke M, Reich K, Blome C et al (2009) Prevalence and clinical features of psoriatic arthritis and joint complaints in 2009 patients with psoriasis: results of a German national survey. J Eur Acad Dermatol Venereol 23:683–691PubMedCrossRef
21.
Zurück zum Zitat Ramonda R, Lo Nigro A, Modesti V et al (2011) Atherosclerosis in psoriatic arthritis. Autoimmun Rev 10(12):773–778PubMedCrossRef Ramonda R, Lo Nigro A, Modesti V et al (2011) Atherosclerosis in psoriatic arthritis. Autoimmun Rev 10(12):773–778PubMedCrossRef
22.
Zurück zum Zitat Raza N, Hameed A, Ali MK (2008) Detection of subclinical joint involvement in psoriasis with bone scintigraphy and its response to methotrexate. Clin Exp Dermatol 33(1):70–73PubMedCrossRef Raza N, Hameed A, Ali MK (2008) Detection of subclinical joint involvement in psoriasis with bone scintigraphy and its response to methotrexate. Clin Exp Dermatol 33(1):70–73PubMedCrossRef
23.
Zurück zum Zitat Reich K, Krüger K, Mössner R, Augustin M (2009) Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis. Br J Dermatol 160:1040–1047PubMedCrossRef Reich K, Krüger K, Mössner R, Augustin M (2009) Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis. Br J Dermatol 160:1040–1047PubMedCrossRef
24.
Zurück zum Zitat Ritchlin CT, Kavanaugh A, Gladman DD et al; Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) (2009) Treatment recommendations for psoriatic arthritis. Ann Rheum Dis 68(9):1387–1394PubMedCrossRef Ritchlin CT, Kavanaugh A, Gladman DD et al; Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) (2009) Treatment recommendations for psoriatic arthritis. Ann Rheum Dis 68(9):1387–1394PubMedCrossRef
25.
Zurück zum Zitat Saber TP, Ng CT, Renard G et al (2010) Remission in psoriatic arthritis: is it possible and how can it be predicted? Arthritis Res Ther 12(3):R94PubMedCrossRef Saber TP, Ng CT, Renard G et al (2010) Remission in psoriatic arthritis: is it possible and how can it be predicted? Arthritis Res Ther 12(3):R94PubMedCrossRef
26.
Zurück zum Zitat Scarpa R, Atteno M, Lubrano E et al (2011) The effectiveness and safety of TNF-alpha blockers in the treatment of early psoriatic arthritis: an Italian multicentre longitudinal observational pilot study. Clin Rheumatol 30(8):1063–1067PubMedCrossRef Scarpa R, Atteno M, Lubrano E et al (2011) The effectiveness and safety of TNF-alpha blockers in the treatment of early psoriatic arthritis: an Italian multicentre longitudinal observational pilot study. Clin Rheumatol 30(8):1063–1067PubMedCrossRef
27.
Zurück zum Zitat Taylor W, Gladman D, Helliwell P et al (2006) Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 54:2665–2673PubMedCrossRef Taylor W, Gladman D, Helliwell P et al (2006) Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 54:2665–2673PubMedCrossRef
28.
Zurück zum Zitat Veale DJ, Fitzgerald O (2002) Psoriatic arthritis – pathogenesis and epidemiology. Clin Exp Rheumatol 20(6 Suppl 28):27–33 Veale DJ, Fitzgerald O (2002) Psoriatic arthritis – pathogenesis and epidemiology. Clin Exp Rheumatol 20(6 Suppl 28):27–33
29.
Zurück zum Zitat Vena GA, Vestita M, Cassano N (2010) Can early treatment with biologicals modify the natural history of comorbidities? Dermatol Ther 23(2):181–193PubMedCrossRef Vena GA, Vestita M, Cassano N (2010) Can early treatment with biologicals modify the natural history of comorbidities? Dermatol Ther 23(2):181–193PubMedCrossRef
30.
Zurück zum Zitat Wiell C, Szkudlarek M, Hasselquist M et al (2007) Ultrasonography, magnetic resonance imaging, radiography, and clinical assessment of inflammatory and destructive changes in fingers and toes of patients with psoriatic arthritis. Arthritis Res Ther 9:R119PubMedCrossRef Wiell C, Szkudlarek M, Hasselquist M et al (2007) Ultrasonography, magnetic resonance imaging, radiography, and clinical assessment of inflammatory and destructive changes in fingers and toes of patients with psoriatic arthritis. Arthritis Res Ther 9:R119PubMedCrossRef
31.
Zurück zum Zitat Wilson FC, Icen M, Crowson CS et al (2009) Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum 61(2):233–239PubMedCrossRef Wilson FC, Icen M, Crowson CS et al (2009) Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum 61(2):233–239PubMedCrossRef
32.
Zurück zum Zitat Zink A, Thiele K, Huscher D et al (2006) Healthcare and burden of disease in psoriatic arthritis. A comparison with rheumatoid arthritis and ankylosing spondylitis. German Collaborative Arthritis Centres. J Rheumatol 33(1):86–90PubMed Zink A, Thiele K, Huscher D et al (2006) Healthcare and burden of disease in psoriatic arthritis. A comparison with rheumatoid arthritis and ankylosing spondylitis. German Collaborative Arthritis Centres. J Rheumatol 33(1):86–90PubMed
Metadaten
Titel
Diagnostik und Therapie der frühen Psoriasis-Arthritis
verfasst von
Dr. M. Köhm
F. Behrens
Publikationsdatum
01.01.2012
Verlag
Springer-Verlag
Erschienen in
Zeitschrift für Rheumatologie / Ausgabe 1/2012
Print ISSN: 0340-1855
Elektronische ISSN: 1435-1250
DOI
https://doi.org/10.1007/s00393-011-0896-1

Weitere Artikel der Ausgabe 1/2012

Zeitschrift für Rheumatologie 1/2012 Zur Ausgabe

CME Weiterbildung · Zertifizierte Fortbildung

Frühe und fortgeschrittene rheumatoide Arthritis

Klinische Studien kurzgefasst

Rheumachirurgie

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.