期刊
RHEUMATOLOGY
卷 54, 期 1, 页码 29-38出版社
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/keu328
关键词
osteoarthritis; psoriatic arthritis; pathogenesis; therapy; enthesitis
类别
资金
- WELMEC, a Centre of Excellence in Medical Engineering - Wellcome Trust
- EPSRC [WT 088908/Z/09/Z]
- EPSRC [EP/J017620/1] Funding Source: UKRI
- Engineering and Physical Sciences Research Council [EP/J017620/1] Funding Source: researchfish
- National Institute for Health Research [NIHR/CS/009/015, CL-2007-02-001] Funding Source: researchfish
Rheumatologists have long considered OA and PsA as two completely distinct arthropathies. This review highlights how some forms of generalized OA and PsA may afflict the same entheseal-associated anatomical territories. While degeneration or inflammation may be clearly discernible at the two extremes, there may be a group of patients where differentiation is impossible. Misdiagnosis of a primary degeneration-related pathology as being part of the PsA spectrum could lead to apparent failure of disease-modifying agents, including apparent anti-TNF and apparent IL23/17 axis therapy failure. This is not a reflection of poor clinical acumen, but rather a failure to appreciate that the pathological process overlaps in the two diseases. Whether the category of OA-PsA overlap disease exists or whether it represents the co-occurrence of two common arthropathies that afflict the same anatomical territories has implications for the optimal diagnosis and management of both OA and PsA.
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