한국인 건선관절염 환자의 임상적 특징과 치료양상에 대한후향적 단일기관 연구

Abstract

Background: Psoriatic arthritis (PsA) is a seronegative inflammatory arthritis associated with psoriasis. The prevalence of PsA varies across different countries, and a few previous studies have reported that 9∼17% of Korean patients with psoriasis present with PsA. However, limited data are available regarding the clinical features and treatment of Korean patients with PsA. Objective: To evaluate the clinical features of Korean patients with PsA and the treatment modalities used in the real-world setting. Methods: This study was a retrospective single-center study. We analyzed 101 Korean patients who had been diagnosed with PsA based on the Classification Criteria for Psoriatic Arthritis (CASPAR). We reviewed the patients’ medical records, Psoriasis Area and Severity Index (PASI) score, body surface area (BSA), manifestation pattern of PsA, and treatment course. Results: Our study included 101 patients. The mean age was 50.7 years. The mean PASI score was 8.6, and the mean BSA was 11.5%. Spondylitis was the most common manifestation (40.6%). In most patients, psoriatic lesions preceded the onset of PsA (57.4%). Psoriasis and PsA occurred simultaneously in 32.7%, and PsA developed prior to psoriasis in 9.9% of patients. The administration of nonsteroidal anti-inflammatory drugs (NSAIDs) was the most commonly utilized treatment strategy (82.2%), followed by the use of methotrexate and sulfasalazine. Twenty-two patients were treated with biologics with favorable efficacy. Conclusion: Spondylitis was the most common manifestation in patients. NSAIDs, methotrexate and sulfasalazine were the drugs most commonly used to treat Korean patients with PsA. Dermatologists should be mindful of this entity, and during history taking at the patient’s initial visit, those with psoriasis should be asked, “Do you have any pain or swelling of joints?” to ensure early diagnosis of PsA.