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Psoriatic arthritis activity spikes briefly post partum, study finds.


DISEASE ACTIVITY FOR PREGNANT WOMEN with psoriatic arthritis (PsA) was relatively stable through 1 year after delivery, but there was a significant jump at 6 months post partum, in a prospective study of more than 100 patients.

Previous research has described rheumatoid arthritis remission during pregnancy, but PsA symptoms before, during, and after pregnancy have not been well studied, wrote Kristin Ursin, MD, of Trondheim (Norway) University Hospital, and her colleagues. They reviewed data from 108 pregnancies in 103 women with PsA who were diagnosed between January 2006 and October 2017 and were enrolled in a Norwegian nationwide registry that followed women with inflammatory diseases from preconception through 1 year after delivery.

Disease activity was measured using the DAS28-CRP (28-Joint Disease Activity Score with C-Reactive Protein). Participants were assessed at seven time points: before pregnancy, during each trimester, and at 6 weeks, 6 months, and 12 months after delivery.

Although approximately 75% of the women had stable disease activity throughout the study period, activity spiked 6 months after delivery; DAS28-CRP scores at 6 months post partum were significantly higher than scores at 6 weeks post partum (2.71 vs. 2.45, respectively; P = .016). Women taking a tumor necrosis factor inhibitor had significantly lower disease activity during pregnancy, compared with women not taking a TNFi; mean DAS28-CRP scores at 6 months post partum for these groups were 2.22 and 2.72, respectively (P = .043).

Acknowledging some limitations of the study, the researchers said that the results suggest that most pregnant women with PsA experience low levels of disease activity, and recommended that future research on pregnancy in women with PsA should include assessment of psoriasis, extended joint count, dactylitis, entheses, and axial skeleton.

They had no financial conflicts to disclose. The study was funded by the department of rheumatology at Trondheim University Hospital and the Research Fund of the Norwegian organization for people with rheumatic disease.


SOURCE: Ursin K et al. Arthritis Care Res. 2018 Sep 7. doi: 10.1002/acr.23747.

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Author:Splete, Heidi
Publication:Dermatology News
Article Type:Medical condition overview
Date:Nov 1, 2018
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