PsA Linked to Catabolic and Anabolic Bone Damage



Results from a recent study showed significant destructive bone changes among participants with psoriatic arthritis (PsA), which were affected by disease duration and age.

“Next to inflammation, bone destruction is a hallmark of the disease, especially in PsA. Surprisingly few studies, however, have yet comprehensively addressed bone changes in PsA,” the researchers wrote. They assessed the extent of bone erosions and enthesiophytes according to categories of age, duration of psoriasis, and duration of PsA among 101 participants with PsA, 55 participants with psoriasis, and 47 healthy controls. All participants underwent high resolution peripheral quantitative computed tomography (HR-pQCT). In addition, demographic and disease-specific data, including physical function, were collected.

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Participants with PsA had significantly more and larger erosions and enthesiophytes compared with participants with psoriasis and healthy controls. While enthesiophytes were more frequent among participants with psoriasis, erosions did not differ between those with psoriasis and healthy controls.

In addition, only bone erosions showed strong age-dependency among all 3 groups whereas enthesiophytes were predominately influenced by disease duration. Enthesiophytes, in contrast to bone erosions, were associated with poorer physical function.

“PsA acts as a strong enhancer of age-related catabolic bone damage. In contrast, enthesiophytes, as signs of anabolic bone damage, are less age-dependent but primarily depend on the duration of PsA. Small enthesiophytes occur before clinical joint involvement and increase in size with progressive disease,” the researchers concluded. “Taken together, these findings highlight the destructive nature of PsA and the necessity for an early intervention to limit the burden of bone damage in PsA.”


Simon D, Kleyer A, Faustini F, et al. Simultaneous quantification of bone erosions and enthesiophytes in the joints of patients with psoriasis or psoriatic arthritis - effects of age and disease duration. Arthritis Res Ther. 2018;20(1):203. doi:10.1186/s13075-018-1691-z