Guest guest Posted February 12, 2004 Report Share Posted February 12, 2004 To those of you wanting the article on Psoriasis that I mentioned, I hadn't realized it was an online learning type thing, with slides and such, so it's really to hard to copy. If you want to see it, it is FREE to join Medscape. Just go to http://www.Medscape.com and sign up. I did find this other article that was dated April, 2003. Hope this helps, and sorry for the confusion!!! Love Lana Interventions for treating psoriatic arthritis Updated: 04/01/2003 from Cochrane Review Abstracts Posted 04/01/2003 G, Crotty M, P A substantive amendment to this systematic review was last made on 31 May 2000. Cochrane reviews are regularly checked and updated if necessary. Background: It has been estimated that arthritis occurs in 5-7% of those with psoriasis. Relatively few clinical trials of treatment are available for psoriatic arthritis and data presentation in these trials is far from uniform making comparison difficult. Objectives: To assess the effects of salazopyrin, auranofin, etretinate, fumaric acid, IMI gold, azathioprine, efamol marine and methotrexate, in psoriatic arthritis. Search strategy: We searched MEDLINE up to February 2000, and Excerpta Medica (June 1974-95). Search terms were psoriasis, arthritis, therapy and/or controlled trial. This was supplemented by manually searching bibliographies of previously published reviews, conference proceedings, contacting drug companies and referring to the Cochrane Clinical Trials Register. All languages were included in the initial search. Selection criteria: All randomized trials comparing salazopyrin, auranofin, etretinate, fumaric acid, IMI gold, azathioprine, and methotrexate, in psoriatic arthritis. Following a published a priori protocol, the main outcome measures included individual component variables derived from Outcome Measures in Rheumatology Clinical Trials (OMERACT). These include acute phase reactants, disability, pain, patient global assessment, physician global assessment, swollen joint count, tender joint count and radiographic changes of joints in any trial of one year or longer [Tugwell 1993], and the change in pooled disease index (DI). Only English trials were included in the review. Data collection and analysis: Data were independently extracted from the published reports by two of the reviewers (MC, GJ). An independent blinded quality assessment was also performed. Main results: Twenty randomized trials were identified of which thirteen were included in the quantitative analysis with data from 1022 subjects. Although all agents were better than placebo, parenteral high dose methotrexate (not included), salazopyrin, azathioprine and etretinate were the agents that achieved statistical significance in a global index of disease activity (although it should be noted that only one component variable was available for azathioprine and only one trial was available for etretinate suggesting some caution is necessary in interpreting these results). Analysis of response in individual disease activity markers was more variable with considerable differences between different medications and responses. In all trials the placebo group improved over baseline (pooled improvement 0.39 DI units, 95% CI 0.26-0.54). There was insufficient data to examine toxicity. Reviewers' conclusions: Parenteral high dose methotrexate and salazopyrin are the only two agents with well demonstrated published efficacy in psoriatic arthritis. The magnitude of the effect seen with azathioprine, etretinate, oral low dose methotrexate and perhaps colchicine suggests that they may be effective but that further multicentre clinical trials are required to establish their efficacy. Furthermore, the magnitude of the improvement observed in the placebo group strongly suggests that uncontrolled trials should not be used to guide management decisions in this condition. Citation: G, Crotty M, P. Interventions for treating psoriatic arthritis (Cochrane Review). In: The Cochrane Library, Issue 2 2003. Oxford: Update Software. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2004 Report Share Posted February 12, 2004 Hi, Just wanted to add a few things to this... A few years ago a large study was done in the Scandinavian countries, to assess the life quality of people with Psoriasis. Around 5-6,000 people participated in the study. All participants were asked if they had Psoriatic Arthritis, and what kind of MD that diagnosed them. 30% of the participants were diagnosed with PA, by a specialist (rheumatologist/dermatologist). Another 7.5% reported to have joint complaints without being diagnosed with PA or they were diagnosed by a GP. It is more and more often mentioned that a large number of people with Psoriasis have _joint complaints_ (i.e. arthralgia/joint pain). All these do not have PA according to clinical examination/diagnostic criteria. I have heard several specialists talk about " Psoriasis Soft Tissue Disease " , without it being an acknowledged diagnosis. We are talking about muscle and joint pain with no evidence of inflammation. I am sure that the next few years will give more information about Psoriatic Arthtitis. I will not be surprised if the prevalence of it is way higher than the 5-7% or even 10% that most sources say today... We also hear more and more about Psoriasis as a Systemic Disease, with many parts of the body affected. I can mention the eyes, the heart, the lungs, blood vessels, the colon etc. This I am sure we will learn a lot more about the next few years. We just decided at a meeting in the Norwegian Pso. Assoc. that we will collect all case reports and studies that mentions these other effects of Psoriasis, in order to learn more about it and possibly be able to write an article about it for our magazine. Of these other effects of it, the most common and known ones today I think are eye involvement (several different types conjunctivitis etc.) and colon involvement. The last one I can say that anecdotally has been discussed amongst Psoriatics for years. Some scientists have also claimed that this is part of it (inflammation and other problems). Have a nice evening everybody!!! hugs, Aase Marit > >Background: It has been estimated that arthritis occurs in 5-7% of >those with psoriasis. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2004 Report Share Posted February 12, 2004 Hi, Just wanted to add a few things to this... A few years ago a large study was done in the Scandinavian countries, to assess the life quality of people with Psoriasis. Around 5-6,000 people participated in the study. All participants were asked if they had Psoriatic Arthritis, and what kind of MD that diagnosed them. 30% of the participants were diagnosed with PA, by a specialist (rheumatologist/dermatologist). Another 7.5% reported to have joint complaints without being diagnosed with PA or they were diagnosed by a GP. It is more and more often mentioned that a large number of people with Psoriasis have _joint complaints_ (i.e. arthralgia/joint pain). All these do not have PA according to clinical examination/diagnostic criteria. I have heard several specialists talk about " Psoriasis Soft Tissue Disease " , without it being an acknowledged diagnosis. We are talking about muscle and joint pain with no evidence of inflammation. I am sure that the next few years will give more information about Psoriatic Arthtitis. I will not be surprised if the prevalence of it is way higher than the 5-7% or even 10% that most sources say today... We also hear more and more about Psoriasis as a Systemic Disease, with many parts of the body affected. I can mention the eyes, the heart, the lungs, blood vessels, the colon etc. This I am sure we will learn a lot more about the next few years. We just decided at a meeting in the Norwegian Pso. Assoc. that we will collect all case reports and studies that mentions these other effects of Psoriasis, in order to learn more about it and possibly be able to write an article about it for our magazine. Of these other effects of it, the most common and known ones today I think are eye involvement (several different types conjunctivitis etc.) and colon involvement. The last one I can say that anecdotally has been discussed amongst Psoriatics for years. Some scientists have also claimed that this is part of it (inflammation and other problems). Have a nice evening everybody!!! hugs, Aase Marit > >Background: It has been estimated that arthritis occurs in 5-7% of >those with psoriasis. Quote Link to comment Share on other sites More sharing options...
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