Table 1
Prevalence of PsA-associated comorbidities
Comorbidity
Prevalence (%)
32.3–59.7
Obesity
Hypertension 19.3–35.8
Hyperlipidaemia 8–61.6
Diabetes 5–15.9
3.3–9.6
Cardiovascular disease
Depression/anxiety 13.8–27.2
References
14, 30
30–32
30–32
30–32
30–33
30–32
(ToPAS), which have been shown to have similar
sensitivities and specificities. 13
Comorbidities and associated conditions
PsA patients often manifest an increased
prevalence of comorbidities, in particular
metabolic and psychiatric diseases (Table 1),
which impair daily activity, disability, treatment
response and impose an economic burden. 14,15
Moreover, psoriatic disease, due to chronic
inflammation, can be considered an additional
risk factor, as arterial hypertension, and therefore
should be taken into account when managing
patients. There are no biomarkers currently
available to identify patients at higher risk
of developing comorbidities or other chronic
inflammatory conditions, such as inflammatory
bowel diseases (IBD), Crohn’s disease and
ulcerative colitis, and uveitis. 16 Therefore, it is
crucial to detect and treat comorbid conditions
early, and refer to the appropriate specialist for
other inflammatory diseases. Experts’ checklists
have been proposed to screen patients for
cardiovascular disease, which however may not
be practical in real-life or might underestimate
patients’ risks. 17,18 With this is mind, the
European League against Rheumatism (EULAR)
has issued recommendations for cardiovascular
risk management in inflammatory arthritis
(Table 2). 19
Furthermore, PsA is associated in particular
with psychiatric comorbidities and depression,
while only psoriasis has been associated with
suicidal ideation, 20 and depression increases
PsA risk in psoriasis patients. 21 Given the
importance of depression, it is critical to
diagnose and refer patients, and questionnaires
have been developed especially for research
purposes. 22 Collaboration with a psychologist/
psychia