Presence of sacroiliac joint disease may identify patients with psoriasis and psoriatic arthritis (PsA) who are at greater risk for cardiovascular disease (CVD), according to results of a study published sacroiliitis in Arthritis Research & Therapy.
Previous studies have shown that CVD risk is increased in patients with psoriasis and PsA, but there are currently no surrogate markers for these inflammatory disorders.
Researchers from the National Institutes of Health hypothesized that presence of sacroiliitis, which may predict more severe PsA, would be associated with increased vascular inflammation defined by 18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), which is an established measure of CVD.
Sixty-five patients underwent whole-body FDG-PET/CT. Metabolic activity of the aorta was measured using the maximal standardized uptake value, and was found to be was greater (P<0.001) in patients with sacroiliitis (mean ± SD = 7.33 ± 2.09) compared to those without sacroiliitis (6.39 ± 1.49, P=0.038).
After adjusting for CVD risk factors, there were associations between PsA and aortic inflammation (β = 0.124, P<0.001) and between sacroiliitis and aortic inflammation (β = 0.270, P<0.001). Sacroiliitis predicted vascular inflammation beyond PsA and CVD risk factors (χ2 = 124.6, P<0.001).
Although the authors concluded that large prospective studies are needed to confirm these findings, this data suggests that sacroiliitis is associated with increased vascular inflammation and that sacroiliac joint disease may identify patients at greater risk for CVD.