Does Age Matter in Psoriatic Arthritis? A Narrative Review
G. Fragoulis, Elena Nikiphorou, Iain B. McInnes, Stefan Siebert
Abstract
Psoriatic arthritis (PsA) affects approximately 0.8% of the general population. PsA, together with psoriasis (PsO), constitute psoriatic disease (PsD). Comorbidities play an important role in the clinical expression and treatment of PsD. Aging adds another level of complexity, partly because age directly accrues increasing risk of comorbidities, but also because of its complex interactions with several factors such as depression and social determinants. Aging seems to have a "paradoxical association" with cardiovascular comorbidities, for which the relative risk is more pronounced in younger patients with PsD. It also affects treatment decisions and treatment response in patients with PsD. Finally, there is convincing evidence that there are clinical, genetic, and histopathological differences between early- and late-onset PsA and PsO. Herein, we review the effect of age in patients with PsD, with a focus on PsA, highlighting the need to consider this factor in routine clinical practice as well as in research.