How does age of onset affect outcomes for psoriatic arthritis?

Psoriatic arthritis causes stiff, painful joints. The age at which a person develops this condition may affect symptom management and treatment. Psoriatic arthritis is a type of inflammatory, autoimmune arthritis. The National Psoriasis Foundation say that 30% of people living with psoriasis develop psoriatic arthritis. They also note that while symptoms can develop at any age, they most often appear between the ages of 30 and 50. In most cases, psoriatic arthritis develops about 10 years after the onset of psoriasis. However, some people develop psoriatic arthritis first. These individuals are likely to be older and have more severe symptoms. They may also respond differently to treatment.

Typical ages of onset for psoriasis and psoriatic arthritis

According to a 2014 study, researchers have used the age of onset of psoriasis for many years to classify people as belonging to one of two subpopulations: type 1 and type 2.

  • Type 1 onset occurs before the age of 40. It represents about 70% of all people living with psoriasis. The peak ages of onset are between 16 and 22 years.
  • Type 2 onset occurs after the age of 40, with the peak age of onset between 57 and 60 years.

Most researchers agree on the age groups for psoriasis. However, there is less agreement on what early or late onset means in relation to psoriatic arthritis. Understanding the age of onset may help with determining risk factors. In the same study, the researchers found that earlier onset psoriasis may be linked to a certain gene that is present in people with type 1 psoriasis.

Symptoms of psoriatic arthritis

Psoriatic arthritis can cause a variety of symptoms. Some symptoms include:

  • limited range of motion
  • fatigue
  • stiffness and tiredness in the morning
  • pain or swelling of tendons
  • swollen fingers and toes
  • pain, stiffness, or swelling in the joints
  • eye pain or redness
  • changes to the nails

In a 2017 study, researchers found that later onset psoriatic arthritis is associated with:

  • more significant fatigue
  • presence of other diseases
  • high pain scores
  • more effects on the nails
  • increased inflammation
Risk factors for developing psoriatic arthritis

A 2017 review of studies looked at the risk factors for developing psoriatic arthritis. The authors considered various factors, including:

  • alcohol consumption
  • obesity
  • smoking
  • nail disease
  • severity of psoriasis

The research suggested that the severity of psoriasis plays a role in the development of late onset psoriatic arthritis. Studies on the condition’s links with smoking and alcohol consumption were less conclusive. In a 2019 study, researchers found that genes play less of a role in late onset psoriatic arthritis than early onset psoriatic arthritis. Other risk factors, such as smoking, may be more significant in the development of late onset psoriatic arthritis.

Responses to treatment

Psoriatic arthritis has no cure. However, treatment can help manage symptoms such as swelling and pain. Treatment can also help slow or prevent the progression of the disease.

There are several approved treatment methods, including:

  • disease-modifying antirheumatic drugs (DMARDs), which help slow joint damage and the progression of the disease
  • newer oral treatments to help suppress swelling
  • biologics, which may prevent joint pain and slow the progression of the disease
  • over-the-counter or prescription strength nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, to help reduce pain and swelling
  • home remedies, including changes to diet and exercise

Early treatment can help prevent disease progression. A person should talk to their doctor if they start developing signs of psoriatic arthritis. In a 2019 study, researchers found that late onset psoriatic arthritis was less responsive to treatment. They suggest that future research should further explore how to treat people with late onset psoriatic arthritis effectively.

When to see a doctor

A person should see a healthcare provider if they experience any of the symptoms associated with psoriatic arthritis. Although there is no cure for psoriatic arthritis, earlier treatment can help prevent joint damage. It may also slow the disease’s progression. A person should also talk to their doctor if their symptoms are not improving or are becoming worse despite treatment. A doctor may need to work with the person to determine a better course of treatment.

Outlook

Psoriatic arthritis can come on at nearly any age. A person should talk to their doctor if they notice symptoms of psoriatic arthritis.

Psoriatic arthritis is not life threatening, but it can increase the risk of other diseases.

Treatments may help reduce symptoms and slow the progression of the disease.

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