Osteoporosis en la artritis psoriásica

Psoriatic arthritis (PA) is defined as an inflammatory form of arthritis associated with psoriasis. This condition is mainly characterized by the presence of arthritis, enthesitis, typical radiographic findings, and the absence of rheumatoid factor. The increase in immune and inflammatory cells of the synovitis produces cytokines and other molecules that may influence bone remodelling, increasing the frequency of osteoporosis and fragility fractures. Osteoporosis has been better documented in rheumatoid arthritis than in PA and there is less information on the bone mass of PA patients. Osteoporosis in PA has been studied less extensively and in heterogeneous groups of patients, and the results are contradictory since not all studies have shown a higher incidence of osteoporosis. The present review summarizes the suggested etiopathogenic mechanisms and possible strategies in the clinical management and treatment of this entity and provides a review of the studies published on the topic. The main mechanisms involved in osteoporosis in PA would seem to be the activation of osteoclastogenesis by the inflammatory disease itself and corticosteroid therapy. PA is a common condition in clinical practice and it more data on osteoporosis in these patients would help to improve decision making in the management of the PA.