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Review
. 2021 Sep 22:8:737573.
doi: 10.3389/fmed.2021.737573. eCollection 2021.

Hyperuricemia in Psoriatic Arthritis: Epidemiology, Pathophysiology, and Clinical Implications

Cesare Tripolino  1 , Jacopo Ciaffi  2 , Piero Ruscitti  3 , Roberto Giacomelli  4 , Riccardo Meliconi  2   5 , Francesco Ursini  2   5
Affiliations
Review

Hyperuricemia in Psoriatic Arthritis: Epidemiology, Pathophysiology, and Clinical Implications

Cesare Tripolino et al. Front Med (Lausanne). .

Abstract

Psoriatic arthritis (PsA) represents the articular component of the systemic psoriatic disease and the extra-cutaneous disorder most frequently found in patients with psoriasis. Besides the articular involvement, PsA is associated with several metabolic abnormalities such as insulin resistance, hypertension, diabetes and hyperuricemia. Uric acid is the final product of purine metabolism and the etiological substrate of gout. Accumulating evidence highlights the emerging role of hyperuricemia as a major cardiovascular risk factor. Moreover, different studies evaluated the interplay between hyperuricemia and psoriatic disease, suggesting that individuals affected by psoriasis or PsA might present higher serum levels of uric acid and that hyperuricemia might affect severity of clinical manifestations and degree of inflammation in PsA patients. In this review, we focus on the bidirectional relationship between uric acid and PsA, analyzing how uric acid may be involved in the pathogenesis of psoriasis/PsA and how clinical manifestations of PsA and inflammatory mediators are affected by uric acid concentrations. Finally, the effects of anti-rheumatic drugs on uric acid levels and the potential benefit of urate-lowering therapies on psoriasis and PsA were summarized.

Keywords: cardiovascular; gout; inflammation; psoriasis; psoriatic arthritis; uric acid.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Main mechanisms of hyperuricemia in psoriatic arthritis.
Figure 2
Figure 2
Key points of the interplay between uric acid and psoriatic disease.
See this image and copyright information in PMC

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