Psoriatic arthritis and heart disease: a matter of life and death

Psoriatic arthritis and heart disease: a matter of life and death

Laura Pavey’s joint pain started when she was just 15, but for over a decade doctors kept dismissing the active young woman’s concerns as just pain. She was referred to a pain management clinic, was put on increasing amounts of opioids, eventually ended up in a wheelchair and was unable to continue her post-secondary education.

As Laura says: “When middle aged women go to the doctor and complain about pain they’re told that it’s menopause; with younger women, they say it’s fibromyalgia.”

Once she was finally referred to a rheumatologist, however, a true diagnosis was quickly confirmed. Laura was not living with just one, but three inflammatory diseases: ankylosing spondylitis (AS) – a form of inflammatory arthritis that attacks the spine, Chron’s disease (CD) – an inflammatory bowel condition – and psoriatic arthritis (PsA) – another form of inflammatory arthritis that develops in up to 30% of people who have the skin condition psoriasis.

This tendency of inflammatory diseases to run in packs – what doctors call “co-morbidity” – has attracted the interest of researcher Dr. Lihi Eder, a scientist and staff rheumatologist at the Women’s College Research Institute in Toronto. Dr. Eder has received a Young Investigator’s Operating Grant from the Arthritis Society to study the relationship between PsA and heart disease.

We know that the inflammation that causes psoriasis and PsA can also lead to the development of heart disease and stroke. To help identify people with PsA who have a high risk of developing these cardiovascular diseases, Dr. Eder is searching for new “biomarkers” – signals of disease in the blood that can be measured in the lab. This could lead to a test to identify who is most at risk and get them into care sooner.

Laura’s diseases are currently managed by a biologic medication, and with the help of therapy from the Arthritis Society’s Mary Pack Centre she no longer needs a wheelchair to get around – and she has resumed her interrupted studies.

Dr. Eder’s work might one day identify Laura as having greater risk of heart disease. That would add another layer of complexity to her already challenging care – but not only would being armed with that knowledge help her cope, it could literally mean the difference between life and death.