FIBROBLAST ACTIVATION IN PSORIASIS PATIENTS ASSESSED BY 68GA-FAPI-04 PET-CT IS ASSOCIATED WITH PROGRESSION TO PSORIATIC ARTHRITIS
Authors: Fagni F et al.
A significant proportion of PsO patients will develop PsA, but no reliable markers for progression to PsA have been identified. 68Ga-FAPI-04 PET-CT uses a radiotracer that targets fibroblast activation protein and may therefore allow in vivo monitoring of activation of synovial and entheseal fibroblasts known to be activated in psoriatic arthritis. 10 patients with cutaneous psoriasis and no evidence for articular, enthesial or axial involvement underwent 68Ga-FAPI-04 PET-CT and were followed subsequently for signs and symptoms of PsA according to the CASPAR criteria. Seven patients showed 68Ga-FAPI-04 uptake at synovial-entheseal sites at baseline, six of these patients progressed to PsA within less than 40 weeks. None of the patients with normal imaging developed PsA after a median follow-up of 301 (301-489) days.
68Ga-FAPI-04 PET-CT may be regarded as a tool to visualize activated fibroblasts and, although the patient cohort was small, was associated with the progression of PsO patients to PsA. These results are exciting as they contribute to our understanding of the pathogenesis of PsA. There are some data suggesting that the use of biologics in PsO might eventually prevent the development of PsA. Would it be a vision for the future to identify patients at risk early? Might this guide therapeutic decisions? 68Ga-FAPI-04 PET-CT might be a suitable tool-but the burden of radiation has to be kept in mind.