{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T16:11:59Z","timestamp":1783959119849,"version":"3.55.0"},"reference-count":24,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"unspecified","delay-in-days":81,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001652","name":"Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg","doi-asserted-by":"publisher","award":["Emerging Fields Initiative MIRACLE"],"award-info":[{"award-number":["Emerging Fields Initiative MIRACLE"]}],"id":[{"id":"10.13039\/501100001652","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["261193037"],"award-info":[{"award-number":["261193037"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["405969122"],"award-info":[{"award-number":["405969122"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["493624887"],"award-info":[{"award-number":["493624887"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"crossref","award":["493624887"],"award-info":[{"award-number":["493624887"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100010767","name":"Innovative Medicines Initiative","doi-asserted-by":"publisher","award":["101007757"],"award-info":[{"award-number":["101007757"]}],"id":[{"id":"10.13039\/501100010767","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010663","name":"H2020 European Research Council","doi-asserted-by":"publisher","award":["Synergy grant 4D Nanoscope"],"award-info":[{"award-number":["Synergy grant 4D Nanoscope"]}],"id":[{"id":"10.13039\/100010663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,2,13]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To assess the clinical and imaging characteristics associated with fibroblast activation detected by\n                      <jats:sup>68<\/jats:sup>\n                      Gallium-labelled fibroblast activation protein inhibitor positron emission tomography\/CT (\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI-PET\/CT) in patients with psoriasis and whether\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI uptake correlates with the risk of progression to psoriatic arthritis (PsA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Psoriasis patients with arthralgia underwent\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI-PET\/CT and were followed up prospectively.\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI uptake was assessed at 71 articular sites and patients with \u22651 joint with\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI uptake and PET\/CT Joint Index\u22652 were considered FAPI positive. The associations between FAPI uptake and clinical and ultrasound (US) findings were investigated. Survival analyses were conducted to assess the association between\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI uptake and progression to PsA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      45 patients with psoriasis were enrolled, 37 of whom (82%) were FAPI positive. FAPI-positive psoriasis patients had significantly higher body mass index (BMI) (p=0.036) and Disease Activity Score 28-C reactive protein (p=0.033) compared with FAPI-negative patients.\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI uptake was most frequent in large joints and mechanically stressed sites and was more likely in the presence of low-grade synovial hyperplasia (OR: 1.77, 95% CI 1.08 to 2.89), entheseal Power Doppler (OR: 3.80, 95% CI 1.66 to 8.72) and concomitant osteoarthritis (OA). FAPI-positive patients showed a higher risk of progression to PsA compared with FAPI-negative patients (HR 7.1, 95%\u2009CI 0.9 to 53.6) (log-rank p=0.028). Only 1\/8 patients with psoriasis (12.5%) without\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI uptake developed PsA, as opposed to 18\/37 (49%) of FAPI-positive patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In psoriasis patients with arthralgia,\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI uptake, indicating fibroblast activation, is associated with higher BMI, more pain, subclinical US changes and concomitant OA. Pathological\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI uptake at articular sites was indicative of higher risk of progression to PsA in our cohort, suggesting fibroblast activation as a crucial step to develop PsA.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-006567","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T16:30:21Z","timestamp":1774283421000},"page":"e006567","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Increased synovial and entheseal fibroblast activation detected by\n                    <sup>68<\/sup>\n                    Ga-FAPI-PET\/CT is associated with the development of psoriatic arthritis in psoriasis patients with arthralgia"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2218-6503","authenticated-orcid":false,"given":"Giulia","family":"Corte","sequence":"first","affiliation":[{"name":"Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Atzinger","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Noversa de Sousa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Servi\u00e7o de Medicina Interna, Hospital Pedro Hispano, Unidade Local de Sa\u00fade de Matosinhos, Matosinhos, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melek Yalcin","family":"Mutlu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0804-3198","authenticated-orcid":false,"given":"Alp","family":"Temiz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2799-184X","authenticated-orcid":false,"given":"Sara","family":"Bayat","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander University (FAU) 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Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Sticherling","sequence":"additional","affiliation":[{"name":"Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Department of Dermatology, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schmidkonz","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Institute for Medical Engineering, Technical University of Applied Sciences Amberg\u2013 Weiden, Weiden, 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