{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:57:17Z","timestamp":1789001837982,"version":"build-2803163510"},"reference-count":50,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T00:00:00Z","timestamp":1678406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>A growing body of evidence on the importance of vitamin D in immune modulation has increased the interest in its possible impact on the course of rheumatological diseases. The scope of our study is to assess if the presence of different statuses of vitamin D could interfere in the clinical subsets, in methotrexate monotherapy discontinuation, and biological drug (b-DMARDs) survival in psoriatic arthritis patients (PsA). We conducted a retrospective study on PsA patients and split them into three groups based on their vitamin D status: the group with 25(OH)D \u2264 20 ng\/mL, the group with levels of 25(OH)D between 20 and 30 ng\/mL, and the group with serum levels of 25(OH)D \u2265 30 ng\/mL. All patients were required to fulfill the CASPAR criteria for psoriatic arthritis and to have the evaluation of vitamin D serum levels at baseline visit and at clinical follow-up visits. The exclusion criteria were ages less than 18 years old, the presence of HLA B27, and satisfaction of rheumatoid arthritis classification criteria (during the study time). Statistical significance was set at p \u2264 0.05. Furthermore, 570 patients with PsA were screened and 233 were recruited. A level of 25(OH)D \u2264 20 ng\/mL was present in 39% of patients; levels of 25(OH)D between 20 and 30 ng\/mL presented in 25% of patients; 65% of patients with sacroiliitis presented 25 (OH)D \u2264 20 ng\/mL. Methotrexate monotherapy discontinuation for failure was higher in the group with 25 (OH)D \u2264 20 ng\/mL (survival time: 92 \u00b1 10.3 weeks vs. 141.9 \u00b1 24.1 weeks vs. 160.1 \u00b1 23.6 weeks; p = 0.02) with higher discontinuation risk (HR = 2.168, 95% CI 1.334, 3.522; p = 0.002) than those with 25(OH)D between 20 and 30 ng\/mL and those with 25(OH)D \u2265 30 ng\/mL. Significantly shorter survival of first b-DMARDs was assessed in the group with 25 (OH)D \u2264 20 ng\/mL versus the other groups (133.6 \u00b1 11 weeks vs. 204.8 \u00b1 35.8 weeks vs. 298.9 \u00b1 35.4; p = 0.028) (discontinuation risk 2.129, 95% CI 1.186, 3.821; p = 0.011). This study highlights significant differences in clinical presentation, in particular sacroiliac involvement and on drug survival (methotrexate and b-DMARDs) in PsA patients with vitamin D deficiency. Further prospective studies, including a larger sample of patients, are needed to validate these data and to assess if the supplementation of vitamin D could improve the b-DMARDs response in PsA patients.<\/jats:p>","DOI":"10.3390\/ijms24065368","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T05:36:21Z","timestamp":1678685781000},"page":"5368","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Vitamin D Status and Psoriatic Arthritis: Association with the Risk for Sacroiliitis and Influence on the Retention Rate of Methotrexate Monotherapy and First Biological Drug Survival\u2014A Retrospective Study"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1356-8423","authenticated-orcid":false,"given":"Cinzia","family":"Rotondo","sequence":"first","affiliation":[{"name":"Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9929-9177","authenticated-orcid":false,"given":"Francesco Paolo","family":"Cantatore","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3532-5791","authenticated-orcid":false,"given":"Daniela","family":"Cici","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6027-5941","authenticated-orcid":false,"given":"Francesca","family":"Erroi","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3499-0140","authenticated-orcid":false,"given":"Stefania","family":"Sciacca","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6708-9105","authenticated-orcid":false,"given":"Valeria","family":"Rella","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Addolorata","family":"Corrado","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1468-3083.2009.03361.x","article-title":"Psoriasis and systemic inflammation: Underdiagnosed enthesopathy","volume":"23","author":"Girolomoni","year":"2009","journal-title":"J. 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