Cardiorespiratory fitness is reduced in psoriatic arthritis, with higher disease activity and adiposity predicting lower VO2peak.
Cardiorespiratory Fitness in Psoriatic Arthritis
In a cross-sectional cohort of 80 adults with psoriatic arthritis, investigators quantified peak oxygen uptake using incremental maximal cardiopulmonary exercise testing. Mean VO2peak measured 26.03 mL per minute per kilogram, corresponding to 74% of a physically active reference population. Forty one percent of participants met the threshold for impaired cardiorespiratory fitness. The between group difference reached statistical significance with p less than 0.001.
Determinants of Lower VO2peak
Multivariable models adjusted for age and sex explained a substantial proportion of fitness variance with an adjusted R squared of 0.71. Higher psoriatic arthritis disease activity was associated with lower VO2peak. Greater waist hip ratio also related to lower VO2peak, which highlights the importance of body composition in this population. Higher patient reported disease impact on the Psoriatic Arthritis Impact of Disease questionnaire showed a negative association with VO2peak. In contrast, more minutes per week of moderate to vigorous physical activity during commuting and leisure related positively to VO2peak.
Clinical Implications for Practice
These results show that many individuals with psoriatic arthritis have impaired cardiorespiratory fitness despite treatment advances. The pattern links inflammation, unfavorable anthropometrics, and perceived disease burden with lower exercise capacity. Routine assessment of physical activity and simple anthropometric indices can help identify patients at higher risk. Integrating structured aerobic conditioning alongside disease control and weight management may support improvement in peak oxygen uptake and daily function. Cardiometabolic risk assessment remains important since reduced fitness often tracks with broader health outcomes.
Reference: Kaerts M et al. Impaired cardiorespiratory fitness in psoriatic arthritis: insights from cardiopulmonary exercise testing. RMD Open. 2025;11(4):e006110.
