AB0778 IMPACT OF DISEASE IN A SPANISH POPULATION WITH PSORIATIC ARTHRITIS

Abstract

Background: Patients with psoriatic arthritis (PsA) experience significant disability and reduced quality of life, resulting from the emotional distress and functional impairment associated with psoriatic skin lesions, as well as joint disease. Patient reported outcomes are important to evaluate healthcare interventions and to reflect the impact of PsA on patients' lives. Objectives: The aims of the present study were to describe disease characteristics of PsA patients with an acceptable symptoms state (PsAID score<4) as well as to analyze predictive factors for PsAID<4. Methods: Post-hoc analysis of data from a cross-sectional observational, multicenter study, aimed at evaluating the prevalence of MDA in a Spanish population with PsA, to describe their characteristics and to evaluate the association between MDA and the impact of the disease as assessed by the PsAID questionnaire. The original study included 227 adult patients of both genders diagnosed with PsA according to CASPAR criteria with at least one year of disease evolution and on treatment with biological and/or conventional synthetic disease modifying anti-rheumatic drugs (cDMARD). The PsAID questionnaire reflects the effect of PsA from the patient's perspective. It is composed of 12 physical and psychological domains. PsAID score < 4 identified patient-acceptable symptoms state. Results: 122 patients with a PsAID score <4 were included. Demographic and clinical characteristics of the study population are shown in Table 1. Overall, 53/102 (52.0%) and 83/122 (68.0%) patients presented articular or skin remission, respectively. 76/122 (62.3%) of patients were in MDA state; the majority presented a low disability state according to HAQ (85.2%). A moderate relationship between HAQ<0.5 and PsAID<4 (k=0.5325) and fair between MDA and PsAID<4 (k=0.3594) were observed. Multivariate logistic regression analysis showed that patients with distal interphalangeal joint (DIP) involvement (odds ratio (OR) [95%CI], 0.402 [0.203-0.799]; p=0.009), family history of PsA (OR: 0.252 [0.089-0.716]; p=0.010) and increased CRP (OR: 0.922 [0.854-0.995; P = 0.036] were significantly less likely to reach a PsAID score<4. Conclusion: There are discrepancies between the treatment goals (MDA) and the impact of disease as assessed by PsAID. Clinical characteristics such as DIP involvement, inflammatory load (PCR) and genetic factors (familial history) seem to be associated with a lower probability of being in an acceptable symptoms state in PsA patients.