Is Skin Disease More Important to Women or Men in the Assessment of Disease Activity in Psoriatic Arthritis?

Maqbool Sheriff¹, Michel Zummer², J Antonio Avina-Zubieta³, Proton Rahman⁴, Wojciech Olszynski⁵, Michael Starr⁶, Philip Baer⁷, Emmanouil Rampakakis⁸, Eliofotisti Psaradellis⁹, Cathy Tkaczyk¹⁰, Brendan Osborne¹⁰, Karina Maslova¹¹, Francois Nantel¹² and Allen J Lehman¹¹, ¹Nanaimo Regional General Hospital, Nanaimo, BC, Canada, ²Rheumatology, Hôpital Maisonneuve-Rosemont and University of Montreal, Montreal, QC, Canada, ³Medicine, University of British Columbia, Department of Medicine, Division of Rheumatology, Vancouver, BC, Canada, ⁴Rheumatology, St. Clare's Mercy Hospital, St. John's, NF, Canada, ⁵University of Saskatchewan, Saskatoon, SK, Canada, ⁶Rheumatology, McGill University, Montreal, QC, Canada, ⁷Section on Rheumatology, Ontario Medical Association/Journal of the Canadian Rheumatology Association, Toronto, ON, Canada, ⁸JSS Medical Research, St-Laurent, QC, Canada, ⁹JSS Medical Research, Montreal, QC, Canada, ¹⁰Medical Affairs, Janssen Inc., Toronto, ON, Canada, ¹¹Janssen Inc., Toronto, ON, Canada, ¹²19 Green belt Dr, Janssen Inc., Toronto, ON, Canada

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: anti-TNF therapy, Outcome measures, psoriatic arthritis and skin

Session Information

Date: Sunday, November 8, 2015

Title: Spondylarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment Poster I: Clinical Aspects and Assessments

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Patient global assessment of disease activity (PtGA) is a standard outcome measure used both in randomized controlled trials and in clinical practice to ascertain patient subjective perception of disease activity in psoriatic arthritis (PsA). Given that previous studies have shown gender-specific differences with respect to disease parameters and patient reported outcomes, the aim of this analysis was to compare the patient profile at initiation of the first anti-TNF agent and to assess whether skin disease has a bigger impact on PtGA in women vs. men with PsA treated with infliximab (IFX) or golimumab (GLM) in a Canadian real-world, routine clinical practice setting.

Methods:

BioTRAC is an ongoing, prospective registry of patients initiating treatment for rheumatoid arthritis, ankylosing spondylitis, or PsA with IFX or GLM. Eligible people for this analysis included PsA patients treated with IFX who were enrolled since 2005 or with GLM enrolled since 2010. The correlation between disease parameters was assessed with the Pearson’s correlation coefficient (r), while generalized linear models were used to assess the independent predictors of PtGA.

Results:

A total of 238 patients (51.7% male) were included. At baseline, no significant differences in age (49.9 vs. 50.1; P=0.907), disease duration (4.8 vs. 6.2; P=0.214), or concomitant DMARD use (60.2% vs. 58.3%; P=0.765) were observed between genders. Mean (SD) disease parameters (men vs. women) were: PASI: 2.7 vs. 2.7, P=0.985; swollen joint count (SJC28): 4.3 vs. 5.2, P=0.121; tender joint count (TJC28): 5.6 vs. 7.7, P=0.016; HAQ: 1.18 vs. 1.51, P<0.001; pain (VAS mm): 44.2 vs. 50.0, P=0.101; PtGA: 45.4 vs. 51.2, P=0.114; MDGA (0-10 NRS) = 4.9 vs. 5.4, P=0.111.

Overall, a weak linear correlation was observed between PASI and PtGA in both men (r=0.272; P<0.001) and women (r=0.203; P<0.001). A moderate to strong correlation was observed between SJC28 and PtGA (mean: r=0.421, P<0.001; women: r=0.398; P<0.001). Univariate analysis independent of time of assessment showed that female gender (ΔPtGA=3.6; P=0.050), higher PASI [ΔPtGA (for each increase in PASI by 1)=2.2; P<0.001], and higher SJC28 (ΔPtGA=3.2; P<0.001), but not baseline age or disease duration, were associated with increased PtGA. However, upon adjusting for PASI (ΔPtGA=1.6; P<0.001) and SJC28 (ΔPtGA=2.7; P<0.001), no significant differences in PtGA were observed between genders.

Conclusion:

The results of this analysis show that, upon adjusting for PASI and SJC28, no significant differences exist in PtGA between genders. Furthermore, the association of PtGA was stronger with SJC28 than with PASI in both men and women, suggesting that both genders place more emphasis on articular disease severity than on skin symptoms when evaluating the global status of PsA.

Disclosure: M. Sheriff, Janssen Inc., 5; M. Zummer, Janssen Inc, 5; J. A. Avina-Zubieta, Janssen Inc., 5; P. Rahman, Janssen Inc, 5; W. Olszynski, Janssen Inc., 5; M. Starr, Janssen Inc, 5; P. Baer, Janssen Inc., 5,AbbVie, 5,Amgen, 5,BMS, 5,Pfizer Inc, 5,Roche Pharmaceuticals, 5; E. Rampakakis, Bristol-Myers Squibb, 2; E. Psaradellis, JSS Medical Research, 3; C. Tkaczyk, Janssen Inc., 3; B. Osborne, Janssen Inc., 3; K. Maslova, Janssen Inc., 3; F. Nantel, Janssen Inc., 3; A. J. Lehman, Janssen Inc., 3.

To cite this abstract in AMA style:

Sheriff M, Zummer M, Avina-Zubieta JA, Rahman P, Olszynski W, Starr M, Baer P, Rampakakis E, Psaradellis E, Tkaczyk C, Osborne B, Maslova K, Nantel F, Lehman AJ. Is Skin Disease More Important to Women or Men in the Assessment of Disease Activity in Psoriatic Arthritis? [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/is-skin-disease-more-important-to-women-or-men-in-the-assessment-of-disease-activity-in-psoriatic-arthritis/. Accessed .

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