A Gender-based Analysis of Disease Activity and Its Relationship with Anxiety, Depression, Fatigue, and Fibromyalgia in Psoriatic Arthritis

Mehmet Tuncay Duruoz¹, Halise Hande Gezer ², Kemal Nas ³, Erkan Kilic ⁴, Betul Sargin ⁵, Sevtap Acer Kasman ¹, Hakan Alkan ⁶, Nilay Sahin ⁷, Gizem Cengiz ⁸, Nihan Cuzdan ⁹, Ilknur Albayrak Gezer ¹⁰, Dilek Keskin ¹¹, Cevriye Mulkoglu ¹², Hatice Resorlu ¹³, Şebnem Ataman ¹⁴, Ajda Bal ¹⁵, Okan Kucukakkas ¹⁶, Ozan Volkan Yurdakul ¹⁶, Meltem Alkan Melikoglu ¹⁷, Yildiray Aydin ³, Fikriye Figen Ayhan ¹⁸, Hatice Bodur ¹⁹, Mustafa Calis ⁸, Erhan Capkin ²⁰, Gul Devrimsel ²¹, Kevser Gök ²², Sami Hizmetli ²³, Ayhan Kamanli ³, Yasar Keskin ¹⁶, Hilal Kocabas ²⁴, Oznur Kutluk ²⁵, Nesrin Sen ²⁶, Omer Faruk Sendur ²⁷, Ibrahim Tekeoglu ³, Sena Tolu ²⁸, Murat Toprak ²⁹ and Tiraje Tuncer ²⁵, ¹Marmara University School of Medicine, PMR Department, Rheumatology Division, İstanbul, Turkey, ²Marmara University School of Medicine, PMR Department, Rheumatology Division, İstanbul, Istanbul, Turkey, ³Sakarya University School of Medicine, PMR Department, Rheumatology and Immunology Division, Sakarya, Turkey, ⁴Afyonkarahisar State Hospital, Afyonkarahisar, Turkey, ⁵Adnan Menderes University School of Medicine, PMR Department, Rheumatology Division, Aydın, Turkey, ⁶Pamukkale University School of Medicine, PMR Department, Rheumatology Division, Denizli, Turkey, ⁷Balıkesir University School of Medicine, PMR Department, Balıkesir, Turkey, ⁸Erciyes University School of Medicine, PMR Department, Rheumatology Division, Kayseri, Turkey, ⁹Şanlıurfa Training and Research Hospital, Rheumatology Clinic, Şanlıurfa, Turkey, ¹⁰Selçuk University School of Medicine, PMR Department, Konya, Turkey, ¹¹Kırıkkale University School of Medicine, PMR Department, Kırıkkale, Turkey, ¹²Ankara Training and Research Hospital, PMR Clinic, Ankara, Turkey, ¹³Çanakkale Onsekiz Mart University School of Medicine, PMR Department, Çanakkale, Turkey, ¹⁴Ankara University School of Medicine, Physical Medicine and Rehabilitation, Rheumatology Department, Ankara, Ankara, Turkey, ¹⁵Dışkapı Yıldırım Beyazıt Training and Research Hospital, PMR Clinic, Ankara, Turkey, ¹⁶Bezmialem Vakıf University School of Medicine, PMR Department, İstanbul, Turkey, ¹⁷Atatürk University School of Medicine, PMR Department, Rheumatology Division, Erzurum, Turkey, ¹⁸Uşak University School of Health Sciences, PMR Department, Uşak, Turkey, ¹⁹Yıldırım Beyazıt University School of Medicine, PMR Department, Ankara, Turkey, ²⁰Karadeniz Teknik University School of Medicine, PMR Department, Trabzon, Turkey, ²¹Recep Tayyip Erdoğan University School of Medicine, PMR Department, Riza, Turkey, ²²Numune Training and Research Hospital, Rheumatology Clinic, Ankara, Turkey, ²³Cumhuriyet University School of Medicine, PMR Department, Rheumatology Division, Sivas, Turkey, ²⁴Necmettin Erbakan University Meram School of Medicine, PMR Department, Rheumatology Division, Konya, Turkey, ²⁵Akdeniz University School of Medicine, PMR Department, Rheumatology Division, Antalya, Turkey, ²⁶Kartal Dr. Lütfi Kırdar Training and Research Hospital, Rheumatology Clinic, İstanbul, Turkey, ²⁷Adnan Menderes University School of Medicine, PMR Department, Aydın, Turkey, ²⁸Medipol University School of Medicine, PMR Department, İstanbul, Turkey, ²⁹Yüzüncü Yıl University School of Medicine, PMR Department, Van, Turkey

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Disease Activity, fatigue and depression, gender, Psoriatic arthritis

Session Information

Date: Tuesday, November 12, 2019

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster III: Psoriatic Arthritis, Clinical Features

Session Type: Poster Session (Tuesday)

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

Background/Purpose: This study sought to compare the disease activity and its relationship with anxiety, depression, fatigue, and fibromyalgia of patients with psoriatic arthritis (PsA) between female and male gender in a Turkish population.

Methods: This multi-center Turkish League Against Rheumatism (TLAR) Network study included 1134 patients (726 females, 408 males) diagnosed with PsA according to the CASPAR criteria. Demographic and clinic parameters of the patients were recorded. Disease activity was evaluated using the scores of DAS28, DAPSA, cDAPSA, MDA, VLDA, and BASDAI. Health Assessment Questionnaire (HAQ), SF-36, Hospital Anxiety and Depression Scale (HAD), fatigue VAS (0-10), and Fibromyalgia Rapid Screening Tool (FIRST) were assessed. Disease activity and remission rates were compared in male and female patients, and their relationship with fatigue, anxiety, depression, and fibromyalgia scores was analyzed. The Spearman correlation coefficient was used to assess correlations. Comparisons were made using the Mann-Whitney U and chi-squared tests. p< 0.05 was considered significant.

Results: The mean age of the patients was 47.4 years (SD:12.1) for females, 46 years (SD:12.2) for males (Table-1). Disease activity scores of DAS28, DAPSA, cDAPSA, and BASDAI were significantly higher in women than in men (p< 0.05) (Table-2), with men having both higher remission and low-activity rates. There was a significant difference in the rate of MDA in favor of men (p< 0.05), but not in the rate of VLDA. The frequencies of dactylitis, enthesitis, inflammatory bowel disease, and arthritis were similar in men and women, while men had a higher incidence of spondylitis (p< 0.05). Both men and women with MDA had significant improvements in the scores of fatigue, HAQ, FIRST, anxiety and depression as well as in SF-36 subscales as compared with their counterparts without MDA (p< 0.05). Overall, although there was no significant between-group difference in age, body mass index, and disease duration, women had significantly higher anxiety, depression, and FIRST scores (fibromyalgia) compared with men (p< 0.05) (Table-2). In both men and women, disease activity scores of DAPSA, DAS28, and BASDAI were significantly correlated with the scores of FIRST, anxiety, depression, fatigue, and HAQ (p< 0.05).

Conclusion: In patients with PsA, women seem to have lower levels of remission and higher levels of disease activity than men. In both women and men, disease activity scores are significantly correlated with fatigue, functional status, anxiety, depression, fibromyalgia, and quality of life.

Gender Table1

Gender Table2

Disclosure: M. Duruoz, İbrahim etem, 8, Abdi İbrahim, 8, Abdi Ibrahim, 8, Abvie, 2, 8, AMGEN, 8, AMGEN, Novartis, ILKO, ONKO, İbrahim Ethem, Abdi İbrahim, 8, Ibrahim Ethem, 8, ILKO, 8, Novartis, 8, ONKO, 8; H. Gezer, None; K. Nas, None; E. Kilic, None; B. Sargin, None; S. Acer Kasman, None; H. Alkan, None; N. Sahin, None; G. Cengiz, None; N. Cuzdan, None; I. Albayrak Gezer, None; D. Keskin, None; C. Mulkoglu, None; H. Resorlu, None; �. Ataman, None; A. Bal, None; O. Kucukakkas, None; O. Yurdakul, None; M. Alkan Melikoglu, None; Y. Aydin, None; F. Ayhan, None; H. Bodur, None; M. Calis, None; E. Capkin, None; G. Devrimsel, None; K. Gök, None; S. Hizmetli, None; A. Kamanli, None; Y. Keskin, None; H. Kocabas, None; O. Kutluk, None; N. Sen, None; O. Sendur, None; I. Tekeoglu, None; S. Tolu, None; M. Toprak, None; T. Tuncer, None.

To cite this abstract in AMA style:

Duruoz M, Gezer H, Nas K, Kilic E, Sargin B, Acer Kasman S, Alkan H, Sahin N, Cengiz G, Cuzdan N, Albayrak Gezer I, Keskin D, Mulkoglu C, Resorlu H, Ataman �, Bal A, Kucukakkas O, Yurdakul O, Alkan Melikoglu M, Aydin Y, Ayhan F, Bodur H, Calis M, Capkin E, Devrimsel G, Gök K, Hizmetli S, Kamanli A, Keskin Y, Kocabas H, Kutluk O, Sen N, Sendur O, Tekeoglu I, Tolu S, Toprak M, Tuncer T. A Gender-based Analysis of Disease Activity and Its Relationship with Anxiety, Depression, Fatigue, and Fibromyalgia in Psoriatic Arthritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/a-gender-based-analysis-of-disease-activity-and-its-relationship-with-anxiety-depression-fatigue-and-fibromyalgia-in-psoriatic-arthritis/. Accessed .

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