ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1584

Evaluation of the Patient Acceptable Symptom State in Patients with Psoriatic  Arthritis

Pinar Cetin1, Dilek Solmaz2, Murat Keser3, Ismail Sari1, Merih Birlik1, Nurullah Akkoc1 and Fatos Onen1, 1Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey, 2Department of Internal Medicine, Division of Rheumatology, Namik Kemal University School of Medicine, Tekirdag, Turkey, 3Internal Medicine, Dokuz Eylul University School of Medicine, Izmir, Turkey

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Spondyloarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment II

Session Type: Abstract Submissions (ACR)

Background/Purpose

The Patient Acceptable Symptom State (PASS), a single-question outcome, has been defined as an absolute level of patient well-being, which was used in the evaluation of treatment efficacy in several rheumatologic diseases. We aimed to evaluate the acceptability, reliability and discriminant capacity of the PASS in patients with psoriatic arthritis (PsA).

Methods

This study included PsA patients who fulfilled the CASPAR criteria. Disease activity was assessed in the patients by using “Composite Psoriatic Disease Activity Index (CPDAI)”, “Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)”, “Patient Global” and “Disease Activity Score (DAS) 28”. “Psoriasis Area Severity Index (PASI)” was used for the measurement of severity of psoriasis and high-sensitive C-reactive protein (hs-CRP) level was measured as laboratory parameter of disease activity. Other follow-up parameters such as “Bath Ankylosing Spondylitis Functional Index (BASFI)”,”Health Assessment Questionnaire (HAQ)” and “Ankylosing Spondylitis Quality of Life (ASQoL)” were also included in the study. PASS (+) and PASS (–) groups were compared for demographic features and disease severity parameters using Mann-Whitney U test. Stepwise logistic regression was used to assess contributors to PASS. PASS thresholds were estimated with receiver operating characteristic (ROC) curve analysis. Cut off levels targeting the 75th percentile of the cumulative distribution were also determined.

Results

There were 101 PsA patients (34 male, 67 female; mean age: 46.8 ± 11.5). Eighteen (17.8%) patients had predominantly axial disease, 52 (51.5%) had predominantly peripheral disease and 31 (30.7%) had mixed symptoms. Thirty-four (33.6%) of 101 patients were in PASS. The patients with an acceptable status had significantly lower mean CPDAI, BASDAI, DAS28-CRP, ASQoL and patient global scores than the others (Table 1). The significant contributor to PASS was BASDAI (r:-0,343 Exp(B):  0.71; p<0.001). PASS (+) 75th percentile thresholds were 4.3 for BASDAI (sensivity:70.6%, specificity: 64%) and 4.0 for CPDAI (sensivity:76.5%, specificity: 54%).

Conclusion

PASS can be considered as a method in determination of PSA disease activity in the future. 

Table 1. Clinical and demographic feautures of the PASS (+) and PASS (–)  PSA patients 

 

PASS (+) (n:34)

PASS( –) (n:67)

P

Age , mean ± SD

47.9 ± 12.3

46 ± 11.0

>0.05

Male , n; %

13, 38.2

21, 31.3

>0.05

Education (years), mean ± SD

9.1 ± 4.1

9.2 ± 4.0

>0.05

CPDAI, mean ± SD

2.9 ± 2.1

4.0 ± 2.5

0.012

BASDAI, mean ± SD

2.5 ± 2.2

4.5 ± 2.3

<0.001

DAS28 CRP, mean ± SD

2.2 ± 0.8

2.7 ± 1.1

0.044

PASI, mean ± SD

5.8 ± 7.4

6.7 ± 10.1

>0.05

hs CRP, mean ± SD

10.4 ± 13.1

10.2 ± 12.5

>0.05

BASFI, mean ± SD

1.9 ± 2.1

2.9 ± 2.7

>0.05

HAQ, mean ± SD

0.4 ± 0.5

0.8 ± 0.6

>0.05

ASQoL, mean± SD

5.7 ± 5.8

8.6 ± 5.7

0.012

Patient  global, mean ± SD

2.85 ± 2.8

4.4 ± 2.8

0.011

Disclosure:

P. Cetin,
None;

D. Solmaz,
None;

M. Keser,
None;

I. Sari,
None;

M. Birlik,
None;

N. Akkoc,
None;

F. Onen,
None.

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