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Abstract Number: 2550

A New and Simpler Tool for Global Psoriatic Arthritis Assessment: Simplified Composite Psoriatic Disease Activity Index (sCPDAI)

Maria Laura Acosta Felquer1, Musaab Elmamoun2, Agnes Szentpetery3,4, Phil Gallagher5, Oliver FitzGerald6 and Enrique R. Soriano7, 1Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano de Buenos Aires, and Fundacion PM Catoggio, Buenos Aires, Argentina, 2Rheumatology, St. Vincent's University Hospital, Dublin 4, Ireland, 3Rheumatology, Department of Rheumatology, St. Vincent's University Hospital, Dublin, Ireland, 4Bone & Joint Unit, Department of Rheumatology, St. Vincent's University Hospital, Dublin, Ireland, 5St. Vincent's University Hospital, Department of Rheumatology, Dublin, Ireland, 6St. Vincent's University Hospital, Department of Rheumatology. UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland, 7Rheumatology Unit, Internal Mecine Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

Meeting: ACR/ARHP Annual Meeting 2017

Date of first publication: September 18, 2017

Keywords: , ,

Session Information

Date: Tuesday, November 7, 2017

Title: Spondyloarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment Poster III: Outcomes, Outcome Measures, and Comorbidities

Session Type: ACR Poster Session C

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

Background/Purpose: The heterogeneity of psoriatic arthritis ( PsA) that includes a possible combination of axial disease, peripheral arthritis, enthesitis, dactylitis, skin and nail involvement, makes its global assessment a significant challenge for clinical metrology. Over the last years different tools are used for measuring the disease activity in patients with PsA.The Composite Psoriatic Disease Activity Index (CPDAI) is one of the more comprehensive, taking into account the assessment of five different domains. One of the problems with CPDAI is its complexity and the large number of instruments that need to be applied for a full assessment

The aim of this study was to evaluate the performance of a simplified CPDAI (sCPDAI) in a large group of PsA patients

Methods: We evaluated consecutive PsA patients included in the MOPSA database. Measuring Outcome in Psoriatic Arthritis (MOPsA) is a new web- based tool which calculates both MDA and CPDAI based on patient reported outcomes and assessment by physicians. Data collected included: joint counts, patient pain and global activity ratings, HAQ, PASI, BASDAI, DLQI, PsAQoL. Clinical DAPSA (Disease Activity for PSoriatic Arthritis), MDA (Minimal Disease Activity)and CDAI (Clinical Disease Activity Index) were also calculated. Pearson’s correlations between CPDAIs and different measures of disease activity were calculated. CPDAI values between patients fulfilling and not fulfilling MDA were compared using Mann-Whitney U test. The area under the ROC curve (AUC) was calculated to quantify the discriminative performance for MDA

Results: 214 PsA patients, fulfilling CASPAR criteria, with mean age of 49 years (SD: 12), and 111 (52%) females, were included. Seventy-six (35.5 %) patients were in MDA. Median (IQR) CDAI, cDAPSA, CPDAI, and PASI were 7 (4-16), 10 (5-18), 3 (2-5), and 0.8 (0-3), respectively. Table 1 shows the variables used to construct sCPDAI, and table 2 shows sCPDAI correlation with different variables. Patients in MDA had significantly lower sCPDAI than patients not in MDA (mean (SD) 1.7 (1.4) vs 5.3 (2.8); p<0.0001). The sCPDAI AUC of the ROC curve for MDA was 0.87 (95% CI: 0.83-0.92), with 4 as the best cut off value to discriminate among patients not in MDA status (sensitivity: 68.42%; specificity: 87.67%; +LR: 5.55, -LR: 0.36)

Table1: Simplified CPDAI variables

Not Involved (0)

Mild (1)

Moderate (2)

Severe (3)

Peripheral arthritis

Not involved

≤ 4 joints (TJC or SJC) & HAQ ≤ 0.5

≤ 4 joints (TJC or SJC) & HAQ > 0.5 OR >4 joints (TJC or SJC) & HAQ <0.5

> 4 Joints (TJC or SJC) & HAQ > 0.5

Skin disease

Not involved

BSA ≤3

BSA > 3 ≤30

BSA >30

Enthesitis

Not involved

≤ 3 sites & HAQ

< 0.5

≤ 3 sites & HAQ > 0.5 OR

>3 sites &

HAQ < 0.5

>3 sitios & HAQ > 0.5

Dactylitis

Not involved

≤ 3 digits & HAQ < 0.5

≤ 3 digits & HAQ

> 0.5 OR

>3 digits & HAQ

< 0,5

>3 digits & HAQ

> 0.5

Spinal Disease

Not involved

BASDAI < 4 & HAQ < 0.5

BASDAI < 4 & HAQ > 0.5

BASDAI > 4 & HAQ<0.5

BASDAI >4 & HAQ > 0.5

Table 2. Spearman correlation between sCPDAI and different outcome measures

Spearman (rho) correlation coefficient with CPDAIs

P value

CPDAI

0.9717

<0.0001

CDAI

0.8364

<0.0001

cDAPSA

0.8042

<0.0001

PASI

0.4033

<0.0001

Tender Joint Count

0.7937

<0.0001

Swollen Joint Count

0.5995

<0.0001

DLQI

0.2626

0.001

PsAQol

0.5339

<0.0001

Patient Pain (VAS)

0.6100

<0.0001

Patient Global Assessment (VAS)

0.6067

<0.0001

Physicians Global Assessment (VAS)

0.7362

<0.0001

Conclusion: A simplified CPDAI, that includes only HAQ and BASDAI over usual daily clinical practice assessment, showed very good correlation with most outcome measurements used in PsA, and a very good discriminatory power for patients not in remission by MDA

Disclosure: M. L. Acosta Felquer, None; M. Elmamoun, None; A. Szentpetery, None; P. Gallagher, None; O. FitzGerald, AbbVie, Bristol-Myers Squibb, Novartis, Pfizer Inc, 2,Amgen, Celgene, Eli Lilly, Janssen, 5; E. R. Soriano, Abbvie, BMS, Novartis, Janssen, Pfizer, Roche, UCB, 2,Abbvie, BMS, Novartis, Janssen, Pfizer, Roche, UCB, 5,Abbvie, BMS, Novartis, Janssen, Pfizer, Roche, UCB, 8.

To cite this abstract in AMA style:

Acosta Felquer ML, Elmamoun M, Szentpetery A, Gallagher P, FitzGerald O, Soriano ER. A New and Simpler Tool for Global Psoriatic Arthritis Assessment: Simplified Composite Psoriatic Disease Activity Index (sCPDAI) [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/a-new-and-simpler-tool-for-global-psoriatic-arthritis-assessment-simplified-composite-psoriatic-disease-activity-index-scpdai/. Accessed .

ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-new-and-simpler-tool-for-global-psoriatic-arthritis-assessment-simplified-composite-psoriatic-disease-activity-index-scpdai/