Background/Purpose: Oligoarticular PsA accounts for ≈50% of PsA worldwide, but only a paucity of data describes disease burden among these patients. The Corrona PsA/SpA Registry, a prospective, US-based, observational cohort study, collects real-world data on PsA patient characteristics and treatment, including oligoarthritis. This analysis characterized patient demographics, clinical characteristics, and patient-reported outcomes (PROs) at treatment initiation in the Corrona PsA/SpA Registry in biologic-naïve patients with oligoarticular (≤4 swollen and ≤4 tender joints) vs polyarticular ( >4 swollen or >4 tender joints) PsA.

Methods: Biologic-naïve patients ≥18 years of age diagnosed with PsA and enrolled in the registry who initiated apremilast, biologics, and/or csDMARDs for PsA from March 2013‒December 2018 were included. Patient demographics, disease activity, treatment history, comorbidities, and PRO data were analyzed at treatment initiation; comparisons between oligoarticular and polyarticular PsA patients were performed using t-tests or Wilcoxon rank-sum tests for continuous variables and chi-square tests or Fisher’s exact tests for categorical variables.

Results: 330 biologic-naïve PsA patients initiating apremilast, biologics, and/or csDMARDs were included (oligoarthritis: n=149; polyarthritis: n=181). Demographics and clinical characteristics were mostly similar for patients with oligoarthritis and polyarthritis, including mean age (51.6 vs 54.3 years; P=0.068), proportion of females (51.0% vs 59.7%; P=0.117), mean disease duration (3.0 vs 3.1 years; P=0.789), and prior use of csDMARDs (13.4% vs 21.0%; P=0.072). Comorbidity history was similar between the 2 groups, but the proportion of patients with fibromyalgia was higher in the polyarthritis group (2.0% vs 8.8%; P=0.008; Table 1). Patients with oligoarthritis had lower disease activity at treatment initiation vs those with polyarthritis based on SJC (0-66) and TJC (0-68), nail psoriasis VAS score, cDAPSA score, presence of enthesitis, SPARCC enthesitis score, presence of dactylitis, and dactylitis count. More patients with oligoarthritis were classified with minimal disease activity vs patients with polyarthritis (Table 2). Mean Pain VAS (42.6 vs 59.8), Fatigue VAS (41.9 vs 55.3), Patient’s Global Assessment of Disease Activity VAS (38.6 vs 47.7), and HAQ-DI (0.7 vs 1.0) scores were significantly lower and the proportion of patients with HAQ-DI score < 0.5 was significantly greater for patients with oligoarthritis vs polyarthritis (39.7% vs 20.1%) (all P≤0.001). Presence of inflammatory back pain (8.7% vs 10.5%; P=0.588) and mean psoriasis-involved body surface area (8.0% vs 6.8%; P=0.276) were similar in the 2 groups.

Conclusion: This Corrona PsA/SpA Registry analysis showed similar overall disease and comorbidity burden in biologic-naïve patients with oligoarthritis and polyarthritis. However, patients with oligoarthritis vs polyarthritis had lower scores on disease activity and PRO measures at treatment initiation.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/burden-of-disease-at-treatment-initiation-among-biologic-naive-patients-with-oligoarticular-versus-polyarticular-psoriatic-arthritis-in-the-corrona-psoriatic-arthritis-spondyloarthritis-registry/