Session Type: Poster Session (Monday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) share many clinical features but are differentiated by key clinical and molecular characteristics. Patients with RA are often seropositive (S+) for rheumatoid factor (RF) or anti-cyclic citrullinated peptide (CCP) antibodies, whereas those with PsA or axSpA are usually seronegative (S−) for these antibodies. Limited data are available comparing patients with S+ and S− RA, and few studies have compared disease burden across patients with S+ RA, S− RA, PsA, and axSpA. We compared clinical and disease characteristics among these 4 groups in the Corrona RA and PsA/SpA Registries.
Methods: Adult patients with RA enrolled in the Corrona RA Registry and those with PsA or axSpA enrolled in the Corrona PsA/SpA Registry between March 2013 and February 2019 were included. Patients with RA must have had nonmissing RF and anti-CCP values at enrollment and were classified as S+ (RF or anti-CCP ≥ 20 U/mL) or S− (RF and anti-CCP < 20 U/mL). Patient demographics, clinical characteristics, and disease activity and patient-reported outcome (PRO) measures collected at registry enrollment were compared between patients with S+ RA vs S− RA, PsA, or axSpA using t or Wilcoxon rank-sum tests for continuous variables and χ2 or Fisher exact tests for categorical variables.
Results: A total of 4827 patients with S+ RA, 1959 with S− RA, 3001 with PsA, and 512 with axSpA were included. Patients with S− RA had a higher prevalence of comorbidities than those with S+ RA, including fibromyalgia (13.1% vs 5.9%) and depression (22.7% vs 17.6%) (Table 1). Patients with axSpA had a lower prevalence of comorbidities than those with S+ RA; there was no clear trend in prevalence of comorbidities between patients with PsA and S+ RA. Overall biologic and prednisone use were comparable between patients with S+ and S− RA, whereas patients with PsA or axSpA had more biologic use and less prednisone use than those with S+ RA (Table 2). Prior csDMARD use was higher among patients with S− RA and lower among patients with axSpA than those with S+ RA; current csDMARD use was comparable between patients with S+ and S− RA but lower among those with PsA or axSpA. Patients with S+ RA had higher swollen joint counts, ESR, and CRP levels than those with S− RA, PsA, or axSpA, and higher tender joint counts than those with PsA and axSpA (Table 3). Patients with S+ RA had a higher mean physician global assessment score than those with S− RA or PsA but lower than those with axSpA. Patients with S+ RA had a mean patient global assessment score comparable with that of patients with S− RA but lower than those with PsA or axSpA.
Conclusion: Patients with S− RA had a higher comorbidity burden but similar treatment profiles and PRO scores compared with those with S+ RA. Patients with PsA or axSpA had more biologic use and worse PRO scores than those with S+ RA. These results demonstrate the differences in disease manifestations of patients with these diseases. Further studies are needed to identify factors that differentiate these disease groups, particularly regarding therapeutic response.
To cite this abstract in AMA style:Ogdie A, Liu M, Rebello S, Cronin A, Dube B, McLean R, Yi E, Hur P, Mease P. Characteristics of Patients with Seropositive or Seronegative Rheumatoid Arthritis, Psoriatic Arthritis, or Axial Spondyloarthritis: Data from the US-Based Corrona Rheumatoid Arthritis and Psoriatic Arthritis/Spondyloarthritis (PsA/SpA) Registries [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/characteristics-of-patients-with-seropositive-or-seronegative-rheumatoid-arthritis-psoriatic-arthritis-or-axial-spondyloarthritis-data-from-the-us-based-corrona-rheumatoid-arthritis-and-psoriatic-a/. Accessed December 5, 2020.
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