Comparative Disease Burden in Patients with Rheumatoid Arthritis, Psoriatic Arthritis or Ankylosing Spondylitis: Data from COVAD Patient-reported E-survey

Diego Benavent¹, Marco Fornaro², Florenzo Iannone³, Lorenzo Cavagna⁴, Masataka Kuwana⁵, Naveen R⁶, Vishwesh Agarwal⁷, Jessica Day⁸, Mrudula Joshi⁹, Sreoshy Saha¹⁰, Kshitij Jagtap¹¹, Wanruchada Katchamart¹², Phonpen Akarawatcharangura Goo¹³, Binit Vaidya¹⁴, Tsvetelina Velikova¹⁵, Parikshit Sen¹⁶, Samuel Shinjo¹⁷, Ai Lyn Tan¹⁸, Nelly Ziade¹⁹, Marcin Milchert²⁰, Abraham Edgar Gracia-Ramos²¹, Carlo Caballero²², Hector Chinoy²³, Vikas Agarwal⁶, Rohit Aggarwal²⁴, Latika Gupta²⁵ and Vincenzo Venerito²⁶, ¹Hospital la Paz, Madrid, Spain, ²University of Bari, Grottaglie, Italy, ³Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, Italy, ⁴Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, ⁵Nippon Medical School Graduate School of Medicine, Tokyo, Japan, ⁶Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India, ⁷Mahatma Gandhi Missions Medical College, Lucknow, India, ⁸Walter and Eliza Hall Institute, Melbourne, Australia, ⁹Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India, ¹⁰Mymensingh Medical College, Faridpur, Bangladesh, ¹¹Seth Gordhandhas Sunderdas Medical College and King Edwards Memorial Hospital, Mumbai, India, ¹²Mahidol University, Bangkok, Thailand, ¹³Department of Medicine, Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand, ¹⁴National Center for Rheumatic Diseases (NCRD), Ratopul, Kathmandu, Nepal., Kathmandu, India, ¹⁵Department of Clinical Immunology, Medical Faculty, University Hospital "Lozenetz", Sofia University St. Kliment Ohridski, Sofia, Bulgaria, ¹⁶Maulana Azad Medical College, 2-Bahadurshah Zafar Marg, New Delhi, Delhi-110002, India., Dalhi, India, ¹⁷Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil, ¹⁸University of Leeds, Leeds, United Kingdom, ¹⁹Saint-Joseph University, Beirut, Lebanon, ²⁰Department of Internal Medicine, Rheumatology, Diabetology, Geriatrics and Clinical Immunology, Pomeranian Medical University in Szczecin, Szczecin, Poland, ²¹Department of Internal Medicine, General Hospital, National Medical Center "La Raza", Instituto Mexicano del Seguro Social, Av. Jacaranda S/N, Col. La Raza, Del. Azcapotzalco, C.P. 02990, Mexico City, Mexico, ²²Universidad del Norte, Barranquilla, Colombia, ²³The University of Manchester, Sale, United Kingdom, ²⁴University of Pittsburgh, Pittsburgh, PA, ²⁵Royal Wolverhampton Trust, Wolverhampton/University of Manchester, United Kingdom, ²⁶Rheumatology Department, Università degli Studi di Bari, Bari, Italy

Meeting: ACR Convergence 2023

Keywords: Patient reported outcomes, Psoriatic arthritis, rheumatoid arthritis, spondyloarthritis

Session Information

Date: Sunday, November 12, 2023

Title: (0325–0344) Patient Outcomes, Preferences, & Attitudes Poster I

Session Type: Poster Session A

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

Background/Purpose: Rheumatoid arthritis (RA) and spondyloarthritis (SpA), including either Psoriatic Arthritis (PsA) and Ankylosing Spondylitis (AS), are some of the most commonly diagnosed autoimmune rheumatic diseases in rheumatologists’ routine clinical practice. Both can lead to joint destruction and substantial disability. Understanding patients’ health and functional status is crucial to provide personalized management strategies to optimize disease control and enhance the quality of life. We aimed to compare disease burden in patients with RA, PsA or AS by assessing Patient-Reported Outcome Measurement Information System (PROMIS) Physical Health, Global Mental Health, Physical Function and Fatigue 4a together with Visual Analogue Scale (VAS) Pain.

Methods: Data were obtained in the international COVID vaccination in autoimmune rheumatic diseases study second e-survey (COVAD study). Demographics, AIRD diagnosis, disease activity, PROMIS Global Physical health, PROMIS Global Mental Health, PROMIS Physical Function SF10 and PROMIS Fatigue 4a scores were extracted from the COVAD study database. For this study, we only included patients with self-reported RA or spondyloarthritis (either PsA or AS) undergoing active treatment with conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) and/or biologic DMARDs, who answered all the survey questions. Active disease was defined as the patient’s perception of their disease as active in the four weeks before the first dose of COVID-19 vaccination. Analysis of Variance with Bartlett’s and Tukey’s test was used to compare continuous variables between groups.

Results: From January to June 2022, 1907 patients with RA, female 87.62% (1671/1907), with mean age (±SD) 50.95 ± 13.67, 311 patients with PsA, female 67.20% (209/311), with a mean age of 50.42 ± 12.70, and 343 patients with AS, male 63.27% (217/343), with a mean age of 43.13 ± 12.75 years, responded to the COVAD e-survey. When assessed in those with active disease, neither physical health, global mental health, physical function, fatigue, nor pain were different among groups (Table 1, Figure 1). Patients with inactive AS had higher mean global physical health scores than RA patients (13.13 ± 2.93 VS RA 12.48 ± 2.90, p=0.01, Table 1). Nevertheless, those with inactive RA or PsA showed more severe fatigue (PsA 10.58 ± 2.22, RA 10.45 ± 4.08, vs AS 9.4 ± 4.13, p =0.01 for both). Patients with inactive RA also reported poorer physical function and more residual pain than those with AS (37.79 ± 8.86 VS 41.13 ± 7.79, p< 0.001; 3.87 ± 2.45 VS 3.34 ± 2.39, p=0.01, respectively). Similarly, residual pain was perceived as higher in patients with inactive PsA than those with AS (4.04 ± 2.50 VS 3.34 ± 2.39, p=0.01).

Conclusion: The burden of disease is approximately similar in patients with active RA, PsA or AS. However, patients with inactive RA and PsA report a considerably greater disease burden compared to those with AS.

Figure 1. Violin plots showing kernel densities, quartiles and median for Patient-Reported Outcome Measures for patients with RA, PsA and AS, stratified by disease activity status.

Table 1. Patient-Reported Outcome Measures between groups.

Disclosures: D. Benavent: Abbvie, 5, Galapagos, 6, Janssen, 6, Novartis, 5, Roche, 6; M. Fornaro: None; F. Iannone: Abbvie, 2, 5, BMS, 2, 5, Janssen, 2, 5, Lilly, 2, 5, MSD, 2, 5, Novartis, 2, 5, Pfizer, 2, 5, Roche, 2, 5, UCB, 2, 5; L. Cavagna: None; M. Kuwana: AbbVie/Abbott, 6, Asahi-Kasei, 5, 6, Astellas, 6, AstraZeneca, 2, Boehringer-Ingelheim, 2, 5, 6, Chugai, 2, 5, 6, Corbus, 2, Eisai, 6, GlaxoSmithKlein(GSK), 2, Horizon, 2, Janssen, 6, Kissei, 2, MBL, 2, 5, Mitsubishi Tanabe, 2, 5, 6, Mochida, 2, 6, Nippon Shinyaku, 6, Ono, 5, 6; N. R: None; V. Agarwal: None; J. Day: CSL limited, 5; M. Joshi: None; S. Saha: None; K. Jagtap: None; W. Katchamart: None; P. Akarawatcharangura Goo: None; B. Vaidya: None; T. Velikova: AstraZeneca, 6, Pfizer, 6; P. Sen: None; S. Shinjo: None; A. Tan: Abbvie, 1, 6, Gilead, 6, Janssen, 6, Lilly, 6, Novartis, 6, Pfizer, 6, UCB, 6; N. Ziade: Abbvie, 6, Boehringer-Ingelheim, 6, Eli Lilly, 6, Janssen, 6, Newbridge, 6, Novartis, 6, Pfizer, 6, Pierre Fabre, 6, Roche, 6, sanofi, 6; M. Milchert: None; A. Gracia-Ramos: None; C. Caballero: None; H. Chinoy: AstraZeneca, 1, Biogen, 2, Eli Lilly, 5, GlaxoSmithKlein(GSK), 6, Novartis, 2, Orphazyme, 2, Pfizer, 1, UCB, 6; V. Agarwal: None; R. Aggarwal: Actigraph, 2, Alexion, 2, ANI Pharmaceuticals, 2, Argenx, 2, AstraZeneca, 2, Boehringer-Ingelheim, 2, 5, Bristol-Myers Squibb(BMS), 2, 5, CabalettaBio, 2, Capella Bioscience, 2, Corbus, 2, CSL Behring, 2, EMD Serono, 2, 5, Galapagos, 2, Horizon Therapeutics, 2, I-Cell, 2, Janssen, 2, 5, Kezar, 2, Kyverna, 2, Mallinckrodt, 5, Merck, 2, Octapharma, 2, Pfizer, 2, 5, Q32, 5, Roivant, 2, Sanofi, 2, Teva, 2; L. Gupta: None; V. Venerito: None.

To cite this abstract in AMA style:

Benavent D, Fornaro M, Iannone F, Cavagna L, Kuwana M, R N, Agarwal V, Day J, Joshi M, Saha S, Jagtap K, Katchamart W, Akarawatcharangura Goo P, Vaidya B, Velikova T, Sen P, Shinjo S, Tan A, Ziade N, Milchert M, Gracia-Ramos A, Caballero C, Chinoy H, Agarwal V, Aggarwal R, Gupta L, Venerito V. Comparative Disease Burden in Patients with Rheumatoid Arthritis, Psoriatic Arthritis or Ankylosing Spondylitis: Data from COVAD Patient-reported E-survey [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/comparative-disease-burden-in-patients-with-rheumatoid-arthritis-psoriatic-arthritis-or-ankylosing-spondylitis-data-from-covad-patient-reported-e-survey/. Accessed .

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