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Abstract Number: 2306

Comparative Study Of Patients With Peripheral Psoriatic Arthritis, Axial Psoriatic Arthritis and Axial Spondyloarthritis Without Psoriasis

Abhijeet Danve1, Neha Garg2 and Atul A. Deodhar3, 1Rheumatology, Oregon Health and Science University, Portland, OR, 2Internal Medicine, Division of arthritis and rheumatic diseases, Oregon Health and Sciences University, Portland, OR, 3Oregon Health and Science University, Portland, OR

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Psoriatic arthritis and spondylarthritis

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Session Information

Title: ARHP Rheumatoid Arthritis - Clinical Aspects: Clinical Practice/Patient Care

Session Type: Abstract Submissions (ARHP)

Background/Purpose:

Axial involvement in Psoriatic Arthritis (PsA) is reported to be between 40 -70%. Both, axial and peripheral arthritis in patients with PsA can cause unique functional challenges and can reduce quality of life substantially. We aimed to compare the disease characteristics and quality of life (QoL) in three groups of patients: PsA with axial involvement (PsAax), PsA with only peripheral disease (PsApr), and axial spondyloarthritis patients without psoriasis (axSpA).

Methods:

Patients with new diagnosis of PsAax seen at Oregon Health & Sciences University between 2007 and 2012 were identified by searching electronic medical records. Age and sex matched patients with PsApr and axSpA without psoriasis were identified. Demographic and clinical data was collected retrospectively. Disease activity and QoL was measured using validated measures such as RAPID 3 and BASDAI.  Statistical significance was calculated using Mann-Whitney, Chi square and Fisher’s exact tests as applicable.

Results:

We found 28 patients with PsAax, who were compared with age and sex matched patients with PsApr (n=26) and axSpA without psoriasis (n=29) respectively. Disease duration, BMI, BASDAI and RAPID 3 scores were similar among three groups (see Table).  Smokers were more prevalent in PsAPr than axSpA patients (p = 0.05). PsAax patients had more peripheral arthritis and uveitis compared to axSpA patients (p = 0.01 for both). Prevalence of depression was more in patients with psoriasis (PsAax and PsApr (about 40%) compared to axSpA (24%) but did not reach statistical significance. Prevalence of fibromyalgia, inflammatory bowel disease, mean ESR and CRP were similar in all three groups. More patients in axSpA group used NSAIDs compared to PsAax group (p = 0.05).  DMARDs were used more often in patients with PsAax (p = 0.01) and PsApr (p = 0.01) than in axSpA. TNF blockers were used more often in PsAax than in axSpA group (p = 0.03).

Conclusion:

In this comparative analysis of PsA patients with axial and peripheral disease and axSpA patients without psoriasis, PsAax patients had higher prevalence of peripheral arthritis compared to those with axSpA alone. Uveitis was less prevalent in PsAax and PsApr compared to axSpA patients.  Depression was more prevalent in patients with psoriasis suggesting an important impact on QoL related to skin disease.

 

PsA with axial disease (PsAax)

N =28

 Mean (SD) or %

PsA peripheral (PsApr)

N=26

Mean (SD) or %

Axial spondyloarthritis without psoriasis (axSpA)

N=29
Mean (SD) or %

Age (years)

48 (14)

45 (14)

45 (13)

Females

57

62

55

Disease duration (years)

13 (13)

8 (9)

13 (13)

BMI (kg/m2)

29 (7)

31 (10)

30 (10)

Smoking

32

12*

34*

Peripheral arthritis

50∞

100

10∞

Uveitis

4∞

0*

31* ∞

Depression

39

42

24

RAPID3

4 (2)

5 (2)

5 (2)

BASDAI

4 (1)

NA

5 (5)

NSAID use

17*

21

26*

DMARD use

68∞

85

17∞

Anti-TNF use

82*

77

55*

* p < 0.05

∞ p = 0.01

NA= Not applicable


Disclosure:

A. Danve,
None;

N. Garg,
None;

A. A. Deodhar,

AbbVie, Merck-Sharp-Dohme, Pfizer and UCB,

5,

AbbVie, Merck-Sharp-Dohme, Pfizer and UCB,

8,

AbbVie, Amgen, Novartis, UCB,

2.

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