ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 632

Interpretation of Symptoms Should Take into Account Gender in Psoriatic Arthritis: An Analysis of 451 Patients

Clémence Gorlier1, Laure Gossec2, Deborah Puyraimond-Zemmour1, Laura C. Coates3, Uta Kiltz4, Ying Ying Leung5, Penelope Palominos6, Juan D. Cañete7, Rossana Scrivo8, Andra Rodica Balanescu9, Emmanuelle Dernis10, Sandra Tälli11, Adeline Ruyssen-Witrand12, Martin Soubrier13, Sibel Zehra Aydın14, Lihi Eder15, Inna Gaydukova16, Ennio Lubrano17, Pascal Richette18, M. Elaine Husni19, Maarten de Wit20, Josef S. Smolen21 and Ana-Maria Orbai22, 1Sorbonne Université, PARIS, France, 2Rhumatologie, Médecine Sorbonne Université, Pitié-Salpétrière Hospital, Paris, France, 3University of Oxford, Oxford, United Kingdom, 4Rheumatology, Rheumazentrum Ruhrgebiet, Herne, and Ruhr University Bochum, Herne, Germany, 5Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore, 6Rheumatology, Hospital de Clinicas de Porto Alegre, Santa Cecilia, Brazil, 7Rheumatology, Hospital Clinic and IDIBAPS, Barcelona, Spain, 8Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy, 9Department of Internal Medicine and Rheumatology “Sf. Maria” Hospital, Bucharest, Romania, 10Service de Rhumatologie, CH du Mans, Le Mans, France, 11East-Tallinn Central Hospital, Department of Rheumatology, Tallinn, Estonia, 12Rheumatology, Purpan Hospital, Toulouse III University, Toulouse, France, 13Rheumatology, Department of Rheumatology, CHU Gabriel Montpied, Clermont-Ferrand, France, 14University of Ottawa, Ottawa, ON, Canada, 15Women's College Research Institute, University of Toronto, Women's College Hospital, Toronto, ON, Canada, 16North-western state medical university n.a. II Mechnikov, St. Petersburg, Russian Federation, 17Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy, 18Rheumatology, Université Paris Diderot, Paris, France, 19Orthopedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, OH, 20Dept. Medical Humanities, Amsterdam Public Health (APH), VU University Medical Centre, Amsterdam, Netherlands, 21Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria, 22Johns Hopkins University School of Medicine, Baltimore, MD

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Date: Sunday, October 21, 2018

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster I: Imaging, Clinical Studies, and Treatment

Session Type: ACR Poster Session A

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

Background/Purpose:

Treatments targets in psoriatic arthritis (PsA) are remission (REM) or Low Disease Activity (LDA) which are usually defined based on objective disease activity but also patient-reported outcomes (PROs). The objective was to analyze if there was a gender difference for PROs in PsA, a real-life setting and if this difference was associated with disease activity.

Methods:

ReFlap (NCT03119805) is a cross-sectional study in 14 countries of consecutive adult patients with definite PsA and more than 2 years of disease duration. Each patient underwent articular, entheseal and skin assessment and composite measures i.e. clinical Disease Activity in PSoriatic Arthritis (cDAPSA) and Minimal Disease Activity (MDA) were assessed. PROs were collected: Patient Global Assessment (PGA) (range 0-10), Health Assessment Questionnaire, HAQ-DI (0 – 3) and the Psoriatic Arthritis (PsA) Impact of Disease questionnaire (PsAID12) (comprising 12 questions including pain and fatigue with a final 0 – 10 score where 0 is perfect). Differences in scores between men and women were calculated and p-values were computed.

Results:

Of 466 patients, 451 could be analyzed: 226 (50.1%) were men, mean age (standard deviation) was 53.1 (12.7) years, mean disease duration was 11.1 (8.2) years, 62.9% were taking conventional synthetic DMARDs and 60.6% a biologic. Disease activity was moderate: 9.5% had a Body Surface Area of psoriasis (BSA)≥ 5%, mean Tender Joint Count (TJC 0-68) was 4.6 (9.4), mean Swollen Joint Count (SJC 0-66) was 2.1 (6.3). Overall, 62.1% patients had cDAPSA levels< 13 and 37.9% fulfilled MDA5/7 (i.e. remission and low disease activity). Concerning PROs, mean PGA was 4.1 (2.9), mean HAQ-DI was 0.66 (0.67) and mean PsAID12 was 3.4 (2.5). According to gender, PROs were significantly higher in women: 4.7 (2.8), 0.86 (0.69) and 4.1 (2.5) in females versus 3.4 (2.9), 0.46 (0.60) and 2.7 (2.3) in males for PGA, HAQ-DI and PsAID12, respectively (all p < 0.001). When comparing components of PsAID12 scores, they were systematically higher in women (all p <0.01) except skin problems (2.9 (3.0) females, 2.5 (2.6) males, p=0.23). Conversely, objective measures of disease activity didn’t differ by gender: SJC 2.1 (5.7) females, 2.0 (6.8) males, p=0.14; BSA≥5%: 8.4% females, 10.6% males, p=0.49, except for TJC: 5.4 (9.2) females, 3.8 (9.5) males, p<0.001 and CRP>5mg/L: 38.7% females, 30.1% males, p=0.045. MDA5/7 was less often reached in women: 25.8% females versus 50.0% males, p<0.001.

Conclusion:

A significant gender difference was observed in this cross-sectional analysis of unselected PsA patients from 14 countries, with females reporting worse symptoms although musculoskeletal and skin disease activity was similar. This gender difference has to be taken into account when targeting remission or low disease activity, and in the overall management of PsA activity and impact.

Disclosure: C. Gorlier, None; L. Gossec, None; D. Puyraimond-Zemmour, None; L. C. Coates, None; U. Kiltz, None; Y. Y. Leung, None; P. Palominos, None; J. D. Cañete, None; R. Scrivo, None; A. R. Balanescu, None; E. Dernis, None; S. Tälli, None; A. Ruyssen-Witrand, None; M. Soubrier, None; S. Z. Aydın, None; L. Eder, None; I. Gaydukova, None; E. Lubrano, None; P. Richette, Fidia, 5, 8; M. E. Husni, None; M. de Wit, None; J. S. Smolen, None; A. M. Orbai, None.

To cite this abstract in AMA style:

Gorlier C, Gossec L, Puyraimond-Zemmour D, Coates LC, Kiltz U, Leung YY, Palominos P, Cañete JD, Scrivo R, Balanescu AR, Dernis E, Tälli S, Ruyssen-Witrand A, Soubrier M, Aydın SZ, Eder L, Gaydukova I, Lubrano E, Richette P, Husni ME, de Wit M, Smolen JS, Orbai AM. Interpretation of Symptoms Should Take into Account Gender in Psoriatic Arthritis: An Analysis of 451 Patients [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/interpretation-of-symptoms-should-take-into-account-gender-in-psoriatic-arthritis-an-analysis-of-451-patients/. Accessed .

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