Background/Purpose: Coping may be defined as the set of adaptive processes a patient uses to live well with aspects of disease such as pain. Coping may represent an ability to help manage symptoms in patients with arthritides. This study aimed to explore the influence of patient’s ability to cope on patient reported outcome measures (PROs) and composite clinical scores in psoriatic arthritis (PsA), and to determine whether differential ability to cope influences the association between clinical and ultrasonographic (US) findings in PsA.

Methods: In this cross sectional study 141 PsA patients were consecutively recruited from an out-patient clinic. They all fulfilled the CASPAR criteria for PsA. 66 swollen/68 tender joint count (SJC/TJC), PROs and composite scores were registered. US evaluation of 34 joints and additionally joints found to be swollen/tender by 66/68 joint count, 15 tendons, 10 entheses and additionally entheses found to be tender by clinical examination of 19 other entheses was performed. Patients reported their level of coping on a visual analogue scale (VAS, range 0-100 mm, 100 mm worst coping). Gray scale (GS) and power Doppler (PD) sum scores of joints, entheses and tendons were assessed. Correlation analyses were performed by Spearman’s rank correlation test (non-parametric distribution of the data). To explore the relation between patient’s ability of coping, clinical factors and composite scores we used multiple regression analyses.

Results: We found that coping was strongly correlated (p<0.001) to joint pain (r=0.67), patient global assessment (PGA) (r=0.73) and TJC68 (r=0.42). When separating into good (116 patients) and poor (24 patients) ability of coping (defined as ≤50 and >50 mm on a VAS scale, respectively), we found that patients with poor ability of coping had no correlations between several PROs and composite scores, whereas patients with good ability of coping had weak to moderate correlations (table). Patients with poor ability of coping had on average higher Disease Activity Index for Psoriatic Arthritis (DAPSA) (20.0±2.5, p<0.001), Composite Psoriasis Disease Activity Index (CPDAI) (2.8±0.5, p<0.001 ), Psoriatic ArthritiS Disease Activity Score (PASDAS) (0.27±0.1, p=0.006) score, Disease Activity Score 28 (DAS28) (1.1±0.2, p<0.001) and Simple Disease Activity Index (SDAI) (10,7±1.3, p<0.001), model adjusted for age, gender and PD sum score.

Spearman’s rank correlation test, *p<0.05, **p<0.01, ***p<0.001

Conclusion: Patient’s ability of coping is influencing PROs in PsA. US evaluation of disease activity is correlated to clinical findings for patients with good ability of coping, but not for patients with poor ability of coping.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/patients-ability-of-coping-is-influencing-the-correlation-between-clinical-and-ultrasonographic-evidence-of-disease-activity-in-psoriatic-arthritis/