Background/Purpose: Cervical inflammatory pain is very common and rarely studied in patients with Psoriatic Arthritis (PsA). The purpose of our study was to evaluate the prevalence of Inflammatory Neck Pain (INP) in patients with PsA and its association with clinical features.

Methods: Patients with PsA according to CASPAR criteria ≥ 18 years, belonging to RAPSODIA cohort were included. Sociodemographic data, clinical features and treatment received were recorded. Peripheral joints assessment was performed by counting 66/68 swollen/tender joints and the following indexes were calculated DAS28, DAPSA, CPDAI and MDA. Cutaneous involvement was evaluated by PASI and BSA, and nail by PNSS. The presence of dactilitis and enthesitis (MASES) was assessed. Spinal disease activity (BASDAI), functional capacity (HAQ and BASFI) and quality of life (PsAQol and ASQoL) were evaluated with appropriate self- administered questionnaires. The presence of INP was defined as pain in the cervical region with classical inflammatory characteristics and was evaluated as a dichotomous variable (yes/no). Radiographs of the spine and pelvic region were performed and read by a single blinded physician according to BASRI and mSASSS indexes.

Results: 110 patients were included, 56 men (50.9%) with a median age of 55 years (IQR 44.7-63.2). Inflammatory neck pain was reported by 32 patients (29.1%), and it was significantly more frequent in those with mixed involvement (axial and peripheral) (68.8%) vs those with only peripheral involvement (31.3%), p = 0.01. Patients with INP had poorer quality of life for ASQoL (6.1 ± 3.6 vs 6 ± 5.3, p = 0.04) and PsAQoL (8.9 ± 6 vs 6 ± 6, p = 0.02), worse functional capacity (BASFI 4.6 ± 2.5 vs 3.3 ± 2.8, p = 0.03), and higher disease activity [(BASDAI 5.4 ± 2.7 vs 3.8 ± 2.7, p = 0.007) and CPDAI (8.2 ± 3.5 vs 6.3 ± 3.7, p = 0.03)]. MDA was less frequently met by patients with INP (7.1% vs 29.3%, p=0.02). In the logistic regression analysis, fulfillment of ASAS criteria for axSpA was the only variable associated with INP (OR = 7.96, 95%CI: 1.6-40.4, p = 0.01).

Conclusion: A third of patients in this cohort had INP, and it was significantly more common in those fulfilling ASAS criteria for axSpA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-of-inflammatory-neck-pain-in-a-cohort-of-patients-with-psoriatic-arthritis-and-its-association-with-clinical-and-radiographic-features/