ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 536

Psoriasis and Psoriatic Arthritis in a Diverse Ethnic Cohort

Gail S. Kerr1, Seema Qaiyumi2, John S. Richards2, Chesahna Kindred3, Sean A. Whelton4 and Florina M. Constantinescu5, 1Rheumatology, Washington DC VAMC, Georgetown and Howard University, Washington, DC, 2Rheumatology Section, Washington DC VA and Georgetown University, Washington, DC, 3Division of Dermatology, Howard University Hospital, Washington, DC, 4Division of Rheumatology, Georgetown University, Washington, DC, 5Rheumatology, Washington Hospital Center, Washington, DC

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment

Session Type: Abstract Submissions (ACR)

Background/Purpose: Few clinical studies describe psoriasis (PSO) and psoriatic arthritis (PsA) in ethnic minority groups. Previous patient-reported data show PSO/PsA to be less frequent in African Americans (AA) compared to Caucasians, but of equal severity. We describe the clinical characteristics of a diverse ethnic cohort of patients with PSO and PsA in an urban setting.

Methods: IRB consented patients with PSO diagnosed by a dermatologist and PsA satisfying CASPAR criteria, were enrolled from 4 academic outpatient clinics. Socio-demographic data, disease duration, time to diagnosis, disease phenotype and activity, quality of life measures, comorbidities, use of disease modifying anti-rheumatic drugs (DMARD) and biologic therapies were recorded.

Results: There were 160 PSO/PsA patients enrolled; 41.9% were non-Caucasian, 90% of whom were AA (Table). Mean PSO and PsA disease duration was 18.1 (SD14.3) and 13.3 (SD10.9) years, respectively. Mean BMI was 30.3 (SD5.7) kg/m2 and PsA patients had a mean DAS28 of 2.7 (SD1.7). Non-Caucasians had worse PASI scores. Compared to Caucasians, AA had a lower frequency of PsA, worse SF-36 mental component and psoriasis related quality of life scores, received less years of education, had lower frequencies of private insurance coverage, DMARD and biologic use, and lower Vitamin D levels. AA also had higher frequencies of tobacco use, hypertension, diabetes, hyperlipidemia and cerebrovascular accidents. There were no differences in alcohol use, uric acid levels or other psoriatic disease-related parameters.

Conclusion: Compared to Caucasians, African Americans had less frequent PsA but experienced greater impact on quality of life from psoriatic disease. Improved implementation and evaluation of disease activity and quality of life measures are needed in psoriatic disease, particularly in African American patients. Ours is the first study to use validated clinical measures to describe psoriatic disease in a diverse ethnic cohort.

Variable, n (%)

Cohort

Caucasian

Non Caucasian**

African American

p-value

Cohort

160 (100)

93 (60.8)

67 (41.9)

60 (39.2)

—

PSO Only

75 (49.0)

33 (35.5)

44 (65.7)

42 (70.0)

<0.001

PSA

78 (51.0)

60 (64.5)

23 (34.3)

18 (30.0)

<0.001

Age (Mean ± SD)

56.7 ± 13.3

55.6 ± 13.4

56.8 ± 14.7

58.7 ± 13.2

0.18

Male

120 (78.4)

77 (82.8)

48 (71.6)

43 (71.7)

—

Education Years (Mean ± SD)

14.5 ± 3.3

15.1 ± 3.2

13.6 ± 3.2

13.4 ± 3.3*

0.0025*

Private Insurance

71 (46.4)

51 (54.8)

8  (11.9)

20 (33.3)*

0.009*

Tobacco Use

39 (26.4)

19 (20.7)

21 (33.3)

20 (35.7)

0.044

Dactylitis

15 (9.8)

13 (14.0)

2(11.1)

2 (3.3)

0.034

Oligoarthritis

42 (53.8)

32 (53.3)

10 (43.5)

7 (38.9)

—

Symmetric

14 (17.9)

12 (20)

2 (8.7)

2 (11.1)

—

PASI (Mean ± SD)

6.6 ± 8.1

5.5 ± 6.4

8.6± 10.4

8.4± 10.0

0.04

SF36 Physical

40.5  ± 11.9

41.0  ± 12.3

40.1 ± 11.1

39.7  ± 11.4

0.54

SF36 Mental

45.8  ± 12.0

47.7  ± 11.7

43.5 ±12.2

42.8  ± 12.1*

0.02*

PSAQOL

5.5  ± 5.8

5.2  ±5.7

5.81 ± 6.23

6.3  ± 6.4

0.56

PSOQOL

7.5  ± 6.8

6.1  ± 6.6

9.32 ±6.6

9.9  ± 6.7*

0.02*

DMARD

31 20.3)

26 (28.0)

7 (10.5)

4 (8.3)*

0.044*

Biologic

51 (33.3)

43 (46.2)

9 (13.4)

8 (13.3)*

0.014*

Diabetes

28 (18.3)

14 (15.0)

14(25.5)

14 (23.3)

0.05

Hypertension

68 (44.4)

33 (35.5)

36(65.5)

35 (58.3)*

<0.001*

Hyperlipidemia

51 (33.3)

28 (30.1)

25(45.5)

23 (38.3)

0.046

Cerebrovascular Accident

7 (4.6)

2 (2.2)

5(8.8)

5 (8.3)

0.045

Vitamin D (Mean ± SD)

28.3 ± 13.8

31.2 ± 13.9

21.8 ± 10.8

21.6 ± 11.0*

0.02*

*Indicates corresponding p-value

**Includes African American, Hispanic and Asian

Disclosure:

G. S. Kerr,

Amgen, Abbott,

2;

S. Qaiyumi,
None;

J. S. Richards,
None;

C. Kindred,
None;

S. A. Whelton,
None;

F. M. Constantinescu,
None.

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