Psoriasis Onset Before Rheumatic Symptoms in Patients with Spondyloarthritis: Does It Relate to Clinical Characteristics and the Rheumatologist’s Diagnosis? Data from REGISPONSER Registry

Ignacio Gomez-Garcia¹, Teresa García-Puga², Nuria Barbarroja³, Mara ngeles Puche Larrubia⁴, Pilar Font⁵ and Clementina López Medina⁶, ¹Rheumatology Department, Reina Sofia University Hospital. Cordoba (Spain) / University of Cordoba (Spain) / Maimonides Institute for Biomedical Research (IMIBIC). Cordoba (Spain) / Physical Medicine and Rehabilitation Department. Infanta Margarita Hospital. Cabra (Spain), Córdoba, Spain, ²University of Cordoba, Cordoba, Spain, ³University of Cordoba/IMIBIC/Reina Sofia Hospital, Cordoba, Spain, ⁴Hospital Universitario Reina Sofía, Córdoba, Spain, ⁵IMIBIC/Reina Sofia Hospital/University of Córdoba, Córdoba, Spain, ⁶Department of Rheumatology, Reina Sofia Hospital, IMIBIC, University of Cordoba, Cordoba, Spain/ Department of Rheumatology, University of Paris, Cochin Hospital, Paris, France

Meeting: ACR Convergence 2021

Keywords: Psoriatic arthritis, spondyloarthritis

Session Information

Date: Tuesday, November 9, 2021

Title: Spondyloarthritis Including PsA – Diagnosis, Manifestations, & Outcomes Poster IV: Clinical Aspects of PsA & Peripheral SpA (1773–1800)

Session Type: Poster Session D

Session Time: 8:30AM-10:30AM

Background/Purpose: To describe if the time of the onset of psoriasis (Pso) relative to the appearance of rheumatic symptoms in patients with spondyloarhtritis (SpA) is associated with a clinical phenotype, the rheumatologist’s diagnosis and the evolution of the disease.

Methods: This was a cross-sectional study with data extracted from the REGISPONSER (Spondyloarhritis Registry of the Spanish Rheumatology Society) registry. Patients were classified in two groups to compare the clinical characteristics, disease activity, radiographic damage, functional ability and received treatment: “Pso as first symptom” and “Pso after rheumatic symptoms”. Moreover, the rheumatologist’s diagnosis was compared between the two groups. We use chi-square test and Student t-test to compare qualitative and quantitative variables in both groups, respectively. Multivariate analysis was performed in variables with significant differences.

Results: A total of 433/2367 (18.3%) patients included in the REGISPONSER database had Pso onset data available. Patients with Pso as first symptom had less body mass index [0.90 (95% CI 0.83 – 0.96)], shorter disease duration [0.94 (95% CI 0.91 – 0.97)], less prevalence of HLA-B27 antigen [0.22 (95% CI 0.11 – 0.44)] and higher prevalence of dactylitis [2.12 (95% CI 1.01 – 4.46)] with regard to patients with Pso after rheumatic symptoms. Furthermore, a higher prevalence of Psoriatic Arthritis (PsA) diagnosis [257/329 (78.1%) vs 57/101 (56.4%); p< 0.001)] and a lower prevalence of ankylosing spondylitis (AS) diagnosis [68/329 (20.7%) vs 38/101 (37.6%); p< 0.001] were found in patients with Pso as first symptom vs. Pso after rheumatic symptoms. Indeed, axial involvement was less frequent in patients with Pso as first symptom [29/330 (8.8%) vs 20/103 (19.4%); p=0.003], while peripheral involvement was more frequent [192/330 (58.2%) vs 39/103 (37.9%; p< 0.001]. The use of DMARDs was not statistically different between the two groups.

Conclusion: The moment of appearance of psoriasis influences significantly the clinical phenotypic of spondyloarthritis. Thus, the presence of psoriasis before the rheumatic symptoms could determine a more frequent diagnosis of PsA by Rheumatologist.

Disclosures: I. Gomez-Garcia, None; T. García-Puga, None; N. Barbarroja, None; M. Puche Larrubia, None; P. Font, None; C. López Medina, None.

To cite this abstract in AMA style:

Gomez-Garcia I, García-Puga T, Barbarroja N, Puche Larrubia M, Font P, López Medina C. Psoriasis Onset Before Rheumatic Symptoms in Patients with Spondyloarthritis: Does It Relate to Clinical Characteristics and the Rheumatologist’s Diagnosis? Data from REGISPONSER Registry [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/psoriasis-onset-before-rheumatic-symptoms-in-patients-with-spondyloarthritis-does-it-relate-to-clinical-characteristics-and-the-rheumatologists-diagnosis-data-from-regisponser-registry/. Accessed .

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