Regional Differences in Clinical Characteristics and Treatment of Psoriatic Arthritis with Axial Involvement: Results from the Cross Sectional International ASAS PerSpA Study

Haruki Sawada¹, Mitsumasa Kishimoto², Kurisu Tada¹, Gautam Deshpande³, Daiki Kobayashi⁴, Keisuke Ono⁵, Yoshinori Taniguchi⁶, Ayako Hirata⁷, Hideto Kameda⁷, Shigeyoshi Tsuji⁸, Yuko Kaneko⁹, Tadashi Okano¹⁰, Yoichiro Haji¹¹, Hiroaki Dobashi¹², Akimichi Morita¹³, Akihiko Asahina¹⁴, Masato Okada¹⁵, Tetsuya Tomita¹⁶, Diego Benavent¹⁷, Chamaida Plasencia-Rodríguez¹⁸, Victoria Navarro-Compán¹⁷, Clementina López Medina¹⁹, Anna Molto²⁰, Désirée van der Heijde²¹, Maxime Dougados²² and Naoto Tamura¹, ¹Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine, Tokyo, Japan, ²Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Yokohama, Japan, ³Department of General Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan, ⁴Department of Internal Medicine, St. Luke's International Hospital, Tokyo, Japan, ⁵Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan, ⁶Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, Japan, ⁷Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Toho University, Tokyo, Japan, ⁸Department of Orthopedics and Rheumatology, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan, ⁹Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan, ¹⁰Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan, ¹¹Department of Rheumatology, Daido Hospital, Nagoya, Japan, ¹²Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan, ¹³Department of Geriatric and Environmental Dermatology, Nagoya City University, Nagoya, Japan, ¹⁴Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan, ¹⁵Immuno-Rheumatology Center, St. Luke’s International Hospital, Tokyo, Japan, ¹⁶Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Suita Osaka, Japan, ¹⁷Rheumatology service, Hospital Universitario La Paz-IdiPaz, madrid, Spain, ¹⁸Immuno-Rheumatology Research Group, Hospital La Paz Institute for Health Research-IdiPAZ, Rheumatology, La Paz University Hospital, Madrid, Spain, ¹⁹Department of Rheumatology, Reina Sofia Hospital, IMIBIC, University of Cordoba, Cordoba, Spain/ Department of Rheumatology, University of Paris, Cochin Hospital, Paris, France, ²⁰Department of Rheumatology, University of Paris, Cochin Hospital, Paris, France, ²¹Department of Rheumatology, Leiden University Medical Center, Meerssen, Netherlands, ²²Université de Paris . Department of Rheumatology - Hôpital Cochin. Assistance Publique - Hôpitaux de Paris . INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité. Paris, France., 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: Psoriatic arthritis (PsA) shares genetic and clinical features with other forms of spondyloarthritis (SpA). However, no studies have evaluated regional differences regarding characteristics of PsA with axial involvement (axPsA). The aim of this study is to evaluate regional differences regarding clinical characteristics of axPsA patients.

Methods: Data from the ASAS-PerSpA study, a cross-sectional database recruiting SpA patients between July 2018 and February 2020 from 68 centers worldwide, was analyzed. For this analysis, PsA patients presenting at any time with axial involvement per physician judgement were defined as axPsA. AxPsA was further categorized by 5 regions (Europe and North America, Latin America, Japan, Asia (except for Japan) and Middle East and North Africa). Patient and disease characteristics, activities, and treatments were compared.

Results: Of 4465 SpA patients from the study, 1033 (23.1%) had psoriatic arthritis (PsA). 367 AxPsA patients (35.5% of those with PsA) were compared by region. Percentage of axPsA patients among PsA by region were as follows: 164/489 (34%) from Europe and North America; 56/176 (32%) from Latin American; 37/90 (41%) from Japan; 32/75 (43%) from other Asian countries; and 78/203 (38%) from Middle East and North Africa (Table 1). At 12.4 years (SD 13.0), diagnostic delay in Japan was longer than those in other parts of the world (Table 2). Patients in Europe and North America had less AxSpA, with only 38% fulfilling ASAS AxSpA criteria. Disease activity was lower in Japan with mean ASDAS-CRP score of 2.2 (SD 1.0), despite less frequency of csDMARD (78%) and bDMARD (27%) use. In patients treated specifically for axial involvement, however, AxPsA patients in Japan demonstrated more frequent csDMARD (62%) and bDMARD (51%) use. Both Latin America and Asia showed higher disease activity with mean ASDAS-CRP of 3.2 (SDv1.2) and 3.2 (SD 1.5), respectively; both regions demonstrated less bDMARD use (43% and 19%, respectively) as a specific treatment for axial involvement.

Conclusion: This study suggests axPsA patients demonstrate differing disease manifestations, activities, and treatments by region.

Disclosures: H. Sawada, None; M. Kishimoto, AbbVie, 2, Amgen-Astellas BioPharma, 2, Asahi-Kasei Pharma, 2, Ayumi Pharma, 2, BMS, 2, Celgene, 2, Chugai, 2, Daiichi-Sankyo, 2, Eisai, 2, Eli Lilly, 2, Gilead, 2, Janssen, 2, Kyowa Kirin, 2, Novartis, 2, Ono Pharma, 2, Pfizer, 2, Tanabe-Mitsubishi, 2, Teijin Pharma, 2, UCB Pharma, 2; K. Tada, None; G. Deshpande, None; D. Kobayashi, None; K. Ono, a, 1; Y. Taniguchi, None; A. Hirata, None; H. Kameda, Asahi-Kasei, 2, 5, 6, Novartis, 2, 5, 6, AbbVie, 2, 5, 6, Chugai, 5, 6, Mitsubishi-Tanabe, 5, 6, Astellas, 2, Eli Lilly, 2, 6, Pfizer, 6, Eisai, 5, 6, Gilead Sciences, 2, Janssen, 2, 6, Sanofi, 2, UCB, 2; S. Tsuji, None; Y. Kaneko, None; T. Okano, None; Y. Haji, None; H. Dobashi, None; A. Morita, None; A. Asahina, Sun Pharmaceutical Industries, Inc., 5, 6, AbbVie, 5, 6, Janssen, 5, 6, Celgene, 5, 6, Eisai, 5, 6, Kyowa Kirin, 5, 6, LEO Pharma, 5, 6, Maruho, 5, 6, Mitsubishi Tanabe Pharma, 5, 6, Taiho Pharma, 5, 6, Torii Pharmaceutical, 5, 6, UCB, 5, 6, Eli Lilly Japan, 5, 6; M. Okada, AbbVie, 2, Eli Lilly, 2, AbbVie Japan, 6, Eli Lilly and Company, 6, Ono Pharmaceutical, 6; T. Tomita, None; D. Benavent, None; C. Plasencia-Rodríguez, None; V. Navarro-Compán, Abbvie, 5, Lilly, 5, Novartis, 5, Pfizer, 5, UCB, 5, Janssen, 5; C. López Medina, None; A. Molto, None; D. van der Heijde, AbbVie, 2, Amgen, 2, Astellas, 2, AstraZeneca, 2, Bayer, 2, BMS, 2, Boehringer Ingelheim, 2, Celgene, 2, Cyxone, 2, Daiichi, 2, Eisai, 2, Eli Lilly, 2, Galapagos, 2, Gilead, 2, GlaxoSmithKline, 2, Janssen, 2, Merck, 2, Novartis, 2, Pfizer, 2, Regeneron, 2, Roche, 2, Sanofi, 2, Takeda, 2, UCB Pharma, 2, Imaging and Rheumatology BV, 4; M. Dougados, AbbVie, 2, 5, Bristol-Myers Squibb, 2, 5, Eli Lilly, 2, 5, Merck, 2, 5, Novartis, 2, 5, Pfizer Inc, 2, 5, Roche, 2, 5, UCB, 2, 5; N. Tamura, AbbVie Japan GK, 6, Bristol-Myers Squibb Co. Ltd, 6, Chugai Pharmaceutical Co. Ltd, 6, Eisai Co. Ltd, 6, Eli Lilly Japan K.K, 6, Glaxo Smith Kline K.K., 6, Janssen Pharmaceutical K.K., 6, Mitsubishi-Tanabe Pharma Co., 6, Novartis Pharma K.K, 6.

To cite this abstract in AMA style:

Sawada H, Kishimoto M, Tada K, Deshpande G, Kobayashi D, Ono K, Taniguchi Y, Hirata A, Kameda H, Tsuji S, Kaneko Y, Okano T, Haji Y, Dobashi H, Morita A, Asahina A, Okada M, Tomita T, Benavent D, Plasencia-Rodríguez C, Navarro-Compán V, López Medina C, Molto A, van der Heijde D, Dougados M, Tamura N. Regional Differences in Clinical Characteristics and Treatment of Psoriatic Arthritis with Axial Involvement: Results from the Cross Sectional International ASAS PerSpA Study [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/regional-differences-in-clinical-characteristics-and-treatment-of-psoriatic-arthritis-with-axial-involvement-results-from-the-cross-sectional-international-asas-perspa-study/. Accessed .

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