Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
In clinical practise patients with psoriatic arthritis (PsA) seem to have milder disease expression compared with patients having rheumatoid arthritis (RA). Studies have, however, shown that PsA is a more severe disease than known before. The aim of this study was to compare the disease activity and treatment between psoriatic arthritis (PsA) and rheumatoid arthritis (RA) in patients with early disease, and after five years of disease duration.
Methods:
208 patients included in SwePsA were compared to 381 patients included in SRR. The patients were matched (1:1-2) for age, gender, year of inclusion in the registries and region of residence. Inflammatory parameters such as DAS28, its components, CRP, HAQ, pain VAS and treatment (DMARDs, steroids and biologics), were measured at inclusion and at 5 year-follow up. Single and multiple regression analyses were performed and the stratified proportional hazards model has been used to model the 1-2 or 1-1 matching designs depending on the number of controls available for a case.
Results:
At inclusion, patients with RA had significantly higher DAS28, ESR, CRP, tender joint counts (TJC), swollen joint counts (SJC), HAQ, pain VAS and patient global VAS (PGVAS) compared to patients with PsA (Table 1). After 5 years all parameters had decreased and ESR was slightly higher in RA-patients compared with PsA-patients (15.22 vs 12.36, p=0.046), while tender joint count now was higher in patients with PsA (3.58 vs 1.95, p=0.000). No other differences between the groups were seen (See Table). DMARDs, steroids and biologics were less common among PsA-patients than RA-patients at inclusion ( 40.9 % vs 84.7%, 9.1 vs 39.6 and 0.5 vs 2.8% respectively), and at 5-year-follow up (46.2% vs 80%, 8.2% vs 18.7%, and 13% vs 37.7% respectively).
Conclusion:
In this study, the disease activity at inclusion was higher in patients with RA compared to PsA. At 5-year-follow up the disease activity had decreased in both patient groups and there were only significant differences in two of the parameters, ESR that was slightly higher in the RA-patients and TJC that was higher in the PsA-patients showing that PsA-patients suffer from joint pain. The patients in the RA-group were more often aggressively treated with steroids, DMARDs and biologics indicating that RA may be a more severe disease. However, after 5 years the PsA-patients had more tender joints which could have an effect on quality of life.
Table
|
|
Inclusion
|
5-year-follow up |
||||
|
|
PsA Mean (±SD)
|
RA Mean (±SD)
|
P (95% CI) |
PsA Mean (±SD)
|
RA Mean (±SD)
|
P (95% CI) |
|
DAS28
|
3.34 (±1.34) |
5.04 (±1.34) |
0.000 (0.330-0.485) |
2.62 (±1.22) |
2.81 (±1.38) |
0.281 (0.812-1.062) |
|
ESR
|
18.72(±20.13) |
32.98(±25.03) |
0.000 (0.954-0.976) |
12.36(±12.47) |
15.22(±14.58) |
0.046 (0.970-1.000) |
|
CRP
|
16.67(±25.65) |
30.51(±33.36) |
0.000 (0.970-0.987) |
7.28 (±8.71) |
8.09(±13.54) |
0.540 (0.980-1.010) |
|
TCJ
|
5.59 (±7.82) |
7.17 (±5.65) |
0.000 (0.934-0.990) |
3.58 (±6.39)
|
1.95 (±3.58) |
0.000 (1.035-1.123) |
|
SJC
|
4.31 (±4.87) |
8.73 (±5.76) |
0.009 (0.787-0.868) |
1.53 (±2.87) |
2.03 (±3.35) |
0.089 (0.894-1.008) |
|
PGVAS
|
43.48(±25.59) |
49.43(±25.60) |
0.008 (0.983-0.997) |
31.86(±23.83) |
29.49(±23.64) |
0.193 (0.998-1.012) |
|
PainVAS
|
44.15(±25.72) |
50.75(±25.07) |
0.003 (0.982-0.996) |
31.50(±25.38) |
29.20(±23.16) |
0.216 (0.997-1.012) |
|
HAQ
|
0.62 (±0.53) |
0.99 (±0.60) |
0.000 (0.179-0.391) |
0.48 (±0.6) |
0.54 (±0.59) |
0.521 (0.668-1.227) |
Disclosure:
G. M. Alenius,
None;
T. Husmark,
None;
E. Theander,
None;
P. Larsson,
None;
M. Geijer,
None;
A. Teleman,
None;
U. R. C. Lindqvist,
None.
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