Journal Article

AB0432 CLINICAL CHARACTERISTICS OF “SEVERE” PERIPHERAL PSORIATIC ARTHRITIS: A RETROSPECTIVE ANALYSIS OF A LONGITUDINAL COHORT

Scriffignano, S., Perrotta, F. M., Lubrano, E.

2024

Overview

Background:The concept of severity in a multidomain disease such as Psoriatic Arthritis (PsA) is still not well defined and often can be confused with disease activity. In this context, no validated severity indices for PsA have been publishedObjectives:The aims of this study were to identify patients with severe PsA symptoms in a cohort of PsA patients with peripheral joint involvement, to evaluate the presence of clinical differences among severe and non-severe PsA patients and to evaluate the presence of clinical factors associated to severe PsAMethods:Retrospective analysis of a longitudinal cohort of peripheral PsA patients. Demographic and clinical characteristics of patients were collected at baseline and at last follow-up. We defined the severe population using the modified Composite Psoriatic Disease Activity Index (mCPDAI - which excludes ankylosing spondylitis quality of life scale) domain [1]. Hence, patients with a score of 3 (the highest score) in at least one domain were defined as having severe PsA. Clinical characteristics of patients fulfilling the definition of severe PsA were compared to those not severe at baseline and at last follow-up.Results:177 PsA patients with peripheral involvement (M/F: 98/76) were evaluated. Of these, 64 (36.1%) were identified as severe according to the mCPDAI criteria, at baseline. Of the 64 severe patients, 42 (65.6%) were identified as severe by the peripheral arthritis domain, 11 (16.1%) by the dactylitis domain, 8 (11.7%) by skin involvement domain and 3 (4.4%) by entheseal domain. At follow-up visit, only 18 (10.1%) PsA patients still met the definition of severe PsA in almost one domain. At last follow-up visit, severe PsA patients were only males (18/18, p<0.01), showing worse outcomes in terms of disease activity, pain, function and impact of disease (Table 1). Male sex and the severity of skin involvement assessed by PASI at baseline were identified as factors associated to the presence of severe PsA at last follow-up, independently by other factors (Table 2). Moreover, the agreement between the presence of severe PsA at last follow-up defined with mCPDAI and the absence of MDA was slight [Cohen’s k: 0.174 (0.084-0.264)].Conclusion:Our study showed that severe PsA patients had more disease activity, pain and impact of disease than non-severe patients. They also tend to have higher disease activity, pain and impact of disease during the course of follow-up. Furthermore, we demonstrated that severity and disease activity in PsA are not interchangeable concepts, open the way for further studies in this field.REFERENCES:[1] Kameda H, Hagimori K, Morisaki Y, Holzkämper T, Konomi A, Dobashi H. Ixekizumab Efficacy in Patients with Severe Peripheral Psoriatic Arthritis: A Post Hoc Analysis of a Phase 3, Randomized, Double-Blind, Placebo-Controlled Study (SPIRIT-P1). Rheumatol Ther 2023. doi: 10.1007/s40744-023-00605-6Acknowledgements:NIL.Disclosure of Interests:None declared.

• Publisher: BMJ Publishing Group Ltd and European League Against Rheumatism,Elsevier B.V
• Subject: Observational studies/ registry / Outcome measures / Patient Reported Outcome Measures / Scientific Abstracts