Philip J Mease1, Chitra Karki2, Jacqueline B Palmer3, Carol J Etzel4, Arthur Kavanaugh5, Christopher T Ritchlin6, Wendi Malley2, Vivian Herrera3, Melody Tran7, Jeffrey D Greenberg8. 1. Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington. 2. Corrona, Southborough, Massachusetts. 3. Novartis Pharmaceuticals, East Hanover, New Jersey. 4. Corrona, and The University of Texas MD Anderson Cancer Center, Houston, Texas. 5. University of California at San Diego, La Jolla. 6. University of Rochester Medical Center, Rochester, New York. 7. Scott& White Health Plan, Temple, Texas. 8. Corrona and New York University School of Medicine, New York.
Abstract
OBJECTIVE: To characterize psoriatic arthritis (PsA) patients with dactylitis or enthesitis and evaluate the associations of these manifestations with disease activity and patient-reported outcomes. METHODS: Using the Corrona PsA/Spondyloarthritis Registry, patient characteristics, disease activity, and patient-reported outcomes at registry enrollment were assessed for PsA patients ages ≥18 years with or without dactylitis or enthesitis. Regression models were used to evaluate associations of dactylitis and enthesitis with outcomes, including minimal disease activity, Health Assessment Questionnaire scores, patient-reported pain and fatigue, and work productivity (Work Productivity and Activity Impairment questionnaire). Adjustments were made for age, sex, race, body mass index, disease duration, and history of biologic agent, disease-modifying antirheumatic drug, and prednisone use. RESULTS: This analysis included 1,567 PsA patients (420 with enthesitis; 228 with dactylitis). Patients with versus without dactylitis or enthesitis had greater disease activity and were less likely to be in minimal disease activity (P < 0.05). Patients with versus without enthesitis had poorer functional status as assessed by the Health Assessment Questionnaire (adjusted P = 4.15 x 10-5 ), greater patient-reported pain and fatigue (adjusted P < 0.0001), and greater likelihood of any impairment while working (adjusted odds ratio [OR] 1.57, P = 0.027), overall work impairment (OR 1.85, P = 0.006), and activity impairment (OR 1.77, P = 0.008). Dactylitis was associated with similar numerical trends, but differences versus patients without dactylitis did not reach statistical significance. CONCLUSION: Enthesitis and dactylitis are associated with greater overall disease burden of PsA, underscoring the importance of identifying, assessing, and effectively managing these periarticular manifestations.
OBJECTIVE: To characterize psoriatic arthritis (PsA) patients with dactylitis or enthesitis and evaluate the associations of these manifestations with disease activity and patient-reported outcomes. METHODS: Using the Corrona PsA/Spondyloarthritis Registry, patient characteristics, disease activity, and patient-reported outcomes at registry enrollment were assessed for PsA patients ages ≥18 years with or without dactylitis or enthesitis. Regression models were used to evaluate associations of dactylitis and enthesitis with outcomes, including minimal disease activity, Health Assessment Questionnaire scores, patient-reported pain and fatigue, and work productivity (Work Productivity and Activity Impairment questionnaire). Adjustments were made for age, sex, race, body mass index, disease duration, and history of biologic agent, disease-modifying antirheumatic drug, and prednisone use. RESULTS: This analysis included 1,567 PsA patients (420 with enthesitis; 228 with dactylitis). Patients with versus without dactylitis or enthesitis had greater disease activity and were less likely to be in minimal disease activity (P < 0.05). Patients with versus without enthesitis had poorer functional status as assessed by the Health Assessment Questionnaire (adjusted P = 4.15 x 10-5 ), greater patient-reported pain and fatigue (adjusted P < 0.0001), and greater likelihood of any impairment while working (adjusted odds ratio [OR] 1.57, P = 0.027), overall work impairment (OR 1.85, P = 0.006), and activity impairment (OR 1.77, P = 0.008). Dactylitis was associated with similar numerical trends, but differences versus patients without dactylitis did not reach statistical significance. CONCLUSION: Enthesitis and dactylitis are associated with greater overall disease burden of PsA, underscoring the importance of identifying, assessing, and effectively managing these periarticular manifestations.
Authors: Peter Nash; Laura C Coates; Roy Fleischmann; Kim A Papp; Juan Jesus Gomez-Reino; Keith S Kanik; Cunshan Wang; Joseph Wu; Sujatha Menon; Thijs Hendrikx; William C Ports Journal: Rheumatol Ther Date: 2018-11-09
Authors: Iain B McInnes; Soumya D Chakravarty; Isabel Apaolaza; Shelly Kafka; Elizabeth C Hsia; Yin You; Arthur Kavanaugh Journal: RMD Open Date: 2019-08-18