Potential Differences in Clinical Features, Disease Activity, Function and Impact of Disease Between Oligo and Polyarticular Psoriatic Arthritis

2020 ◽  
pp. 247553032097537
Author(s):  
Ennio Lubrano ◽  
Silvia Scriffignano ◽  
Mauro Fatica ◽  
Fabio Massimo Perrotta
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Clinical Features ◽  
Clinical Phenotype ◽  
Disease Characteristics ◽  
Baseline Evaluation ◽  
Axial Disease ◽  
Global Disease Activity ◽  
The Impact

Objective: The primary aim of the study was to assess the potential differences in clinical features, disease activity, function and impact of disease between Psoriatic Arthritis (PsA) patients with oligoarticular and polyarticular involvement. Methods: Consecutive PsA patients attending our unit were divided into 2 groups: 1) Oligoarticular (<5 involved joints with or without enthesitic/axial manifestations) and 2) Polyarticular (≥5 joints with or without enthesitic/axial manifestations). A full clinical examination with the assessment of disease characteristics, disease activity (DAPSA, MDA), function (HAQ-DI) and impact of disease (PsAID-12) was performed. Furthermore, a 6-month follow-up evaluation was carried out in order to assess disease differences at baseline and at follow-up. Results: Of the 102 enrolled patients, oligoarticular subset was present in 63 (61.7%), while 39 (38.3%) patients had polyarticular involvement. Patients with oligoarticular subset showed, at baseline evaluation, lower values of global disease activity assessed by physician, HAQ-DI and DAPSA compared to patients with polyarticular pattern. No differences in the impact of disease (PsAID), patient global assessment of disease activity or pain were found. At 6-month follow-up, no significant changes in each group occurred. Conclusion: Our study showed some differences in patients with oligoarticular and polyarticular involvement in terms of disease activity and HAQ-DI, while the overall impact of the disease and the presence of enthesitis, dactylitis and axial disease seem to be similar, with no substantial changes after 6-month follow-up. These results could mean that clinical phenotype might not be responsible for the impact of the disease perceived by the patient.

scholarly journals Descriptive Comparisons of the Impact of Apremilast and Methotrexate Monotherapy in Oligoarticular Psoriatic Arthritis: the Corrona Psoriatic Arthritis/Spondyloarthritis Registry Results

2020 ◽  
pp. jrheum.191209
Author(s):  
Alexis Ogdie ◽  
Mei Liu ◽  
Meghan Glynn ◽  
Kelechi Emeanuru ◽  
Leslie Harrold ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Therapeutic Response ◽  
Effective Option ◽  
Disease Modifying ◽  
The Impact ◽  
Rheumatic Drug

Objective Therapeutic response was evaluated among new apremilast, methotrexate, or biologic disease-modifying anti-rheumatic drug (bDMARD) initiators with oligoarticular psoriatic arthritis (PsA). Methods Patients with oligoarticular PsA in the Corrona PsA/Spondyloarthritis Registry initiating treatment with apremilast, methotrexate, or bDMARD and completing 6-month follow-up were included. Results In total, 150 patients initiated monotherapy (apremilast: n=34; methotrexate: n=15; bDMARD: n=101). Apremilast initiators had higher baseline disease activity than methotrexate initiators. At follow-up, apremilast initiators experienced numerically greater disease activity improvements than methotrexate initiators and similar improvements to bDMARD initiators. Conclusion Findings suggest apremilast monotherapy is an effective option for patients with oligoarticular PsA.

scholarly journals POS1043 NETAKIMAB REDUCES PSORIATIC ARTHRITIS ACTIVITY IN PATIENTS WITH OR WITHOUT AXIAL DISEASE: SUBANALYSIS OF THE PATERA STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 796-797
Author(s):  
T. Korotaeva ◽  
I. Gaydukova ◽  
V. Mazurov ◽  
A. Samtsov ◽  
V. Khayrutdinov ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Missing Values ◽  
Categorical Variables ◽  
Inflammatory Back Pain ◽  
Rapid Decline ◽  
Inadequate Response ◽  
Low Disease Activity ◽  
Axial Disease ◽  
The Impact

Background:PATERA is an ongoing phase 3 international double-blind, placebo-controlled clinical study of netakimab (NTK) in psoriatic arthritis (PsA) (NCT03598751). Netakimab (NTK) is an anti-interleukin-17A monoclonal antibody approved for psoriasis, ankylosing spondylitis, PsA in Russia and Belarus.Objectives:A subanalysis was performed to define the impact of NTK on PsA activity depending on the presence of axial disease: a subset of patients with inflammatory back pain (IBP) according to self-reported ASAS IBP criteria, 2009 (IBP(+) was compared to those without IBP (IBP(-)).Methods:194 eligible adult patients with PsA fulfilling the CASPAR criteria, with inadequate response to csDMARD or one TNFi, were randomly assigned to receive NTK 120mg or placebo at weeks 0,1,2,4,6,8,10,14,18,22. Patients with missing values for categorical variables were considered as non-responders in the analysis. For quantitative variables, missing values were replaced using the multiple imputation method.Results:97 PsA patients (N=54 IBP(+), N=43 IBP(-)) received NTK. Both subpopulations were comparable in gender, age and PsA activity at baseline. The treatment led to a pronounced decline in PsA activity in both subpopulations, significant differences between arms were observed only in DAPSA remission and very low disease activity (VLDA) at week 24 (Figure 1A). Changes from baseline in DAS28-CRP were consistent between IBP(+) and IBP(-) patients with a rapid decline during the first month with further improvement up to week 24 (Figure 1B). A similar trend was observed PsA-specific composite responder index (PSARC) (data not shown). A comparable percentage of IBP(+) and IBP(-) patients achieved PSARC at each timepoint of evaluation with 87% and 86% of responders respectively at week 24.Conclusion:NTK significantly improved PsA activity regardless of the presence of IBP.Figure 1.PsA activity after 24-week treatment with NTK. (A) Percentage of patients with DAPSA remission (0-4), very low disease activity (VLDA), minimal disease activity (MDA) at week 24; (B) change from baseline in DAS28-CRPAcknowledgements:This study was sponsored by JSC BIOCAD.Disclosure of Interests:Tatiana Korotaeva Speakers bureau: Abbvie, Biocad, Eli Lilly, Johnson & Johnson, Janssen, Novartis, Pfizer, UCB, Inna Gaydukova Speakers bureau: Abbvie, Biocad, Eli Lilly, MSD, Novartis, Pfizer, Sandoz, V Mazurov: None declared, Aleksey Samtsov: None declared, Vladislav Khayrutdinov: None declared, Andrey Bakulev: None declared, Alena Kundzer: None declared, Nikolaj Soroka: None declared, Anna Eremeeva Employee of: Biocad.

scholarly journals AB0825 TIME-COURSE CHANGE IN AXIAL MOBILITY IN PSORIATIC ARTHRITIS PATIENTS UNDER bDMARD

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1716-1717
Author(s):  
M. Rato ◽  
F. Pinheiro ◽  
S. Garcia ◽  
B. M. Fernandes ◽  
S. Ganhão ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Physical Function ◽  
Time Course ◽  
Functional Limitation ◽  
Spinal Mobility ◽  
University Hospital ◽  
The Impact

Background:Spinal mobility is assessed frequently in patients with psoriatic arthritis (PsA) usingBath Ankylosing Spondylitis Metrology Index(BASMI) to provide baseline measurement, monitor changes over time and to assess the impact of clinical interventions. BASMI comprises 4 measures of spinal mobility (cervical rotation, tragus-to-wall distance, modified Schober’s test and lumbar lateral flexion) and one hip mobility measurement (intermalleolar distance).Objectives:The aim of this study is to investigate the time-course change of BASMI in PsA patients after 6 months ofBiologic Disease-modifying Antirheumatic Drug(bDMARD) therapy. The authors also pretend to evaluated, at baseline and after 6 months of treatment, the association between BASMI, disease activity scores and physical function.Methods:An observational retrospective study was performed in patients with PsA under bDMARD followed in the Rheumatology department of a tertiary university hospital. Were included patients treated with only one bDMARD. Demographic and clinical data were collected from the Rheumatic Diseases Portuguese Register. For spinal mobility calculation BASMI was used. Disease activity was evaluated withAnkylosing Spondylitis Disease Activity Score(ASDAS) andBath Ankylosing Spondylitis Activity Index(BASDAI). Physical function was assessed withBath Functional Index(BASFI). The variation of BASMI, ASDAS, BASDAI and BASFI was calculated as the difference between values registered at 6 months and at baseline and presented as Δ. Correlations between ΔBASMI, ΔASDAS and ΔBASFI was calculated using Pearson test.Results:A total of 55 patients were included. Thirty patients were males (54.5%). The mean age at diagnosis was 44.6 ± 12.6 years and the median disease duration at start of bDMARD was 5.4 years (min: 0.30; max: 25.5). In total, 19 (34.5%) patients had predominant axial involvement, 36 (65.5%) peripheric and 36 (65.5%) enthesopathic. Almost all patients fulfilled the CASPAR criteria for PsA (n=50, 90.9%). According to ASDAS criteria, at the baseline 20 patients (36.4%) had high disease activity and 34 (61,8%) very high. The most used bDMARD was etanercept (n=21, 38,3%) followed by golimumab (n=19, 34.5%) and adalimumab (n=8, 14.5%). Three patients were treated with infliximab, two with certolizumab and other two with secukinumab. Forty-one patients (75.9%) were concomitantly treated with conventional synthetic DMARDs. Axial PsA patients had more limitations in spinal mobility (BASMI mean 4.5 ± 1.5) and more functional limitation (BASFI mean 6.8±1.9) than patients with predominant peripheric involvement (BASMI mean 3.3± 1.2, p=0.004; BASFI mean 5.4±3, p=0,0048). Statistically significant differences in ASDAS and BASDAI in these two groups were not observed (p=0.332 and p=0.605, respectively). For all patients, BASMI did not vary significantly (p=0.691) at baseline (mean 3.7± 1.4) and after 6 months (mean 3.8±1.3) of treatment. Although the ΔBASMI for etanercept was negative (mean -0.12±0.9) and for golimumab positive (0.14±0.8), it was not statistically significant. At baseline there is a significant positive association between BASMI and ASDAS (r=0.435, p=0.001), BASMI and BASDAI (r=0.567, p<0.001) and BASMI and BASFI (r=0.510, p<0.001). However, there was not a statistically significant association between ΔBASMI and: ΔASDAS, ΔBASDAI and ΔBASFI (r=0.158; p=0.269, r=0.019; p=0.096 and r=0.121; p=0.397, respectively).Conclusion:In PsA patients treated with bDMARDs, at least in short-term follow-up, BASMI does not improve with time. Changes in BASMI did not correlate with changes in activity disease and in functional outcome. Studies with longer follow-up and with more patients are needed to better evaluate these associations.Disclosure of Interests:Maria Rato: None declared, Filipe Pinheiro: None declared, Salomé Garcia: None declared, Bruno Miguel Fernandes: None declared, Sara Ganhão: None declared, Rita Gaio: None declared, Miguel Bernardes Speakers bureau: Abbvie, Amgen, Biogen, Eli-Lilly, Glaxo-Smith-Kline, Pfizer, Janssen, Novartis, Alexandra Bernardo: None declared, Lúcia Costa: None declared

scholarly journals Impact of Multidomain Disease Presentations on Patients With Psoriatic Arthritis in the Corrona Psoriatic Arthritis/Spondyloarthritis Registry

2020 ◽  
pp. jrheum.200371
Author(s):  
Alexis Ogdie ◽  
Peter Hur ◽  
Mei Liu ◽  
Sabrina Rebello ◽  
Robert R. McLean ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Skin Disease ◽  
Health Assessment ◽  
Work Productivity ◽  
Single Domain ◽  
Linear Regression Models ◽  
Disease Characteristics ◽  
Axial Disease ◽  
Active Disease

Objective To compare disease characteristics, quality of life (QOL), and work productivity of patients with psoriatic arthritis (PsA) who had multidomain vs single-domain presentations. Methods Adults with PsA enrolled in the Corrona PsA/SpA Registry (March 2013-August 2018) were included. Six PsA disease domains were evaluated: enthesitis, dactylitis, peripheral arthritis (PA), nail psoriasis, axial disease, and skin disease. Patients were classified as having multidomain (≥ 2 domains) or single-domain disease presentations; biologic initiators were characterized separately. Linear regression models evaluated the association of multidomain presentations with disease characteristics, QOL, and work productivity vs single-domain presentations. Results Of 2617 patients with PsA, 1698 (64.9%) had multidomain presentations, 617 (23.6%) had single-domain presentations, and 302 (11.5%) had no active disease features. Of 354 biologic initiators, 289 (81.6%) had multidomain presentations, 45 (12.7%) had single-domain presentations, and 20 (5.6%) had no active disease features. Overall, the most common singledomain and multidomain presentations, respectively, were skin disease (12.7%) and PA + skin disease (11.7%). Multidomain presenters were more likely to have fibromyalgia, depression, anxiety, and prior biologic use than single-domain presenters. Multidomain presentations were associated with significantly worse patient and physician global assessments of disease activity, pain, and fatigue; Health Assessment Questionnaire Disability Index and EQ-5D scores; and work productivity at enrollment. Conclusion In this US real-world cohort, most patients had multidomain disease presentations, which was associated with worse disease activity, QOL, and work productivity measures. This study highlights the heterogeneity of PsA and the importance of assessing all PsA domains for optimizing disease management.

Gender-Related Differences in Disease Activity and Clinical Features in Patients with Peripheral Psoriatic Arthritis: A Multi-Center Study

2021 ◽  
pp. 105177
Author(s):  
Mehmet Tuncay Duruöz ◽  
Halise Hande Gezer ◽  
Kemal Nas ◽  
Erkan Kılıç ◽  
Betül Sargın ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Clinical Features ◽  
Multi Center Study ◽  
Center Study

scholarly journals POS1234 IMPACT OF THE CHANGE IN ADMINISTRATION ROUTE OF TOCILIZUMAB AND ABATACEPT, DUE TO THE COVID-19 LOCKDOWN ON DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 900.1-900
Author(s):  
L. Diebold ◽  
T. Wirth ◽  
V. Pradel ◽  
N. Balandraud ◽  
E. Fockens ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Disease Activity ◽  
Univariate Analysis ◽  
Route Of Administration ◽  
Anxiety And Depression ◽  
Administration Route ◽  
Factors Associated ◽  
The Impact

Background:Among therapeutics used to treat rheumatoid arthritis (RA), Tocilizumab (TCZ) and Abatacept (ABA) are both biologic agents that can be delivered subcutaneously (SC) or intravenously (IV). During the first COVID-19 lockdown in France, all patients treated with IV TCZ or IV ABA were offered the option to switch to SC administration.Objectives:The primary aim was to assess the impact of changing the route of administration on the disease activity. The second aim was to assess whether the return to IV route at the patient’s request was associated with disease activity variation, flares, anxiety, depression and low physical activity during the lockdown.Methods:We conducted a prospective monocentric observational study. Eligibility criteria: Adult ≥ 18 years old, RA treated with IV TCZ or IV ABA with a stable dose ≥3 months, change in administration route (from IV to SC) between March 16, 2020, and April 17, 2020. The following data were collected at baseline and 6 months later (M6): demographics, RA characteristics, treatment, history of previous SC treatment, disease activity (DAS28), self-administered questionnaires on flares, RA life repercussions, physical activity, anxiety and depression (FLARE, RAID, Ricci &Gagnon, HAD).The primary outcome was the proportion of patients with a DAS28 variation>1.2 at M6. Analyses: Chi2-test for quantitative variables and Mann-Whitney test for qualitative variables. Factors associated with return to IV route identification was performed with univariate and multivariate analysis.Results:Among the 84 patients who were offered to switch their treatment route of administration, 13 refused to change their treatment. Among the 71 who switched (48 TCZ, 23 ABA), 58 had a M6 follow-up visit (13 lost of follow-up) and DAS28 was available for 49 patients at M6. Main baseline characteristics: female 81%, mean age 62.7, mean disease duration: 16.0, ACPA positive: 72.4%, mean DAS28: 2.01, previously treated with SC TCZ or ABA: 17%.At M6, the mean DAS28 variation was 0.18 ± 0.15. Ten (12.2%) patients had a DAS28 worsening>1.2 (ABA: 5/17 [29.4%] and TCZ: 5/32 [15.6%], p= 0.152) and 19 patients (32.8%) had a DAS28 worsening>0.6 (ABA: 11/17 [64.7%] and TCZ: 8/32 [25.0%], p= 0.007).At M6, 41 patients (77.4%) were back to IV route (26 TCZ, 15 ABA) at their request. The proportion of patients with a DAS28 worsening>1.2 and>0.6 in the groups return to IV versus SC maintenance were 22.5%, 42.5% versus 11.1% and 22.2% (p=0.4), respectively. The univariate analysis identified the following factors associated with the return to IV route: HAD depression score (12 vs 41, p=0.009), HAS anxiety score (12 vs 41, p=0.047) and corticosteroid use (70% vs 100%, p=0.021), in the SC maintenance vs return to IV, respectively.Conclusion:The change of administration route of TCZ and ABA during the first COVID-19 lockdown was infrequently associated with a worsening of RA disease. However, the great majority of the patients (77.4%) request to return to IV route, even without disease activity worsening. This nocebo effect was associated with higher anxiety and depression scores.Disclosure of Interests:None declared

scholarly journals SAT0501 EARLY START OF BIOLOGICAL TREATMENT IN JUVENILE IDIOPHATIC ARTHRITIS: DOES A THERAPEUTIC WINDOW EXIST IN REAL LIFE?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1207.2-1207
Author(s):  
A. García Fernández ◽  
A. Briones-Figueroa ◽  
L. Calvo Sanz ◽  
Á. Andreu-Suárez ◽  
J. Bachiller-Corral ◽  
...  
Keyword(s):  
Disease Activity ◽  
Biological Treatment ◽  
Real Life ◽  
Therapeutic Window ◽  
Systemic Jia ◽  
Active Arthritis ◽  
The Impact ◽  
Active Patients ◽  
Active Disease

Background:Biological therapy (BT) has changed the treatment and perspectives of JIA patients but little is known about when is the best moment to start BT and the impact of this prompt iniciation.Objectives:To analyze the response to BT of Juvenile Idiophatic Arthritis (JIA) patients according to the time when the BT was started.Methods:A retrospective, descriptive study was conducted on JIA patients followed up in a referal hospital that started BT up to 24 months after diagnosis from 2000 to 2018. Disease activity was measured, at 2 years after diagnosis, according to Wallace criteria for remission (absence of: active arthritis, active uveitis, fever, rash or any other manifestation attributable to JIA, normal CRP and ESR, PGA indicating no active disease) for at least 6 months.Results:55 JIA patients that started BT up to 24 months from diagnosis were analyzed. 69,1% were girls with a median age at diagnosis of 8 years old IQR(3-13), median age at the start of BT of 9 years old IQR(3-13). Regarding JIA categories: 25,5% were Oligoarticular Persistent (OligP), 18,2% Systemic JIA (sJIA), 16,4% Entesitis related Arthritis (ERA), 12,7% Psoriatic Arthritis (APso) and Polyarticular RF- (PolyRF-), 5,5% Oligoarticular Extended (OligE) and Polyarticular RF+ (PolyRF+), 3,6% Undifferentiated (Und). 20% of patients had uveitis during followup. Conventional DMARD (cDMARD) was indicated in 83,6% of patients (95,7% Methotrexate) at diagnosis [median 0 months IQR(0-2,3)]. At the end of followup (2 years) only 30,9% of patients continued with cDMARDs. The main causes of discontinuation were: adverse events (46,7%), remission (36,7%). TNF inhibitors were precribed in 81,8% of patients and 18,2% of patients recieved two BT during the first 2 years from diagnosis. 54,5% of BT were indicated during the first 6 months from diagnosis, 27,3% from 7 to 12 months, 12,7% from 13 to 18 months, 5,5% from 19 to 24 months.After 2 years from diagnosis, 78,2% of patients were on remission and 21,8% active. Among patients with active disease: 75% had arthritis, 16,7% had uveitis and 8,3% had both. There were no differences regarding disease activity among patients with uveitis and neither taking cDMARDs. Regarding JIA categories: 66,7% of OligE, 57,1% of PolyRF- and 57,1% of APso patients were active at 2 years from diagnosis when compared to the other categories (p=0.004).Patients on remission at 24 months from diagnosis started sooner the BT than active patients [CI 95% (0,46-8,29) p=0,029]. The time when the BT was started was correlated to the activity at 2 years (K= 0,294 p=0,029). When the BT was prescribed after 7,5months from diagnosis it was correlated, in a COR curve, with a higher probability of active disease at 2 years (S= 0,67 E= 0,63). There was a correlation, among patients on remission at 2 years, between prompt start of BT and less time to reach remission (K= -0,345 p=0,024). Patients with active disease at 2 years, regardless of moment of BT iniciation, required more BT during follow-up (p=0,002).Conclusion:Prompt iniciation of BT was correlated with a better outcome. JIA patients that started BT early after diagnosis had a higher probability of remission after 2 years. Starting BT after 7,5 months was correlated with a higher probability of active disease at 2 years. Active disease at 24 months was correlated with persistent active disease during follow-up.Disclosure of Interests:None declared

scholarly journals POS0208 GENDER DIFFERENCES IN RESPONSE TO BIOLOGICALS. WOMEN FARE WORSE ACROSS INFLAMMATORY ARTHRITIS DISEASES - DATA FROM THE BIOREG

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 320.1-321
Author(s):  
E. Loibner ◽  
V. Ritschl ◽  
B. Leeb ◽  
P. Spellitz ◽  
G. Eichbauer-Sturm ◽  
...  
Keyword(s):  
Gender Differences ◽  
Psoriatic Arthritis ◽  
Gender Difference ◽  
Disease Activity ◽  
Inflammatory Arthritis ◽  
Tnf Inhibitors ◽  
Significant Difference ◽  
The Difference ◽  
All Diseases

Background:Gender differences in prevalence and disease course are known in various rheumatic diseases; however, investigations of gender difference concerning therapeutical response have yielded variable results.Objectives:The aim of this retrospective study was to investigate, whether a gender difference in response rate to biological disease-modifying antirheumatic drugs (bDMARDs) and apremilast in bDMARD-naïve patients could be observed across the three most prevalent inflammatory arthritis diseases: rheumatoid arthritis (RA), spondylarthritis (SpA) and psoriatic arthritis (PsA). Additionally, a response to individual TNF blockers was investigated in this respect.Methods:Data from bDMARD-naïve RA-, SpA- and PsA-patients from Bioreg, the Austrian registry for biological DMARDs in rheumatic diseases, were used. Patients with a baseline (Visit 1=V1) and follow-up visits at 6 months (Visit 2=V2) and 12 months (Visit 3=V3) were included and response to therapy with TNF-inhibitors (TNFi), furthermore to therapy with rituximab, tocilizumab and apremilast was analyzed according to gender. The remaining bDMARDs were not analyzed due to small numbers. Key response-parameter for RA was disease activity score (DAS28), whereas for PsoA the Stockerau Activity Score for Psoriatic Arthritis (SASPA) and for SpA the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were employed; in addition, the Health assessment Questionnaire (HAQ) was used. Data were analyzed in R Statistic stratified by gender using Kruskal-Wallis and Wilcoxon tests.Results:354 women and 123 men with RA (n=477), 81 women and 69 men with PsA (n=150), 121 women and 191 men with SpA (n=312) were included. No significant differences in biometrics was seen between female and male patients at baseline in all diseases.In RA patients overall DAS28 decreased from baseline (V1) to V2 and V3 (DAS28: V1: male: 4.38 [3.66, 5.11], female: 4.30 [3.68, 5.03], p(m/f) = 0.905; V2: male: 2.66 [1.73, 3.63], female: 3.10 [2.17, 3.98], p(m/f) = 0.015; V3: male: 2.25 [1.39, 3.36], female: 3.01 [1.87, 3.87], p(m/f) = 0.002). For TNF inhibitors (n=311), there was a significant difference between genders at V2 (Fig.1a). Patients receiving Rituximab (n=41) displayed a significantly higher DAS28 at baseline in females, which diminished in the follow up: V1: (p(m/f) p=0.002; V2: p=0.019; V3: p=0.13); response to tocilizumab (n=63) did not show any gender differences.In PsA patients overall SASPA decreased from baseline (V1) to V2 and V3 (SASPA: V1: male: 4.00 [2.80, 5.20], female: 4.40 [2.80, 5.80], p(m/f) = 0.399; V2: male: 2.20 [1.20, 3.50], female: 3.40 [2.00, 5.00], p(m/f) = 0.071; V3: male: 1.80 [0.80, 2.70], female: 3.01 [2.35, 4.80], p(m/f) = 0.001). For TNF inhibitors (n=79), there was a significant difference between genders at V3 (Fig 1a). For Apremilast (n=39), there was a significant difference between genders at V2 (Fig.1c).In SpA patients overall BASDAI decreased from baseline (V1) to V2 and V3 (BASDAI: V1: male: 4.70 [2.88, 6.18], female: 4.80 [3.30, 6.20], p(m/f) = 0.463; V2: male: 3.05 [2.00, 4.60], female: 3.64 [2.62, 5.41], p(m/f) = 0.039; V3: male: 3.02 [1.67, 4.20], female: 3.65 [2.18, 5.47], p(m/f) = 0.016). In V3 a differential BASDAI in response to TNFi (n=299) was observed (Fig.1a).Possible differences of response to individual TNFi (etanercept, infliximab, other TNFi) measured by HAQ were investigated in all diseases together. The difference between male and females was significant at baseline for all 3 TNFi; whereas with the use of ETA the significant difference was carried through to V2 and V3, it was lost with the use of IFX and was variable with the other TNFi (Fig.1b)Figure 1.Conclusion:Female patients showed a statistically lower response to TNFi in all three disease entities (RA, SpA and PsoA) to a variable degree in our homogenous central european population. Interestingly, the difference was not uniform across individual TNFi when measured by HAQ. Gender differences were also seen in response to Apremilast.Disclosure of Interests:Elisabeth Loibner: None declared, Valentin Ritschl: None declared, Burkhard Leeb Speakers bureau: AbbVie, Roche, MSD, Pfizer, Actiopharm, Boehringer-Ingelheim, Kwizda, Celgene, Sandoz, Grünenthal, Eli-Lilly, Grant/research support from: TRB, Roche, Consultancies: AbbVie, Amgen, Roche, MSD, Pfizer, Celgene, Grünenthal, Kwizda, Eli-Lilly, Novartis, Sandoz;, Peter Spellitz: None declared, Gabriela Eichbauer-Sturm: None declared, Jochen Zwerina: None declared, Manfred Herold: None declared, Miriam Stetter: None declared, Rudolf Puchner Speakers bureau: AbbVie, BMS, Janssen, Kwizda, MSD, Pfizer, Celgene, Grünenthal, Eli-Lilly, Consultant of: AbbVie, Amgen, Pfizer, Celgene, Grünenthal, Eli-Lilly, Franz Singer: None declared, Ruth Fritsch-Stork: None declared

scholarly journals AB0806 DOES VITAMIN D INFLUENCE THE ACTIVITY OF THE DISEASE IN PATIENTS WITH PSORIATIC ARTHRITIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1704.1-1705
Author(s):  
L. Montolio-Chiva ◽  
A. V. Orenes Vera ◽  
M. Aguilar-Zamora ◽  
C. Vergara-Dangond ◽  
I. Vázquez-Gómez ◽  
...  
Keyword(s):  
Vitamin D ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Functional Capacity ◽  
Inverse Correlation ◽  
Hypovitaminosis D ◽  
Joint Involvement ◽  
Average Value ◽  
Vitamin D Levels

Background:Several studies have shown an inverse relationship between vitamin D levels (25OHD) and disease activity in patients with rheumatoid arthritis (RA). However, the existing data in patients with psoriatic arthritis (PsA) are poor, and they use the DAS28 index as a peripheral joint activity marker by extrapolation with RA.Objectives:To analyze the relationship between 25OHD levels, disease activity and functional capacity in patients with PsA.Methods:Transversal, observational, descriptive study. We included PsA patients with peripheral joint involvement. We collected demographic variables (gender, age), clinical variables [follow-up, received treatments, TJC (68), SJC (68), VAS] and analytical variables (25OHD, CRP, ESR). We usedDisease activity in psoriatic arthritis(DAPSA) score to measure disease activity, and theHealth assessment questionnaire(HAQ) to determine functional capacity. Levels of 25 OHD <20 ng/ml and between 20-30 ng/ml were considered deficient and insufficient, respectively. Statistical analysis was made with SPSS 22.0. The descriptive analysis results were expressed as percentage and mean ± SD. We used Pearson’s correlation to assess the association between quantitative variables and T test to compare means between dichotomous variables.Results:125 patients were included, the majority women (60.8%), with an average age of 55.4 (SD 12.2) years. The average follow-up was 75.5 (SD 68.3) months. 97.6% of patients had received DMARDs and 40.8% biologics, and almost half of the patients (42.7%) took calcium and 25OHD supplements. The average value of 25OHD was 27.1 (SD 12.1) ng/ml, with 30% of patients having 25OHD deficit and 63.3% insufficiency. The majority of patients had an acceptable disease control, with a mean DAPSA of 10.5 (SD 7,9); and mean of CRP, ESR, TJC and SJC was 6.1 (SD 3.7) mg/l, 10.2 (SD 9.9) mm/h, 1.3 (SD 2.5) and 0.7 (SD 2.1), respectively. The average value of HAQ was 0.6 (SD 0.7). We observed an inverse correlation between 25OHD levels and joint counts, TJC (p=0.02) and SJC (p=0.03). On the other hand, patients with hypovitaminosis D presented a tendency to get higher scores in DAPSA index (P=0.07). We do not observe any relationship between 25OHD and HAQ.Conclusion:As can be seen in our sample, low values of 25OHD are related to increased disease activity in patients with PsA.Disclosure of Interests:L Montolio-Chiva: None declared, Ana V Orenes Vera: None declared, Marta Aguilar-Zamora: None declared, C Vergara-Dangond: None declared, I Vázquez-Gómez: None declared, Eduardo Flores: None declared, A Sendra-García: None declared, À Martínez-Ferrer: None declared, Elia Valls-Pascual Grant/research support from: Roche, Novartis, and AbbVie, Speakers bureau: AbbVie, Lilly, Pfizer, MSD, Novartis, Janssen, Bristol Myers Squibb, UCB Pharma, D Ybáñez-García Speakers bureau: Lilly, Roche, Sanofi, V Núñez-Monje: None declared, I Torner-Hernández: None declared, Juanjo J Alegre-Sancho Consultant of: UCB, Roche, Sanofi, Boehringer, Celltrion, Paid instructor for: GSK, Speakers bureau: MSD, GSK, Lilly, Sanofi, Roche, UCB, Actelion, Pfizer, Abbvie, Novartis

scholarly journals SAT0432 EFFECT OF SEX ON DISEASE CHARACTERISTICS AND DISEASE IMPACT IN PATIENTS WITH PSORIATIC ARTHRITIS (PsA): INSIGHTS FROM THE REAL-WORLD, OBSERVATIONAL MULTINATIONAL PsABio COHORT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1171.1-1173
Author(s):  
M. T. Nurmohamed ◽  
I. Van der Horst-Bruinsma ◽  
A. W. Van Kuijk ◽  
S. Siebert ◽  
P. Bergmans ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Physical Functioning ◽  
Real World ◽  
Comprehensive Treatment ◽  
Diagnosis Delay ◽  
Health State ◽  
Research Support ◽  
Disease Characteristics ◽  
Disease Impact

Background:Female sex has been associated with more severe disease and poorer treatment outcomes in PsA. These observations are often based on small populations or national cohorts/registries.Objectives:To investigate the effects of sex on disease characteristics and disease impact in PsA, using data of 929 consecutive patients (pts) from PsABio.Methods:PsABio is a real-world, non-interventional European study in PsA pts treated with UST or TNFi based on their rheumatologist’s choice. Observed male and female baseline (BL) data were described and compared using 95% CI.Results:Women in PsABio (n=512 [55%]) were numerically older than men (mean [SD]: 50.5 [12.7] / 48.7 [12.3] years, respectively). Women were more obese (BMI >30), % (95% CI): F: 35 (30, 39), M: 24 (20, 29), men more overweight (BMI >25–30): F: 31 (27, 36), M:51 (46, 57). Age at diagnosis, delay from first symptom to diagnosis, and disease duration were similar for both sexes.Women entered PsABio more often on 3rd line treatment, whereas men started on 1st-line biologic treatment more often (F/M 1st line 47%/55%; 2nd line 34%/33%; 3rd line 20%/12%). Numerically, concomitant MTX was given more often to women vs men (32% vs 27%). At BL, 60% of women and 64% of men were on NSAIDs; 7.9% and 2.5% on antidepressant drugs. Women had significantly more comorbidities, with numerically more cardiovascular disease and anxiety/depression, and 3 times more IBD.Women had significantly higher 68 tender joint counts (TJC): 13.0 vs 10.4, while 66 swollen joint counts were not significantly different: 5.8 vs 5.5. Axial or combined axial-peripheral disease was similarly frequent, in 29% of women and 26% of men (Figs. 1, 2).Clinical Disease Activity index for PSoriatic Arthritis (cDAPSA) was higher in women (31.8 vs 27.3); pt-reported levels of pain, global disease activity (VAS scales) and higher TJC contributed to this. While enthesitis prevalence (based on Leeds Enthesitis Index) was comparable, men had significantly more frequent dactylitis, nail disease and worse skin psoriasis. At BL, 3.4% of women vs 7.1% of men, were in MDA.Regarding physical functioning (HAQ-DI), impact of disease (PSAID-12) and quality of life (EQ5D-3L health state), women with PsA starting a biologic (b)DMARD, expressed significantly greater negative impact and more limitations due to their disease (Fig. 2).Conclusion:In routine care, women with PsA starting a bDMARD presented with worse outcomes over a range of assessments compared with men (higher pt-reported pain and disease activity, TJC, and worse physical functioning and QoL), while men had worse dactylitis and psoriasis. Follow-up analysis will report whether the effects of biologic therapy are different in both sexes. The increased prevalence of associated features related to pain and impact on functioning and QoL may indicate the need for a more comprehensive treatment approach for women to avoid unnecessary and premature bDMARD stop or switch.Acknowledgments:This study was funded by Janssen.Disclosure of Interests:Michael T Nurmohamed Grant/research support from: Abbvie, Bristol-Myers Squibb, Celltrion, GlaxoSmithKline, Jansen, Eli Lilly, Menarini, Merck Sharp & Dohme, Mundipharma, Pfizer, Roche, Sanofi, USB, Consultant of: Abbvie, Bristol-Myers Squibb, Celltrion, GlaxoSmithKline, Jansen, Eli Lilly, Menarini, Merck Sharp & Dohme, Mundipharma, Pfizer, Roche, Sanofi, USB, Speakers bureau: Abbvie, Bristol-Myers Squibb, Celltrion, GlaxoSmithKline, Jansen, Eli Lilly, Menarini, Merck Sharp & Dohme, Mundipharma, Pfizer, Roche, Sanofi, USB, Irene van der Horst-Bruinsma Grant/research support from: AbbVie, Novartis, Eli Lilly, Bristol-Myers Squibb, MSD, Pfizer, UCB Pharma, Consultant of: AbbVie, Novartis, Eli Lilly, Bristol-Myers Squibb, MSD, Pfizer, UCB Pharma, Arno WR van Kuijk Grant/research support from: Janssen, Stefan Siebert Grant/research support from: BMS, Boehringer Ingelheim, Celgene, GlaxoSmithKline, Janssen, Novartis, Pfizer, UCB, Consultant of: AbbVie, Boehringer Ingelheim, Janssen, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, Celgene, Janssen, Novartis, Paul Bergmans Shareholder of: Johnson & Johnson, Employee of: Janssen, Kurt de Vlam Consultant of: Celgene Corporation, Eli Lilly, Novartis, Pfizer, UCB – consultant, Speakers bureau: Celgene Corporation, Eli Lilly, Novartis, Pfizer, UCB – speakers bureau and honoraria, Elisa Gremese Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Sanofi, UCB, Roche, Pfizer, Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Sanofi, UCB, Roche, Pfizer, Beatriz Joven-Ibáñez Speakers bureau: Abbvie, Celgene, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, Tatiana Korotaeva Grant/research support from: Pfizer, Consultant of: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB, Speakers bureau: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB, Wim Noel Employee of: Janssen Pharmaceuticals NV, Petros Sfikakis Grant/research support from: Grant/research support from Abvie, Novartis, MSD, Actelion, Amgen, Pfizer, Janssen Pharmaceutical, UCB, Elke Theander Employee of: Janssen-Cilag Sweden AB, Josef S. Smolen Grant/research support from: AbbVie, AstraZeneca, Celgene, Celltrion, Chugai, Eli Lilly, Gilead, ILTOO, Janssen, Novartis-Sandoz, Pfizer Inc, Samsung, Sanofi, Consultant of: AbbVie, AstraZeneca, Celgene, Celltrion, Chugai, Eli Lilly, Gilead, ILTOO, Janssen, Novartis-Sandoz, Pfizer Inc, Samsung, Sanofi, Laure Gossec Grant/research support from: Lilly, Mylan, Pfizer, Sandoz, Consultant of: AbbVie, Amgen, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sandoz, Sanofi-Aventis, UCB

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