scholarly journals Mortality trends in a Cohort of Canadian Psoriatic Arthritis Patients

2020 ◽  
Vol 14 (2) ◽  
Author(s):  
Boluwaji Ogunyemi

Methods: We reviewed retrospectively the charts of psoriatic arthritis patients who died from 1995-2010.We included 13 deceased patients with a psoriatic arthritis di-agnosis and compared them with 140 patients living with psoriatic arthritis that at-tend the same clinic. The population was derived from a single academic rheumatol-ogist’s practice in St. John’s, Newfoundland, Canada. Patients are seen at six-month intervals with a history and physical exam performed at each visit. Laboratory data was collected at each visit. Diagnosis of psoriatic arthritis is based on the CASPAR Classifcation and Diagnostic Criteria for Psoriatic Arthritis. Results: The mean age of the 13 deceased patients was 62.9 years. Of these, 38.5% were female and 85.7% had an erythrocyte sedimentation rate greater than 15 mm/hour vs. 36.4% of patients living with psoriatic arthritis. Of deceased patients, 16%had dystrophic nail changes of vs. 59.6% of living patients. Health Assessment Questionnaire was found to show a signifcantly greater loss in function in deceasedpatients. (1.39 vs. 0.70, p= 0.002). Almost half of the deceased patients had used Prednisone (46.2%) as opposed to 11.2% of living patients. Conclusions: We realize that this study employs a small sample size. Increased ESR and Health Assessment Questionnaire score were found to be associated with mor-tality in psoriatic arthritis patients. Dystrophic nail changes were found to be pro-tective for psoriatic arthritis patients.

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Maria Chiara Ditto ◽  
Simone Parisi ◽  
Marta Priora ◽  
Silvia Sanna ◽  
Clara Lisa Peroni ◽  
...  

Abstract AntiTNF-α biosimilars are broadly available for the treatment of inflammatory arthritis. There are a lot of data concerning the maintenance of clinical efficacy after switching from originators to biosimilars; therefore, such a transition is increasingly encouraged both in the US and Europe. However, there are reports about flares and adverse events (AE) as a non-medical switch remains controversial due to ethical and clinical implications (efficacy, safety, tolerability). The aim of our work was to evaluate the disease activity trend after switching from etanercept originator (oETA-Enbrel) to its biosimilar (bETA-SP4/Benepali) in a cohort of patients in Turin, Piedmont, Italy. In this area, the switch to biosimilars is stalwartly encouraged. We switched 87 patients who were in a clinical state of stability from oETA to bETA: 48 patients were affected by Rheumatoid Arthritis (RA),26 by Psoriatic Arthritis (PsA) and 13 by Ankylosing Spondylitis (AS).We evaluated VAS-pain, Global-Health, CRP, number of swollen and tender joints, Disease Activity Score on 28 joints (DAS28) for RA, Disease Activity in Psoriatic Arthritis (DAPSA) for PsA, Health Assessment Questionnaire (HAQ) and Health Assessment Questionnaire for the spondyloarthropathies (HAQ-S),Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS patients. 11/85 patients (12.6%) stopped treatment after switching to biosimilar etanercept. No difference was found between oETA and bETA in terms of efficacy. However, some arthritis flare and AE were reported. Our data regarding maintenance of efficacy and percentage of discontinuation were in line with the existing literature.


2021 ◽  
pp. jrheum.200927
Author(s):  
Weiyu Ye ◽  
Simon Hackett ◽  
Claire Vandevelde ◽  
Sarah Twigg ◽  
Philip S. Helliwell ◽  
...  

Objective To compare physical function scales of the Multi-Dimensional Health Assessment Questionnaire (MDHAQ) to the Health Assessment Questionnaire Disability Index (HAQDI) in patients with psoriatic arthritis (PsA), and examine whether either questionnaire is less prone to ‘floor effects’. Methods Data were collected prospectively from 2018 to 2019 across three UK hospitals. All patients completed physical function scales within the MDHAQ and HAQDI in a single clinic visit. Agreement was assessed using medians and the Bland-Altman method. Intraclass correlation coefficients (ICCs) were used to assess test-retest reliability. Results 210 patients completed the clinic visit; one withdrew consent thus 209 were analysed. 60.0% were male, with mean age of 51.7 years and median disease duration of 7 years. In clinic, median MDHAQ and HAQDI including/excluding aids scores were 0.30, 0.50 and 0.50 respectively. Although the median score for HAQDI is higher than MDHAQ, the difference between the two mostly lies within 1.96 standard deviations from the mean suggesting good agreement. The ICCs demonstrated excellent test-retest reliability for both HAQ questionnaires.Similar numbers of patients scored ‘0’ on the MDHAQ and HAQDI including/excluding aids (48, 47, and 49 respectively). Using a score of ≤0.5 as a cut-off for minor functional impairment, 23 patients had a MDHAQ ≤0.5 when their HAQDI including aids >0.5. Conversely, 4 patients had a MDHAQ > 0.5 when the HAQDI including aids ≤0.5. ConclusionBoth HAQ questionnaires appear to be similar in detecting floor effects in patients with PsA.


2010 ◽  
Vol 37 (5) ◽  
pp. 1024-1028 ◽  
Author(s):  
TIFFANY KWOK ◽  
JANET E. POPE

Objective.To determine the minimally important difference (MID) for the Health Assessment Questionnaire-Disability Index (HAQ-DI), pain, fatigue, sleep, and global visual analog scale (VAS; 0–100 mm) in patients with psoriatic arthritis (PsA) using a patient-reported overall health status anchor. Patient-reported outcomes are often used to gauge the effect of PsA in clinical trials. There is currently no knowledge about the MID for patient-reported outcomes in PsA.Methods.Patients with a diagnosis of PsA who had answered questions about outcomes at 2 consecutive visits and an overall health status question (“How would you describe your overall status since your last visit: much better, better, the same, worse, much worse?”) were included. MID was calculated as the mean change between visits for those who rated their disease as “better” or “worse.”Results.Two hundred patients met inclusion criteria, of whom 17.5% rated their status as “better” and 25.0% rated their status as “worse” than the previous visit. MID estimates for improvement/worsening (SD) respectively were −0.131 (0.411)/0.131 (0.309) for HAQ-DI, −9.37 (24.37)/13.96 (22.05) for pain VAS, −8.15 (23.52)/3.63 (27.62) for fatigue VAS, −10.97 (29.74)/13.81 (27.32) for sleep VAS, and −8.41 (21.17)/11.53 (21.03) for global VAS. Spearman’s r correlation coefficients between the anchor and mean change were 0.374 (HAQ-DI), 0.448 (pain VAS), 0.239 (fatigue VAS), 0.326 (sleep VAS), 0.490 (global VAS); p < 0.01.Conclusion.This is the first study investigating MID of patient-reported outcomes in PsA. MID for HAQ-DI, pain, and global VAS were shown to be the best predictors for a patient’s perception of overall changes in disease status.


RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001067 ◽  
Author(s):  
Alen Zabotti ◽  
Dennis G McGonagle ◽  
Ivan Giovannini ◽  
Enzo Errichetti ◽  
Francesca Zuliani ◽  
...  

ObjectiveNon-specific musculoskeletal pain is common in subjects destined to develop psoriatic arthritis (PsA). We evaluated psoriatic patients with arthralgia (PsOAr) compared with psoriasis alone (PsO) and healthy controls (HCs) using ultrasonography (US) to investigate the anatomical basis for joint symptoms in PsOAr and the link between these imaging findings and subsequent PsA transition.MethodsA cross-sectional prevalence analysis of clinical and US abnormalities (including inflammatory and structural lesions) in PsOAr (n=61), PsO (n=57) and HCs (n=57) was performed, with subsequent prospective follow-up for PsA development.ResultsTenosynovitis was the only significant sonographic feature that differed between PsOAr and PsO (29.5% vs 5.3%, p<0.001), although synovitis and enthesitis were numerically more frequent in PsOAr. Five patients in PsOAr and one in PsO group developed PsA, with an incidence rate of 109.2/1000 person-years in PsOAr vs 13.4/1000 person-years in PsO (p=0.03). Visual Analogue Scale pain, Health Assessment Questionnaire, joint tenderness and US active enthesitis were baseline variables associated with PsA development.ConclusionTenosynovitis was associated with arthralgia in subjects with psoriasis. Baseline US evidence of enthesitis was associated with clinical PsA development in the longitudinal analysis. These findings are relevant for enriching for subjects at risk of imminent PsA development.


2009 ◽  
Vol 36 (9) ◽  
pp. 2033-2041 ◽  
Author(s):  
YONATAN AVIEL BUTBUL ◽  
PASCAL N. TYRRELL ◽  
RAYFEL SCHNEIDER ◽  
SANDEEP DHILLON ◽  
BRIAN M. FELDMAN ◽  
...  

Objective.To compare the clinical features and outcome between patients with juvenile psoriatic arthritis (JPsA) and non-JPsA juvenile idiopathic arthritis (JIA).Methods.Fifty-three children with JPsA, 32 with < 5 joints in the first 6 months of disease (oligo–JPsA) and 21 (≥ 5 joints) polyarticular-onset (poly-JPsA) were compared to 53 patients with JIA who were matched by sex, age, date of diagnosis, and articular onset pattern.Results.There was no difference in the percentage of patients between the oligoarticular groups who developed extended oligoarthritis or in the percentage of patients who were positive for antinuclear antibodies. The only differences were that 25% of patients with oligo-JPsA had dactylitis compared to 0% of patients with oligo-JIA (p < 0.01) and 50% had nail pitting as compared to 18.7% (p < 0.05). In polyarticular patients the percentages with dactylitis were similar (19% vs 38%; p = 0.25). The frequency of uveitis was identical in the oligoarticular patients but a higher rate was seen in poly-JPsA compared to poly-JIA (23.8% vs 0%; p = 0.02), while contractures were more frequent in poly-JIA compared to poly-JPsA during the course of the illness (47.6% vs 14.3%; p = 0.03) but not at last followup (14.3% vs 4.7%; p = 0.6). At last followup the mean Childhood Health Assessment Questionnaire scores were similar in both the polyarticular and oligoarticular groups.Conclusion.There were only a few differences between patients with JPsA and JIA regarding disease onset, disease course, and outcome. We suggest that large, longterm prospective studies are required to accurately determine whether subdividing JIA according to psoriasis is worthwhile.


Sign in / Sign up

Export Citation Format

Share Document