Clinical Characteristics of “Severe” Peripheral Psoriatic Arthritis: A Retrospective Analysis of a Longitudinal Cohort

IF 2.9 3区医学 Q2 RHEUMATOLOGY

Rheumatology and Therapy Pub Date : 2024-04-09 DOI:10.1007/s40744-024-00667-0

Ennio Lubrano, Silvia Scriffignano, Fabio Massimo Perrotta

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Abstract

Introduction

The concept of severity in a multidomain disease such as psoriatic arthritis (PsA) is still not well defined. The aim of this study was to identify the clinical characteristics of patients with severe peripheral PsA.

Methods

Retrospective analysis of a longitudinal cohort. Demographic and clinical characteristics of patients with PsA 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). Hence, patients with a score of 3 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 non-severe.

Results

We evaluated 177 patients with peripheral PsA (M/F: 98/76). Of these, 64 (36.1%) were identified as severe according to the mCPDAI criteria, at baseline. Eighteen patients (10.1%) at last follow-up still met the definition of severe PsA. At last follow-up visit, severe patients with PsA were only males (18/18, P < 0.01) and have worse outcomes in terms of disease activity, pain, function, and impact of disease. Male sex and the severity of skin involvement at baseline were factors associated with the presence of severe PsA. The agreement between the presence of severe PsA and the absence of minimal disease activity was slight [Cohen’s k: 0.174 (0.084–0.264)].

Conclusions

Our study showed that severe patients with PsA had more disease activity, pain, and impact of disease than non-severe patients. Furthermore, we demonstrated that severity and disease activity are not interchangeable concepts.

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严重 "外周型银屑病关节炎的临床特征：纵向队列的回顾性分析

导言：银屑病关节炎（PsA）等多领域疾病的严重程度概念仍未得到很好的界定。本研究旨在确定严重外周型 PsA 患者的临床特征。收集了 PsA 患者在基线和最后一次随访时的人口统计学和临床特征。我们使用改良的综合银屑病疾病活动指数（mCPDAI）来定义重度人群，该指数不包括强直性脊柱炎生活质量量表）。因此，至少在一个领域得分达到 3 分的患者被定义为重度 PsA 患者。我们将符合重度 PsA 定义的患者的临床特征与非重度 PsA 患者的临床特征进行了比较。根据 mCPDAI 标准，其中 64 例（36.1%）在基线时被确定为重度。18名患者（10.1%）在最后一次随访时仍符合重度PsA的定义。在最后一次随访时，重度 PsA 患者中仅有男性（18/18，P <0.01），并且在疾病活动性、疼痛、功能和疾病影响方面的预后较差。男性性别和基线时皮肤受累的严重程度是与出现严重 PsA 相关的因素。我们的研究表明，重度 PsA 患者比非重度患者有更多的疾病活动、疼痛和疾病影响。此外，我们还证明了严重程度和疾病活动性并不是可以互换的概念。

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来源期刊

Rheumatology and Therapy RHEUMATOLOGY-

CiteScore

6.00

自引率

5.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Rheumatology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of rheumatologic therapies. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. Areas of focus include, but are not limited to, rheumatoid arthritis, gout, gouty arthritis, psoriatic arthritis, osteoarthritis, juvenile idiopathic/rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis, Pompe’s disease, inflammatory joint conditions, musculoskeletal conditions, systemic sclerosis, and fibromyalgia. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial protocols, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Rheumatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Ethics and Disclosures The journal is a member of the Committee on Publication Ethics (COPE) and subscribes to its principles on how to deal with acts of misconduct thereby committing to investigate allegations of misconduct in order to ensure the integrity of research. Content in this journal is peer-reviewed (Single-blind). 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