Psoriatic arthritis in Jordan: a cross-sectional study of disease characteristics, patient-reported outcomes, and disease activity.

Abstract

Background: Psoriatic arthritis (PsA) is a chronic, inflammatory rheumatic disease. We aim to describe the characteristics of PsA patients and examine factors affecting their psychological and physical well-being.

Methods: This multicenter, cross-sectional study enrolled consecutive PsA patients from rheumatology clinics over six months. Data was collected through questionnaires and chart reviews. Disease activity was assessed using Disease Activity in Psoriatic Arthritis (DAPSA) and Psoriatic Arthritis Impact of Disease-12 (PsAID-12), with fibromyalgia and psychological well-being screened via Fibromyalgia Rapid Screening Tool (FiRST) and Patient Health Questionnaire-4 (PHQ-4), respectively.

Results: The study enrolled 105 patients with a mean age of 45.6 ± 12.9, and 46.7% (N = 49) were males. The predominant disease type was polyarthritis (80%, N = 84), with 90.5% (N = 95) having psoriasis (PSO). Arthritis and PSO were diagnosed simultaneously in 18 patients (17.1%), arthritis preceded PSO in 11 patients (10.5%) by 3.5 ± 3.8 years, and PSO preceded arthritis in 76 patients (72.4%) by 10.65 ± 11.27 years. The diagnostic delay of PsA was 3.1 ± 4.9 years. Methotrexate was used by 50.5% (N = 53) and 20% (N = 21) used anti-TNF. Severe disease activity, according to DAPSA scores, was present in 38.1%, positive screening for fibromyalgia in 29.5% (N = 31), and 35.2% (N = 37) had severe depression and anxiety-related symptoms. Using multivariate regression analysis, Obesity (OR = 3.267, 95% CI: 1.015-10.513) and the presence of CVD (OR = 4.769, 95% CI: 1.121-20.293) were predictors of bone erosions. PsAID-12 scores and ESR were associated with severe depression and anxiety-related symptoms (95% OR: 1.443-4.459 and 1.001:1.078), respectively.

Conclusions: Patients with PsA often face diagnostic delays, with fibromyalgia, depression, and anxiety being common, resulting in poorer patient-reported outcomes.