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

IF 2.5 Q3 RHEUMATOLOGY

BMC Rheumatology Pub Date : 2025-02-17 DOI:10.1186/s41927-025-00468-0

Fatima Alnaimat, Khaldoon Alawneh, Ayman AbuHelal, Omar Hamdan, Almothana Alelaimat, Manal Al Mashaleh, Ausaylah Burqan, Wala Rababah, Rabaa Rababah, Marwan Adwan

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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.

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约旦银屑病关节炎：疾病特征、患者报告的结果和疾病活动性的横断面研究

背景：银屑病关节炎（Psoriatic arthritis, PsA）是一种慢性炎性风湿病。我们的目的是描述PsA患者的特征，并检查影响其心理和身体健康的因素。方法：这项多中心横断面研究招募了来自风湿病诊所的连续PsA患者超过6个月。通过问卷调查和图表审查收集数据。疾病活动性评估采用银屑病关节炎疾病活动性（DAPSA）和银屑病关节炎疾病影响12 (PsAID-12)，纤维肌痛和心理健康分别通过纤维肌痛快速筛查工具（FiRST）和患者健康问卷-4 （PHQ-4）进行筛查。结果：105例患者入组，平均年龄（45.6±12.9）岁，男性46.7% （N = 49）。主要疾病类型为多关节炎（80%,N = 84），银屑病（PSO）占90.5% （N = 95）。18例（17.1%）患者同时诊断为关节炎和PSO， 11例（10.5%）患者关节炎先于PSO出现3.5±3.8年，76例（72.4%）患者PSO先于关节炎出现10.65±11.27年。PsA的诊断延迟为3.1±4.9年。50.5% （N = 53）使用甲氨蝶呤，20% （N = 21）使用抗tnf。根据DAPSA评分，38.1%存在严重疾病活动，29.5% （N = 31）存在纤维肌痛筛查阳性，35.2% （N = 37）存在严重抑郁和焦虑相关症状。通过多因素回归分析，肥胖（OR = 3.267, 95% CI: 1.015-10.513）和心血管疾病（OR = 4.769, 95% CI: 1.121-20.293）是骨质侵蚀的预测因素。PsAID-12评分和ESR与严重抑郁和焦虑相关症状相关（95% OR: 1.443-4.459和1.001:1.078）。结论：PsA患者经常面临诊断延迟，纤维肌痛、抑郁和焦虑是常见的，导致患者报告的结果较差。

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