Obesity is a common cardiovascular risk factor in psoriatic disease. Although the prevalence of obesity is high, the factors associated with it in patients with psoriatic arthritis (PsA) are poorly understood. We aimed to analyze the frequency and obesity-associated factors in a cohort of PsA. This retrospective cross-sectional study included 290 consecutive patients with PsA according to CASPAR criteria. Three-hundred ten psoriatic patients without arthritis and 600 outpatients without inflammatory conditions were used as comparison populations. The factors associated with obesity were analyzed first using conditional logistic regression. The significant factors in this first model were introduced in a multivariate model using a backward step approach. This series included 159 men (54.8%) and 131 women (45.2%), with an average age of 54 ± 12 years. Obesity was more common both in psoriasis (36.5% vs 22%, OR 2.1 [95%CI: 1.5–2.8), P < .01]) and PsA (27.6% vs 22%, OR 1.4 [95%CI: 1.0–1.9], P < .05) than in the non-inflammatory population. Obesity was more frequent in psoriasis (36.5%) than in PsA (27.6%), OR 1.5 95% CI: 1.1 to 2.1, P < .05. After correcting for age, sex, disease duration, and other confounders, independent associations with obesity ( P < .05) were: PsA family history (OR 3.6, 95%CI: 1.1–12.4), evolution as axial disease (OR 4.4, 95%CI: 1.0–15.4), and dyslipidemia (OR 3.5, 95%CI: 1.5–8.6). Obesity is common in psoriatic disease, but much more frequent among patients with cutaneous than joint disease. Patients who present with spondylitis during evolution are more prone to this comorbidity, and therefore, should be closely monitored to correct this eventuality in a timely manner.

BackgroundObesity (BMI ≥30 kg/m2) is a common cardiovascular risk factor in psoriatic disease1. Although the prevalence of obesity is high, the factors associated with it in psoriatic arthritis (PsA) are poorly understood.ObjectivesWe aimed to evaluate the prevalence and obesity-associated factors in patients with PsA.MethodsRetrospective cross-sectional study that included 205 consecutive patients with PsA according to CASPAR criteria. The prevalence of obesity was compared with that of 310 patients with skin psoriasis of similar age (±3 years). The factors associated with obesity were first analysed by a conditional logistic regression. The significant factors in this first model were then introduced in a multivariate model using a backward step approach (p-values<0.05 were considered significant).ResultsOne-hundred twelve men and 94 women were included, with a mean age of 53±13 years. Obesity was more prevalent among psoriatics (36.5%) compared to PsA patients (24%), OR 1.6 (1.1–2.3), p<0.05. The factors associated with obesity in the univariate analysis (p<0.05) were: onset of psoriasis >40 years (OR 2.4), onset of arthritis >40 years (OR 2.1), PsA family history (OR 3.1), polyarticular presentation (OR 1.9), axial presentation (OR 2.5), polyarticular evolution (OR 2.4), axial evolution (OR 4.2), diabetes (OR 3.6), HBP (OR 3.9), and dyslipidemia (OR 3.5). After correcting for age, sex, disease duration and other confounders, independent associations with obesity found in the multivariate model (p<0.05) were: PsA family history (OR 3.6, IC95%: 1.1–14.4), axial evolution (OR 4.4, IC95%: 1.0–22.4) and dyslipidemia (OR 3.5, IC95%: 1.5–8.6).ConclusionsObesity was more common among our patients with cutaneous psoriasis than in those with arthritis. The model that best explains obesity in this PsA series combines genetic factors (PsA family history), together with factors specific to the metabolic syndrome (dyslipidemia), with others owned to arthritis (axial evolution).Reference[1] Husni ME. Comorbidities in psoriatic arthritis. Rheum Dis Clin North Am2015;41:677–98.Disclosure of InterestNone declared

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Objective The Assessment of SpondyloArthritis international Society-Health Index (ASAS-HI) is a tool designed to assess disease impact in spondyloarthritis (SpA), but its clinical performance is barely known. We aimed to test the clinimetric properties of ASAS HI in a real clinical scenario. Methods This cross-sectional study included 111 consecutive SpA patients. The measurement properties of ASAS HI were tested against conventional assessment measures. Convergent validity was assessed by Spearman's rho correlations, while discriminative validity was analyzed through ROC curves. A multivariate regression analysis was designed to identify ASAS HI items associated with active disease. Results The average ASAS-HI was 5.4 ± 3.8 (IQR: 3-8). ASAS HI showed high convergent validity against other SpA measures (rho ≥ 0.70, p < 0.0005). The optimal criterion for detecting high / very high disease activity ASDAS categories was an ASAS-HI score > 6, area under the ROC curve 0.86 (95%CI: 0.78-0.92), +LR 7.3 (95%CI: 3.1-17.1), p < 0.0001. The ASAS-HI items significantly associated with BASDAI active disease were, "I often get frustrated" [OR 9.2 (95%CI: 1.2-69.4), p = 0.032], and, "I sleep badly at night” [OR 7.7 (95%CI: 1.4-41.6), p = 0.018). As for ASDAS, it was, “pain sometimes disrupts my normal activities” [OR 8.7 (95%CI: 1.7-45.2), p = 0.010]. Conclusion The ASAS HI is a useful and simple instrument for its application in daily practice. Given its good clinimetric properties it could be used as an additional instrument to evaluate SpA.

Background and objectives: Information on the performance of ixekizumab (IXE) in patients with psoriatic arthritis (PsA) in clinical practice is scarce. We aimed to analyze the retention rate and safety of IXE in patients with PsA in routine clinical practice. Methods: A retrospective longitudinal observational single-center study of all patients with PsA who had received at least one dose of IXE. Adverse events (AEs) and drug retention rate were the main study focus. Survival was analyzed using Kaplan–Meier curves and predictive factors using multivariate Cox regression analysis. The hazard ratio (HR) was used as a measure of the association. Results: Seventy-two patients were included (52 women and 20 men). Median disease duration was 5 years (IQR 3–9). More than 90% received ≥2 biologic and/or targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) prior to IXE. Ixekizumab showed a 1-year retention rate of 65% and a 2-year retention rate of 57%. Regarding discontinuation due to AEs, 0.18 AEs per person-year were identified. The number of previous biologics did not influence drug survival but prior use of methotrexate (HR 2.31 (95% CI 1.05–5.10), p < 0.05) and depression (HR 2.40 (95% CI 1.07–5.41), p < 0.05) increased the risk of IXE discontinuation. Conclusions: Ixekizumab showed a good retention rate in a PsA population mostly refractory to biologic and targeted synthetic DMARDs. Drug survival was consistently good regardless of age, gender, metabolic comorbidities, smoking status, or prior number of biologic therapies. This information may be of interest to better position this drug in the PsA treatment algorithms.