Psoriatic arthritis (PsA) is a multi-organ chronic inflammatory disease which impacts patients both physically and psychologically. The highest priority for patients goes to pain relief, but also to ability to function and participate in social life, fatigue, and psychological distress. Areas covered: In the present article, we will review current knowledge on impairments of health-related quality of life related to PsA, as well as patient priorities and patient-reported outcome measures such as the PsA Impact of Disease or the PsA Quality of Life questionnaires. The impact of PsA appears to be very broad, covering all aspects of life, i.e. activities and participation, physical and emotional aspects, but also domains such as fatigue, coping or sleep disturbance. Some of these aspects which are important for PsA patients have been included in the recently updated PsA Core Domain Set to be reported in clinical studies. Expert commentary: A better understanding of quality of life issues faced by patients with PsA could improve patient-physician communication and ultimately, quality of care. QoL is altered in PsA due both to the physical impact, but also the psychological impact of this disease. Several scores are available to better assess these aspects of PsA.

Objective: Vitamin D has pleiotropic effects including immunomodulatory, cardioprotective, and antifibrotic properties and is thus able to modulate the three main links in scleroderma pathogenesis. The aim of the study was to evaluate the level of vitamin D in patients with systemic sclerosis and to analyze the associations between the concentration of vitamin D and the features of systemic sclerosis.Material and Methods: Fifty-one consecutive patients were evaluated for visceral involvement, immunological profile, activity, severity scores, and quality of life. The vitamin D status was evaluated by measuring the 25hydroxy-hydroxyvitamin D serum levels. Results:The mean vitamin D level was 17.06±9.13 ng/dL. Only 9.8% of the patients had optimal vitamin D levels; 66.66% of them had insufficient 25(OH)D levels, while 23.52% had deficient levels. No correlation was found between vitamin D concentration and age, sex, autoantibody profile, extent of skin involvement, or vitamin D supplementation. Vitamin D levels were correlated with the diffusing capacity of the lung for carbon monoxide (p=0.019, r=0.353), diastolic dysfunction (p=0.033, r=−0.318), digital contractures (p=0.036, r=−0.298), and muscle weakness (p=0.015, r=−0.377) and had a trend for negative correlation with pulmonary hypertension (p=0.053, r=−0.29).Conclusion: Low levels of vitamin D are very common in systemic sclerosis. Poor vitamin status seems to be related with a more aggressive disease with multivisceral and severe organ involvement, especially pulmonary and cardiac involvement.

No abstract