AB0934 Does the severity of psoriasis impact on psoriatic arthritis activity? Data from rheumatological clinical practice

Abstract

BackgroundPsoriatic arthritis (PsA) is a chronic, musculoskeletal inflammatory disease that develops in up to 30% of patients (pts) with psoriasis (PsO). There are conflicting data about correlations between skin and joint severity from the observational cohort [1, 2]. But it’s very important for clinical phenotyping and treatment PsA pts.Objectivesto evaluate association between PsO severity and PsA activity.Methods778 (M/F=357/421) PsA pts fulfilling the CASPAR criteria were included into Russian rheumatological observational cohort. Mean age 46.7±13 years (yrs), DAPSA 29.05±19.7, CRP - 15.3±23 mg/l, SJC/66 - 6.6±7.5, TJC/68 – 10.6±10.2, LEI – 1.06±1.4. All pts underwent standard clinical examination: tender joins count (TJC)/68, swelling joints count (SJC)/66, CRP (mg/l), DAPSA, dactylitis, enthesitis by LEI, nail/skin PsO was evaluated. All pts were divided in two groups based on BSA≤3% (mild PsO) and BSA>3% (moderate/severe). M±SD, Me [Q25; Q75], Min-Max, %, t-test, Pierson-χ2, Manna-Whitney tests, ORs with 95% CI were performed. All p<0.05 were considered to indicate statistical significance.ResultsBSA≤3% was found in 427 out of 778 pts (54.9%), BSA>3% in 352 pts out of 778 (45.2%). Nail PsO were seen in 258 out of 778 (33.2%). Among these pts with BSA>3% nail PsO were seen in significantly more cases - 135 out of 258 pts (52.3%) (p=0.03). In pts with BSA>3% all parameters of PsA activity (DAPSA, SJC, TJC, CRP) was significantly higher compare to pts with BSA≤3% (for all p<0.0001).The one-factor model of logistic regression shown that PsO severity significantly associated with nail PsO, higher PsA activity by DAPSA, CRP, SJC, TJC and smoking (OR analysis with CI 95% for all parametres are shown on Figure 1).Figure 1.Forest plot of factors associated with psoriasis severity in PsA pts.ConclusionIn our observational cohort about half of PsA pts had severe PsO. Skin severity associated with higher PsA activity. It should be taken into account for choice of properly treatment both for skin and joint in clinical practice.References[1]Mease PJ, etzel cJ, Huster WJ, et al. Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: experience from the corrona registry. RMD Open 2019;5:e000867. doi:10.1136/ rmdopen-2018-000867.[2]Gottlieb AB, Mease PJ, Mark Jackson J, et al. Clinical characteristics of psoriatic arthritis and psoriasis in dermatologists’ offices. Journal of Dermatological Treatment 2006;17:279–87.AcknowledgementsThe RU-PsART study groupDisclosure of InterestsNone declared