Depression and anxiety in a real-world psoriatic arthritis longitudinal study: should we focus more on patients' perception?

Gialouri, Chrysoula G.; Evangelatos, Gerasimos; Zhao, Sizheng Steven; Kouna, Konstantina; Karamanakos, Anastasios; Iliopoulos, Alexios; Tektonidou, Maria G; Sfikakis, Petros P.; Fragoulis, G.

doi:10.55563/clinexprheumatol/8qxo80

Cited by 10 publications

(7 citation statements)

References 30 publications

(38 reference statements)

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“…This effect was mainly attributed to improvement in axSpA-related symptoms, not to (CRP-mediated) inflammation [ 16 ]. In PsA, similar associations between depressive symptoms and patient-reported disease activity were observed [ 17 ].…”

Section: Introductionmentioning

confidence: 58%

The effect of anti-inflammatory treatment on depressive symptoms in spondyloarthritis: does the type of drug matter?

et al. 2022

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Objective To investigate the effect of pharmacological treatment of SpA on depressive symptoms, and explore whether this effect differs between drug classes. Methods Data from the observational ASAS Health Index Validation Study were used. Patients were assessed at baseline and after initiation of NSAID/conventional synthetic (cs)DMARD/TNFi. Depressive symptoms were assessed with the Hospital Anxiety and Depression Scale depression-subscale (HADS-D, 0-21 [best-worst]). Covariables included demographics and disease characteristics, including disease activity (ASDAS/BASDAI). Change in HADS-D from baseline was compared between treatments (NSAID/csDMARD/TNFi) with ANOVA and multivariable regression analysis. Results 304 patients were included; 102/45/157 initiated NSAID/csDMARD/TNFi and 260/44 (85%/15%) had axial/peripheral SpA. At baseline, mean (SD) HADS-D was 6.9 (4.2), 126 (42%) were possibly depressed (HADS-D≥8) and 66 (22%) probably depressed (HADS-D≥11). At follow-up, depressive symptoms significantly improved in all treatment groups. In multivariable regression without disease activity measures, initiating TNFi compared to NSAID was associated with greater improvement in depressive symptoms (B=-1.27, 95%CI -2.23 to -0.32) and lower odds of possible depression at follow-up (OR = 0.47, 95%CI 0.23-0.94). This association was attenuated after additional adjustment for disease activity (ASDAS/BASDAI) but not CRP. csDMARDs did not differ from NSAIDs regarding their effect on HADS-D. Between-drug class results were confirmed in axSpA, although less clear in pSpA. Conclusion Treatment of active SpA also improves depressive symptoms. Especially in axSpA, TNFi have a larger effect than NSAIDs, which is mainly explained by a stronger effect on disease activity. We found no evidence for a direct link between CRP-mediated inflammation and depressive symptoms in SpA.

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Section: Introductionmentioning

confidence: 58%

The effect of anti-inflammatory treatment on depressive symptoms in spondyloarthritis: does the type of drug matter?

et al. 2022

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“…There is evidence to suggest that comorbid depression and anxiety in PsA leads to a lower likelihood of achieving remission, with recent research showing that depression and mood disorders can predominantly influence patient-reported disease domains. 37 , 38 The relationship between baseline and daily mood and PA, circadian rhythm and disease activity in PsA could be explored in larger cohorts utilizing the approaches from the current study. Our study failed to identify a difference in PA levels related to daily fluctuations in disease symptoms, as measured through the daily PsAID-9 questionnaire.…”

Section: Discussionmentioning

confidence: 99%

Actigraphy-derived physical activity levels and circadian rhythm parameters in patients with psoriatic arthritis: relationship with disease activity, mood, age and BMI

McGagh

McGowan

Hinds

et al. 2023

Therapeutic Advances in Musculoskeletal

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Background: Psoriatic arthritis (PsA) is associated with sleep disturbance, depression and a lifetime risk of obesity and cardiovascular disease. To date, there have been no studies investigating the relationship between objectively-measured physical activity (PA) levels and circadian rhythm disturbance with disease activity, daily symptoms and mood in patients with PsA. Objective: This pilot study aimed to investigate the relationship between disease activity, daily symptoms and mood on PA and circadian rhythm in PsA. Design: A prospective cohort study recruiting adults with PsA from rheumatology clinics at a single centre in the UK. Methods: Participants wore an actigraph and recorded their symptoms and mood on a daily basis via a smartphone app for 28 days. Time spent in sedentary, light and moderate-to-vigorous physical activity (MVPA) and parameters reflecting the circadian rhythm of the rest-activity pattern were derived. This included the onset time of the least active 5-h (L5) and most active 10-h (M10) daily consecutive periods and the relative amplitude (RA). The relationship factors between baseline clinical status, daily symptoms, PA and circadian measures were examined using linear mixed effect regression models. Results: Nineteen participants (8/19 female) were included. Participants with active PsA spent 63.87 min (95% CI: 18.5–109.3, p = 0.008) more in inactivity and 30.78 min (95% CI: 0.4–61.1, p = 0.047) less in MVPA per day compared to those in minimal disease activity (MDA). Age, body mass index and disease duration were also associated with PA duration. Participants with worse functional impairment had an M10 onset time 1.94 h (95% CI: 0.05–3.39, p = 0.011) later than those with no reported functional impairment. No differences were detected for L5 onset time or RA. Higher scores for positive mood components such as feeling energetic, cheerful and elated were associated with less time in inactivity and greater time spent in MVPA overall. Conclusion: Our study highlights differences in PA and circadian rest-activity pattern timing based on disease activity, disability and daily mood in PsA. Reduced PA levels in patients with active disease may contribute to the observed increased risk of cardiovascular and metabolic sequelae, with further studies exploring this need.

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“…Furthermore, comorbidities such as cardiovascular disease and mental health disorders are increasingly recognised as important features of these diseases. 2 , 3 …”

Section: Introductionmentioning

confidence: 99%

Selective JAK-Inhibitors in Spondyloarthritis

Vassilakis,

Magiouf,

Siebert

et al. 2024

MJR

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As our research interest and knowledge increases in the field of Spondyloarthritis, new aspects also emerge as regards to their therapeutic approach. JAK inhibitors (JAKi) are a relatively new treatment option, aiming molecules in the JAK-STAT pathway, which has a leading role in the pathophysiology of both Psoriatic Arthritis and Axial Spondyloarthritis. JAKi exhibit different selectivity towards the four different members of the JAK family (namely JAK1, JAK2, JAK3, and TYK2), possibly reflecting different efficacy and safety profile. Although knowledge is more consolidated for rheumatoid arthritis in which JAKi are being used for more than 10 years, data are still accumulating for PsA/SpA. In this review we aim to present and assess current knowledge about the efficacy of JAKi (with a focus on selective JAKi) in the treatment of patients with SpA and evaluate their safety profile as some concerns may arise around this therapeutic option.

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Depression and anxiety in a real-world psoriatic arthritis longitudinal study: should we focus more on patients' perception?

Abstract: The material cannot be used for any other purpose without further permission of the publisher and is for private use only.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.

Cited by 10 publications

References 30 publications

The effect of anti-inflammatory treatment on depressive symptoms in spondyloarthritis: does the type of drug matter?

The effect of anti-inflammatory treatment on depressive symptoms in spondyloarthritis: does the type of drug matter?

Actigraphy-derived physical activity levels and circadian rhythm parameters in patients with psoriatic arthritis: relationship with disease activity, mood, age and BMI

Selective JAK-Inhibitors in Spondyloarthritis

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