Disease Characteristics, Quality of Life, and Work Productivity by Enthesitis Site: Real-world Data From the US Corrona Psoriatic Arthritis/Spondyloarthritis Registry

Abstract

Objective To assess the impact of clinical enthesitis by body site in patients with psoriatic arthritis (PsA). Methods Adults with PsA enrolled in the Corrona Psoriatic Arthritis/Spondyloarthritis Registry (March 2013–March 2018) were included. Enthesitis at enrollment was assessed via the Spondyloarthritis Research Consortium of Canada Enthesitis Index and classified by affected sites (upper, lower, or both). Disease activity (eg, Clinical Disease Activity Index, clinical Disease Activity Index for PsA), patient-reported outcomes (PROs; eg, patient-reported pain and fatigue), and work productivity were compared between those with and without enthesitis using t or Wilcoxon rank-sum tests for continuous variables and χ2 or Fisher exact tests for categorical variables. The association of enthesitis with disease activity and PRO measures vs no enthesitis was modeled using multivariable-adjusted linear or logistic regression. Results Of 2003 patients with PsA, 391 (19.5%) had enthesitis: 80 (20.5%) in upper sites only, 137 (35.0%) in lower sites only, and 174 (44.5%) in both. Regardless of location, disease activity and PROs were worse in patients with vs without enthesitis. In adjusted models, presence of enthesitis at any site was significantly associated with worse disease activity vs no enthesitis. Enthesitis in lower or both upper and lower sites was associated with higher pain and fatigue scores and greater work impairment vs no enthesitis. Conclusion Patients with clinical enthesitis had worse disease activity regardless of enthesitis location vs those without enthesitis, and patients with enthesitis in lower or both upper and lower sites had worse pain, fatigue, and work impairment.

Characterization of Patients With Axial Spondyloarthritis by Enthesitis Presence: Data from the Corrona Psoriatic Arthritis/Spondyloarthritis Registry

“…Because enthesitis may be one of the pivotal pathological processes in SpA associated with poor disease outcomes (30,38), detection of early enthesitis lesions may be critical for SpA diagnosis. MRI has shown that extracapsular inflammation of joints represents enthesitis with varying extents of soft tissue and bone marrow edema (39,40).…”

A Prospective Study to Evaluate the Impact of Golimumab Therapy on Work Productivity and Activity, and Quality of Life in Patients With Rheumatoid Arthritis, Psoriasis Arthritis and Axial Spondyloarthritis in a Real Life Setting in AUSTRIA. The GO-ACTIVE Study

“…CDAI questionnaire however focuses mainly on the arthritis component and it does not capture the psoriasis component of the disease, which could also contribute to the work impairment. In fact, Mease et al have recently shown that PsA patients with enthesitis had worse work impairment than those without ( 31 ). Several studies investigated the association between WPAI scores and disease activity in patients treated with other biologics ( 26 , 32 , 33 ).…”

Enthesitis in patients with psoriatic arthritis: A nationwide data from the Chinese Registry of Psoriatic Arthritis (CREPAR)

“…[26] In this study, we also found that axial involvement is associated with enthesitis. One probable Polachek et al [16] Canada Mease et al [7] The reason is that the inflammation in spondylitis is located at the entheses, where the ligaments attach to the vertebrae. [28] Alternatively, the higher proportion of axial involvement in our cohort may also be responsible for this result.…”

“…[6] The prevalence of enthesitis in PsA has been reported to range from 19.5% to 65.7% in the US and Europe. [7,8] In an analysis from China, Yang et al [9] observed that enthesitis was present in 26.8% of PsA patients. The clinical features of enthesitis in patients with PsA have been reported in some Western countries.…”

“…The clinical features of enthesitis in patients with PsA have been reported in some Western countries. [ 7 , 8 , 10 ] However, data in China are very limited, hindering the comprehensive understanding of PsA in this region. The Chinese Registry of Psoriatic Arthritis (CREPAR) is a multi-center prospective registry based on the Chinese Rheumatism Data Center (CRDC).…”