Examining the Influence of Disease Manifestations on Quality of Life in Psoriatic Arthritis

Psoriatic arthritis in the hand
Psoriatic arthritis in the hand
Health-related quality of life was diminished in psoriatic arthritis at time of diagnosis compared with the general population.

In patients with psoriatic arthritis (PsA), tender joints, enthesitis at clinical examination, and the presence of chronic back pain affected health-related quality of life (HRQoL), and pain was an important determinant of functioning in those with early disease, according to the results of an analysis published in The Journal of Rheumatology.

The investigators sought to evaluate HRQoL in patients with newly diagnosed PsA from the Dutch South-West Early Psoriatic Arthritis Cohort study and to analyze its association with disease manifestations. HRQoL in participants was assessed using 8 domains of the Medical Outcomes Study Short Form-36 (SF-36) questionnaire. Patients were classified according to primary manifestation in arthritis subtypes (monoarthritis, oligoarthritis, or polyarthritis) and other subtypes (enthesitis, dactylitis, and axial disease). The presence of arthritis, dactylitis, enthesitis, psoriasis, and chronic inflammatory back pain was established in all patients. Associations of PsA manifestations with HRQoL were determined using multivariable linear regression.

A total of 405 participants were included in the study. The primary disease manifestation at the time of diagnosis was peripheral arthritis in 320 patients (78 with monoarthritis, 151 with oligoarthritits, and 91 with polyarthritis), dactylitis in 39 patients, enthesitis in 37 patients, and axial disease in 9 patients. Mean SF-36 domain scores were lower than those in a Dutch reference population and similar across different arthritis subtypes. A higher number of tender joints and enthesitis locations and the presence of chronic back pain were independently associated with worse SF-36 scores. Presence of psoriasis and dactylitis, however, was not associated with worse SF-36 scores.

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The investigators concluded that pain is an important determinant of functioning in patients with early PsA and warrants attention when treating patients with the disease. Additional evaluation is needed regarding the evolution of disease manifestations and the subsequent change in HRQoL over time.

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Wervers K, Luime JJ, Tchetverikov I, et al. Influence of disease manifestations on health-related quality of life in early psoriatic arthritis [published online July 1, 2018]. J Rheumatol. doi: 10.3899/jrheum.171406