Compared with the general population, both patients with early psoriatic arthritis (PsA) and early rheumatoid arthritis (RA) have a significantly reduced health-related quality of life (HRQOL) at disease onset, according to study results published in Seminars in Arthritis and Rheumatism. However, the researchers noted that after 5 years, patients with RA vs PsA exhibit normalization of HRQOL.
Researchers sought to assess HRQOL in patients with early PsA at diagnosis and after 5 years compared with that in patients with early RA and in a matched general population.
A prospective study was conducted that included patients with early RA and early PsA from 2 Swedish registries. Researchers measured HRQOL data using the Medical Outcomes Study Short Form 36 (SF-36) at baseline and at a 5-year follow-up. Physical function, disease activity, delay prior to diagnosis, general well-being, and pain were all used as explanatory variables. Physical functional abilities were measured using the Health Assessment Questionnaire-Disability Index, which comprised of 8 aspects, including dressing and grooming, arising, eating, walking, hygiene, reach, grip, and activities. Skin involvement and inflammation were evaluated using the Psoriasis Area and Severity Index (PASI), which assessed the 4 regions of the body, including head, trunk, upper limb, and lower limb.
Of a total of 209 patients with PsA who completed the 5-year follow-up, 25 were excluded from the study for incomplete SF-36 questionnaires, and 18 were excluded for not meeting the Classification Criteria for Psoriatic Arthritis (CASPAR). Overall, 166 patients (86 women) with PsA enrolled in the registry between 1999 and 2007 were included in the current analysis. Data for comparison with RA were obtained from the Swedish Early Rheumatoid Arthritis 2 (TIRA2) cohort. A total of 131 patients (96 women) with RA and sufficient SF-36 data at baseline or at the 5-year follow-up were enrolled in the current study, with all patients with RA included in the TIRA2 registry between 2005 and 2008.
Results of the study showed that both patients with PsA and RA of both sexes had significantly reduced HRQOL at disease onset. At the 5-year follow-up, patients with PsA continued to exhibit impairments in several SF-36 domains; however, those with RA had an almost normalized HRQOL. Of note, disease activity, time from symptom onset to diagnosis, and disability were all independent contributors to the reduced improvement in HRQOL reported among patients with PsA.
Researchers concluded that the normalization of HRQOL observed among patients with RA, but not those with PsA, may be due to the delay in diagnosis of PsA or more powerful interventions in RA vs PsA. “Earlier detection, lifestyle intervention, and more aggressive management strategies may be needed for PsA,” they added.
Disclosure: One study author declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of the author’s disclosures.
Geijer M, Alenius GM, André L, et al. Health-related quality of life in early psoriatic arthritis compared with early rheumatoid arthritis and a general population. Semin Arthritis Rheum. 2020;51(1):246-252. doi:10.1016/j.semarthrit.2020.10.010