In:
Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 1694.1-1694
Abstract:
Clinical patterns and disease burden of PsA varies in different parts of the world. Demographic studies from Indian subcontinent are sparse Objectives: To study the cutaneous, articular profile of PsA and describe their disease activity, disability and co-morbidities (CMs) Methods: This is a multicenter, cross-sectional, non-interventional study from Karnataka, India. All consecutive PsA patients defined by CASPAR or expert diagnosis were evaluated over 8 months from 17 Rheumatology centers across Karnataka using standard parameters such as PASI, DAPSA, Indian version of HAQ-DI 1 , psoriatic co-morbidity index 2 (Cidx) and MDA 5. Patient consent and EC obtained Results: 549 PsA patients were evaluated and their disease characteristics are shown in Table 1 & 2. PsA preceded psoriasis in in 81 (14.7%). Table 1. Patient characteristics (n=549) DEMOGRAPHICS PsA Commonest age group of PsA (yrs ) 31-40 PsA Subclassification M:F 6:5 Symmetric polyarthritis 216(40.7%) Type 1 Psoriasis Type 2 Psoriasis 279(55.8%) 221(44.2%) Mean duration (yrs ) Asymmetric oligoarthritis 202(38.1%) Psoriasis 8.8(±7.8) DIP predominant 88(16.6%) PsA 5.2(±6.3) Arthritis mutilans 16(4.2%) PsA preceded psoriasis 81(14.7% ) Dactylitis 182(33.9%) Family h/o Psoriasis 107(19.7%) Enthesitis 109(20.3%) PsA 33(6%) Mean TJC68 6.3(±8.9) AS 11(2%) Mean SJC68 3.5(±5.2) Uveitis 5(0.9%) Type of Psoriasis Plaque 253(59.9%) IBD 3(0.5%) Erythrodermic 31(7.3%) Type I & II psoriasis did not differ in PASI, DAPSA, HAQ-DI or having a family h/o psoriasis. Type II psoriasis had higher Cidx than type I (p=0.0001). Pt pain VAS, DAPSA, PhyGA, PtGA & SJC significantly correlated with higher HAQ-DI (p 〈 0.0001). TJC, ESR, CRP & PASI had minor correlation with HAQ-DI. Females had higher HAQ-DI compared to males (p=0.02). Knee joint involvement caused disability most frequently. Cidx was higher in males (p=0.008). Minor correlation was found between Cidx with age, HAQ-DI & DAPSA. Mean BMI of our cohort was 26.8(±14.8) kg/m 2 . 56.5% were overweight. Higher BMI was not associated with age, duration of arthritis, DAPSA, PASI, HAQ-DI & Cidx. Infections (any time) were recorded in 10.8%, of which skin was the commonest site in 38.9%; 30.5% of these needed hospitalizations. Conclusion: Despite mild skin disease in majority, more than half of the patients have moderate to severe joint activity. Mild to moderate functional disability in nearly half of our cohort indicate high burden of damage. High incidence of co-morbidities in PsA compared with general population is in line with published literature. In addition to aggressive control of articular activity, detection and control of co-morbidities must be an integral part of PsA management. References: [1] https://doi.org/10.1093/rheumatology/41.12.1457 [2] http://dx.doi.org/10.1136/annrheumdis-2016-eular.4598 Table 2. Disease characteristics DISEASE ACTIVITY DISABILITY CO-MORBIDITIES Mean PASI: 3.8(7.4) Mean HAQ-DI: 0.3(0.45) Mean Cidx: 0.98(1.6) Mild (PASI 0-5 ) 480(80%) Mild-mod disability 260(48.2%) N with 1 or more CMs 232(42.3%) Severe ( 〉 10 ) 57(10.6%) ADL with most frequent disability Climbing a flight of stairs 189(35%) HTN T2DM Smoking PsA severity 19.8% 16.6% 5.4% 3.2% Mean DAPSA: 18.8(16.6 ) ADL with highest disability score Sitting cross-legged/squatting Anxiety IHD Dyslipidemia Others 3.1% 2.3% 2% 〈 2% each Remission 100(19.9%) Low DA 145(28.8%) Moderate DA 137(27.2%) High DA 123(24.5%) Family h/o CV dis/stroke 72(15.2%) Disclosure of Interests: None declared
Type of Medium:
Online Resource
ISSN:
0003-4967
,
1468-2060
DOI:
10.1136/annrheumdis-2020-eular.2527
Language:
English
Publisher:
BMJ
Publication Date:
2020
detail.hit.zdb_id:
1481557-6
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