Demographics, clinical disease characteristics, and quality of life in a large cohort of psoriasis patients with and without psoriatic arthritis

Abstract

InnovationWhat is already known about the topic: psoriasis (PsO) is a common skin disease with major impact on quality of life (QoL). Patient-reported data on QoL from large number of PsO patients with and without psoriatic arthritis (PsA) are limited. What this study adds: In a large cohort referred to a university psoriasis center, patients with PsO and concomitant PsA (~30% in this group) had greater degrees of skin and nail involvement and experienced greater negative impacts on QoL. Despite large numbers of patients with moderate-to-severe disease, use of systemic therapy by community practitioners was uncommon.BackgroundPsO and PsA are common diseases that have marked adverse impacts on QoL. The disease features and patient-reported QoL data comparing PsO and PsA patients are limited.ObjectiveTo identify and compare demographics, clinical disease characteristics, and QoL scores in a large cohort of PsO patients with and without PsA.MethodsAll PsO patients seen in a psoriasis specialty clinic, named the Center of Excellence for Psoriasis and Psoriatic Arthritis, were enrolled in an observational cohort. Demographic, QoL, and clinical data were collected from patient-reported questionnaires and from physical examinations performed by Center of Excellence for Psoriasis and Psoriatic Arthritis dermatologists and a rheumatologists. Cross sectional descriptive data were collected and comparisons between patients with PsO alone and those with concomitant PsA are presented.ResultsA total of 568 patients were enrolled in the database. Mean age of PsO onset was 28 years and mean disease duration was 18 years. Those with family history had an earlier onset of PsO by ~7 years. Mean body surface area involvement with PsO was 14%. Mean body mass index was 30.7. Prevalence of PsA was 29.8%. PsA patients had a higher mean body surface area compared to patients with PsO alone (16.7% vs 13.4%, P<0.05), higher prevalence of psoriatic nail changes (54.4% vs 36%, P<0.0002), and worse QoL scores as assessed by the Short Form-12 (67 vs 52, P<0.00001), Psoriasis Quality of Life-12 questionnaire (62 vs 71, P<0.01), and Routine Assessment of Patient Index Data 3 (2.3 vs 4.7, P<0.01). Strikingly, 49% of patients with PsO had never received any systemic therapy.ConclusionThese data highlight that PsO has marked negative impacts on QoL, while those patients with concomitant PsA are affected to a much greater degree. Despite large numbers of patients presenting with moderate-to-severe disease, use of systemic therapy for both PsO and PsA was uncommon.

Psoriatic arthritis: exploring the occurrence of sleep disturbances, fatigue, and depression and their correlates

“…The clinical presentation in psoriatic arthritis (PsA) is heterogeneous involving the musculoskeletal system, nails and skin, and other domains [ 1 ]. Health-related quality of life (HRQoL) has been shown to be impaired among patients with both psoriasis (PsO) [ 2 ] and PsA [ 3 ]; however, impairment has been shown to be greater in PsA [ 4 , 5 ]. For PsA patients to reach optimal improvement in HRQoL, improvement in both skin and musculoskeletal involvement must be achieved [ 6 ].…”

Prevalence and risk factors associated with psoriatic arthritis among patients with psoriasis

“…Worldwide prevalence of psoriatic arthritis among psoriasis patients ranges from 7% to 30%. 11,12,14 A population-based incidence cohort in the USA for new-onset psoriatic arthritis found cumulative incidence of 1.7% at 5 years, 3.1% at 10 years, and 5.1% at 20 years following psoriasis incidence. 15 Review of the Malaysia Psoriasis Registry 2007-2019 showed that 13.8% of adult patients with psoriasis suffered from psoriatic arthritis with 23.0% having joint deformity.…”

The Management of Psoriatic Arthritis in Italy: Organizational Impact Analysis of Optimized Pathwaystimized pathways

“…The Management of Psoriatic Arthritis in Italy: Organizational Impact Analysis of Optimized Pathways therapy might lead to benefits to the patients in terms of therapy effectiveness and quality of life (considering the negative effects of psoriatic arthritis on this parameter) [14,15].…”