Factors Associated with Health-Related Quality of Life in Psoriatic Arthritis Patients: A Longitudinal Analysis

Freites, D.; Madrid, Alfredo; León, Leticia; Candelas, Gloria; Núñez, Mercedes; Bello, Natalia; Díaz, Silvia; Fernández‐Gutiérrez, Benjamín; Abásolo, Lydia; Rodríguez‐Rodríguez, Luis

doi:10.1007/s40744-021-00349-1

Cited by 7 publications

(6 citation statements)

References 50 publications

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“…Despite the literature in other rheumatic conditions regarding the impact of IA on physical function and HRQoL, [4][5][6] there is scarce research on this area in SSc and the studies performed are in small SSc cohorts 22 or in SSc-RA overlap. 19 As such, our study adds to this area of unmet need, highlighting the significant impact that IA has on physical function and HRQoL in SSc.…”

Section: Discussionmentioning

confidence: 99%

“…In the latter, significant research has demonstrated the impact that IA has on patients' physical function and HRQoL. [4][5][6] As such, this study sought to determine the prevalence of IA in a large Australian SSc cohort and determine its treatment, disease associations, and impact on outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence and impact of IA in SSc, either in isolation or as part of an overlap syndrome, such as SSc‐rheumatoid arthritis (RA), is less well understood than in other rheumatic conditions, such as RA and psoriatic arthritis. In the latter, significant research has demonstrated the impact that IA has on patients’ physical function and HRQoL 4–6 . As such, this study sought to determine the prevalence of IA in a large Australian SSc cohort and determine its treatment, disease associations, and impact on outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Inflammatory Arthritis in Systemic Sclerosis: Its Epidemiology, Associations, and Morbidity

Schwender,

Hansen,

Stevens

et al. 2024

Arthritis Care & Research

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AimThe aim is to describe the epidemiology, associations, and impact of inflammatory arthritis (IA) in systemic sclerosis (SSc).MethodsSSc patients prospectively enrolled in the Australian Scleroderma Cohort Study were included. IA was defined clinically as the presence of synovitis on examination. Logistic regression was used to determine the associations of IA with SSc manifestations and serological parameters. Patient reported outcome measures were used to capture physical function and health related quality of life (HRQoL).ResultsIA was a common SSc manifestation affecting one‐third (33.3%) of patients over a median follow‐up of 4.3 (1.7‐8.4) years. Associations of IA included diffuse SSc (OR 1.33, 95%CI 1.01‐1.74, p=0.042); concurrent musculoskeletal manifestations (joint contractures and tendon friction rubs, OR 1.70, 95%CI 1.34‐2.15, p<0.001); myositis (OR 2.11, 95%CI 1.39‐3.20, p<0.001); and sicca symptoms (OR 1.57, 95%CI 1.14‐2.16, p=0.006), whilst IA was negatively associated with PAH (OR 0.52, 95% CI 0.35‐0.78, p=0.002). Neither the presence of RhF nor U1RNP were associated with IA (OR 1.13, 95%CI 0.88‐1.44, p=0.331, OR 1.46, 95%CI 0.89‐2.39, p=0.129 respectively). Positive anti‐cyclic citrullinated protein antibodies, although at low frequency, were more common in those with IA compared to those without IA (7.5% vs 1.5%, p<0.001). IA was associated with significantly lower HRQoL score (p<0.001) and more physical disability than in those without IA (p<0.001).ConclusionIA is a common SSc disease manifestation that is more frequently seen diffuse disease. IA is associated with poor HRQoL and physical disability. Further research is needed into the effective management of IA in SSc.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Inflammatory Arthritis in Systemic Sclerosis: Its Epidemiology, Associations, and Morbidity

Schwender,

Hansen,

Stevens

et al. 2024

Arthritis Care & Research

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“…The presence of PsA exerts a deleterious effect on the QoL of psoriasis patients, affecting their emotional, psychological and physical well-being. 55,56 Several studies have revealed that the considerable psychological and functional burden of PsA was similar in magnitude to those of spondyloarthritis and rheumatoid arthritis. 57,58 The DLQI focuses primarily on cutaneous involvement and does not encompass the full impact of articular disease in PsA.…”

Section: Impact Of Psa On Health-related Quality Of Life (Hrqol)mentioning

confidence: 99%

Clinical profile, treatment and quality of life of patients with psoriatic arthritis in Malaysia: A population‐based cross‐sectional study

Goh,

Wong,

Robinson

et al. 2024

Experimental Dermatology

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Psoriatic arthritis (PsA) is a major comorbidity of psoriasis and may lead to irreversible joint damage and disability. This study aims to describe the clinical profile, treatment and quality of life (QoL) of patients with PsA in Malaysia. This is a multicentre retrospective cross‐sectional study of psoriasis patients who were notified to the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018. Of 21 735 psoriasis patients, 2756 (12.7%) had PsA. The male to female ratio was 1:1. The mean age of psoriasis onset for PsA patients was 34.73 ± 14.44 years. They had a higher rate of family history of psoriasis (26% vs. 22.4%, p < 0.001), scalp (82.7% vs. 81.0%, p = 0.04) and nail involvement (73.3% vs. 53.3%, p < 0.001), obesity (62.6% vs. 54.4%, p < 0.001), dyslipidaemia (23.8% vs. 15.4%, p < 0.001), hypertension (31.1% vs. 22.7%, p < 0.001) and diabetes mellitus (20.9% vs. 15.2%, p < 0.001) compared to non‐PsA patients. More than half (54.3%) had severe psoriasis [(body surface area >10% and/or Dermatology Life Quality Index (DLQI) >10)]. Most had oligo‐/monoarthropathy (40.3%), followed by distal interphalangeal arthropathy (31.3%), symmetrical polyarthropathy (28.3%), spondylitis/sacroiliitis (8.2%) and arthritis mutilans (3.2%). Nearly 40% of PsA patients received systemic treatment, but only 1.6% received biologic agents. QoL was more significantly affected in PsA than in non‐PsA patients (mean DLQI 10.12 ± 7.16 vs. 9.52 ± 6.67, p < 0.001). One in eight patients with psoriasis in Malaysia had PsA. They had a higher incidence of comorbidities, severe disease, impaired QoL and were more likely to receive systemic and biological treatment compared to non PsA patients.

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“…Spondyloarthritis (SpA) is a family of chronic inflammatory arthritides primarily targeting the joint entheses, the site of tendon or ligament insertion into bone. Enthesial inflammation can cause pain, joint damage, and loss of mobility in affected sites, leading to significant loss of quality of life ( 1 , 2 ). While in recent years there have been significant advances in the treatment of SpA, headlined by biologic treatments aimed at the blockade of tumor necrosis factor (TNF) and interleukin (IL)-17 ( 3 ); however these treatments are efficacious in only ~60% of patients ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Cytokine competent gut-joint migratory T Cells contribute to inflammation in the joint

et al. 2022

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Although studies have identified the presence of gut-associated cells in the enthesis of joints affected by spondylarthritis (SpA), a direct link through cellular transit between the gut and joint has yet to be formally demonstrated. Using KikGR transgenic mice to label in situ and track cellular trafficking from the distal colon to the joint under inflammatory conditions of both the gut and joint, we demonstrate bona-fide gut-joint trafficking of T cells from the colon epithelium, also called intraepithelial lymphocytes (IELs), to distal sites including joint enthesis, the pathogenic site of SpA. Similar to patients with SpA, colon IELs from the TNFΔARE/+ mouse model of inflammatory bowel disease and SpA display heightened TNF production upon stimulation. Using ex vivo stimulation of photo-labeled gut-joint trafficked T cells from the popliteal lymph nodes of KikGR and KikGR TNFΔARE/+ we saw that the CD4+ photo-labeled population was highly enriched for IL-17 competence in healthy as well as arthritic mice, however in the TNFΔARE/+ mice these cells were additionally enriched for TNF. Using transfer of magnetically isolated IELs from TNF+/+ and TNFΔARE/+ donors into Rag1-/- hosts, we confirmed that IELs can exacerbate inflammatory processes in the joint. Finally, we blocked IEL recruitment to the colon epithelium using broad spectrum antibiotics in TNFΔARE/+ mice. Antibiotic-treated mice had reduced gut-joint IEL migration, contained fewer Il-17A and TNF competent CD4+ T cells, and lessened joint pathology compared to untreated littermate controls. Together these results demonstrate that pro-inflammatory colon-derived IELs can exacerbate inflammatory responses in the joint through systemic trafficking, and that interference with this process through gut-targeted approaches has therapeutic potential in SpA.

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Factors Associated with Health-Related Quality of Life in Psoriatic Arthritis Patients: A Longitudinal Analysis

Cited by 7 publications

References 50 publications

Inflammatory Arthritis in Systemic Sclerosis: Its Epidemiology, Associations, and Morbidity

Inflammatory Arthritis in Systemic Sclerosis: Its Epidemiology, Associations, and Morbidity

Clinical profile, treatment and quality of life of patients with psoriatic arthritis in Malaysia: A population‐based cross‐sectional study

Cytokine competent gut-joint migratory T Cells contribute to inflammation in the joint

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