Patient-reported and Ultrasound Outcomes in PsO and PsA

Patient-reported outcomes (PROs) are significant in patients with psoriatic arthritis (PsA), and while they frequently shed light on disease activity, impact of disease, quality of life (QoL), and disability, other factors may play a role in PROs. In this study, researchers analyzed how inflammation and structural damage detected by ultrasound (US) was associated with PROs in PsA and how this compared to psoriasis (PsO) patients with and without musculoskeletal symptoms. The findings will be presented at the American College of Rheumatology/Empowering Rheumatology Professionals Annual Meeting.

The study included PsA patients who fulfilled the CASPAR criteria, PsO patients with musculoskeletal symptoms who did not meet CASPAR criteria (symptoPsO), and PsO patients without musculoskeletal symptoms (asymptoPsO); collected data included socio0demographic characteristics, comorbidities, disease duration, and treatment. Dermatological and rheumatologic evaluation included PsO severity, swollen joint count (SJC), tender JC (TJC), number of dactylitis and enthesitis, and fibromyalgia criteria; US was used to evaluate joints, tendons, and entheses. PROs included the use of a numeric rating scale (NRS) to assess skin PsO and fatigue, Health Assessment Questionnaire (HAQ), and QoL per the 36-Item Short Form Survey (SF-36).

Final analysis included 158 socio-demographically comparable patients: 54 PsA, 52 symptoPsO, and 52 asymptoPsO. Disease activity was low-to-moderate in the majority of the PsA cohort. All US-detected changes—except enthesophytes—were significantly higher in the PsA group, followed by the symptoPsO patients.

In the entire patient population, a correlation was observed between PROs and demographic variables, comorbidities, TJC, number of enthesitis, skin severity, depression, and fibromyalgia. Scores of fatigue and impact on some QoL domains (vitality, pain, general health, social, and mental) were similar between symptoPsO and PsA patients and were significantly higher compared to asymptoPsO patients. In the PsA group only, there was a correlation between HAQ and total number of US enthesitis and joints with osteophytes/cortical irregularities, and SF-36 physical function domain and the number of joints with osteophytes/cortical irregularities.

“Quality of life, disability and fatigue were more impaired in PsA and symptoPsO patients than asymptoPsO,” the researchers concluded. “In all groups, PROs were mostly associated with socio-demographic characteristics, comorbidities and some clinical variables rather than objective measures such as US changes.”