POS1084 IMPACT OF PSORIASIS REMAINS IMPORTANT IN PSORIATIC ARTHRITIS PATIENTS WITH LOW MUSCULOSKELETAL DISEASE ACTIVITY

Abstract

BackgroundPsoriatic arthritis (PsA) is a complex, chronic auto-immune disease that affects health-related Quality of Life (HRQoL). Earlier research showed that general HRQoL in PsA patients is mainly affected by musculoskeletal pain.1 However, psoriasis has also shown to impact HRQoL.2 Therefore, it is of value to know if HRQoL of PsA patients who reached musculoskeletal low disease activity can be further improved by additionally achieving remission of their psoriasis.ObjectivesThe aim of this study was to assess HRQoL in patients with active psoriasis who reached musculoskeletal low disease activity one year after their diagnosis.MethodsData were collected from the Dutch south west Psoriatic Arthritis cohort. Musculoskeletal low disease activity (LDA) was defined as Disease Activity in Psoriatic Arthritis Low disease activity (DAPSA) ≤14 and active skin at baseline as Psoriasis Area and Severity Index (PASI) >0. Patients who reached DAPSA-LDA after one year were divided based on reaching psoriasis remission (PASI ≤1). General HRQoL, and dermatology-specific HRQoL were compared between both groups.ResultsWe included 624 patients, of which 106 (17%) patients had no psoriasis and 518 (83%) had active psoriasis. After one year, 230 (44%) patients with active psoriasis at baseline reached DAPSA-LDA, of which 108 (47%) patients also achieved psoriasis remission. The group of patients with active psoriasis (n=122, 53%) contained significantly more men (63% vs. 48%) and scored lower on the 12-item Psoriatic Arthritis Impact of Disease questionnaire (p=0.012). This group also had significantly lower median (IQR) scores of the psychosocial subscale (1 [0-5]) and symptoms subscale (4 [2-5]) of the dermatology-specific Skindex-17 questionnaire. Clinically, this implies little impairment psychosocially and a few physical symptoms.Evaluation of the absolute scores of the Skindex-17 subscales in this group showed that 31% of patients experienced moderate to high psychosocial impairment and 28% experienced a lot of symptoms (Figure 1).Figure 1.Clinical categories of Skindex-17 psychosocial and symptoms scores of patients with DAPSA-LDA and active psoriasis (PASI>1) one year after diagnosis (n=116)ConclusionIn daily clinical practice approximately half of PsA patients who reached musculoskeletal low disease activity (DAPSA-LDA) one year after their diagnosis has not reached psoriasis remission. The majority of these patients has a good HRQoL. However, a proportion of them still experiences considerable skin burden. We therefore recommend rheumatologists to always assess and treat psoriasis in order to reduce skin burden, even in PsA patients who achieved musculoskeletal low disease activity.