Time to minimal disease activity in relation to quality of life, productivity, and radiographic damage 1\xa0year after diagnosis in psoriatic arthritis

Kim Wervers,On Behalf Of Cicero ,Johannes H L M Van Groenendael,Marijn Vis,Marc R Kok,Josien J Veris-Van Dieren,Lindy-Anne Korswagen,Ilja Tchetverikov,Cathelijne W Y Appels,Wiebo L Van Der Graaff,Johanna M W Hazes,Andreas H Gerards,Jolanda J Luime

doi:10.1186/s13075-019-1811-4

Abstract

BackgroundIn a cohort of patients with newly diagnosed psoriatic arthritis (PsA) who received usual care, we investigated the impact of time elapsed to minimal disease activity (MDA) on health-related quality of life (HRQoL), work productivity, and radiographic damage throughout the first year after diagnosis.MethodsData collected in the Dutch southwest early PsA cohort (DEPAR) study were analyzed. These three-monthly data encompassed disease activity, HRQOL was measured with the Short Form 36 (SF36) Physical Component Scale (SF36-PCS) and Mental Component Scale, and productivity was measured with the Productivity Cost Questionnaire. Radiographic damage was scored at baseline and at 12 months with the PsA-modified Sharp/van der Heijde score. Patients were classified by time to MDA as in early (within 3 months), late (at 6–12 months), and never MDA in the first year.ResultsWe included 296 patients who had had their 1-year outpatient visit (mean age 51 years, 53% male). Ninety-six (32%) were classified as early MDA, 78 (26%) as late MDA, and 98 (33%) as never MDA. Data of 24 patients (8%) were missing. SF36-PCS and productivity scores improved after gaining MDA, but remained low in never MDA patients. At 1 year, SF36-PCS and productivity scores were similar in early and late MDA patients. Radiographic progression rate was low and similar in all groups.ConclusionGaining MDA was associated with considerable improvement in HRQoL and functioning, irrespective of time to first MDA. In the one third of patients not in MDA in the first year, the disease had a substantial health impact.

Highlights

In a cohort of patients with newly diagnosed psoriatic arthritis (PsA) who received usual care, we investigated the impact of time elapsed to minimal disease activity (MDA) on health-related quality of life (HRQoL), work productivity, and radiographic damage throughout the first year after diagnosis
Psoriatic arthritis (PsA) is a chronic inflammatory disease presenting with arthritis, enthesitis, spondylitis, dactylitis, and psoriasis [1]
We investigated the impact of time elapsed from diagnosis to MDA on HRQoL, productivity, and radiographic damage at 1-year follow-up in a cohort of patients newly diagnosed with PsA and receiving usual care

Summary

Introduction

In a cohort of patients with newly diagnosed psoriatic arthritis (PsA) who received usual care, we investigated the impact of time elapsed to minimal disease activity (MDA) on health-related quality of life (HRQoL), work productivity, and radiographic damage throughout the first year after diagnosis. As in other rheumatic diseases, chronic inflammation leads to progressive joint damage, increased disability, and reduced life expectancy [2,3,4]. In previous cross-sectional studies, a state of MDA was strongly related with better functioning and healthrelated quality of life (HRQoL) [10,11,12]. Longitudinal studies confirming these findings are lacking. We need more information on how the state of MDA is related to long-term improvement in disability and whether achieving MDA early after the diagnosis results in better outcomes than achieving MDA at a later stage

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Results

Discussion

Conclusion