Psoriatic Arthritis Quality Of Life Research Articles

P168 The impact of psoriatic arthritis on quality of life and lifestyle: a systematic review

Abstract Background/Aims Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects adults of all ages. It is common for patients to experience a wide variety of physical and psychological problems. The objective of this systematic review was to determine how PsA impacts a person's quality of life (QoL). Methods A systematic literature search of CENTRAL, CINAHL, AMED, EMBASE, Global Health, MEDLINE and PsycINFO databases was conducted on 28th May 2021. Title, abstract and whole text screening, and data extraction were completed by two independent authors. The primary outcomes of this study were PsA activity and severity, impact of PsA on lifestyle and QoL. As per the protocol (PROSPERO CRD42021257395), studies which reported at least one of these primary outcomes were included. The quality assessment was conducted using the Joanna Briggs Institute Critical Appraisal criteria. Results Of the 20,316 papers identified by the search strategy, 42 papers which reported on at least one of the study primary outcomes were included in the review. 38 studies reported on PsA activity and severity, 26 on impact of PsA on lifestyle and 23 on QoL. 7 different measures were used to assess impact of PsA on lifestyle, including Health Assessment Questionnaire (HAQ) (n = 13), modified HAQs (n = 10), PsA impact of disease measure (n = 2), functional capacity ACR (n = 1), functional assessment of chronic illness therapy (n = 1), Bath ankylosing spondylitis functional index (n = 1) and a patient-directed question (n = 1). 13 papers reported an average HAQ score between 0.13 and 1.3 for PsA participants. Two studies which reported HAQ disability index compared PsA participants to other groups. Thus, the impact of disease on lifestyle is worse for PsA compared to psoriasis, rheumatoid arthritis and healthy controls, psoriasis. DAPSA and PASI were the most used disease activity scores in addition to various patient-reported outcomes. The average DAPSA was 15.5, suggesting that the majority of PsA patients have moderate disease activity. Although the average PASI (skin) score showed mild disease among the PsA (3.82) group, a high PASI score was associated with late/never minimal disease activity and obesity. 8 different measures were used to assess QoL, including Psoriatic Arthritis Quality of Life (n = 6, average), EQ-5D (n = 4), EQ-3D (n = 1), DLQI (n = 7), SF-36 (n = 3), SF-12 (n = 1), WHOQOL-BREF (n = 2), PSQI (n = 1), Rosenberg Self-Esteem Scale (n = 1) and Psoriasis disability index (n = 1). Except for QoL for skin (DLQI), PsA was associated with worse outcomes in all these measures, in comparison with spondylarthritis, healthy control and psoriasis only groups. Conclusion PsA significantly affects a patient's life and health-related QoL. The degree of activity and severity of the disease have a substantial impact. Therefore, for patients with high disease activity, specific management plans should be discussed and facilitated to maintain their mobility and functional abilities. Disclosure L. James: None. R. Suribhatla: None. L.H. Hailey: None. R. Amarnani: None. C. Bundy: None. D. McGagh: None. S. Kirtley: None. D. O'Sullivan: None. I. Steinkoenig: None. L.C. Coates: None.

Psoriatic Arthritis Quality of Life questionnaire: Translation, cultural adaptation and validation into Arabic language.

Psoriatic arthritis (PsA) is a multifaceted inflammatory disease that has a strong negative impact on the quality of life (QoL) of patients. The Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire was the first disease-specific patient-derived instrument developed to measure the QoL in patients with PsA. Our objective was to translate the PsAQol into Arabic language and evaluate its reliability and validity in patients with PsA. This was a cross-sectional study including patients with PsA. A clinical and biological assessment of the patients was performed at inclusion. The translation of the original PsAQoL into Arabic was performed by a professional bilingual and lay panel. Eight patients were interviewed to assess face and content validity. A separate sample of PsA patients (n=30) were invited to participate in a test-retest postal study in order to investigate reproducibility and construct validity. One week separated the two administrations. The Arabic version of Health Assessment Questionnaire (HAQ) was used as a comparator instrument for convergent validity. Face and content validity were satisfactory. The Arabic version of the PsAQoL was found to be relevant, understandable and easy to complete in only a few minutes. One item was excluded (item 16). It had no correlation with either the other 19 items or the total score of PsAQol. The Arabic PsAQol had excellent internal consistency (Cronbach's a=0.926), and test-retest reliability (r=0.982). There was a positive correlation between the total score of the PsAQoL and the Arabic version of HAQ (Spearman's r=0.838, p<10-3 ). Exploratory factor analysis had extracted two factors explaining 55% of the total variance. Nineteen items were selected to compose the Arabic version of PsAQoL, which was found to be relevant and understandable and has excellent reliability and construct validity. The new measure will be a valuable new tool for use in routine care for patients' assessment.

Recent developments for new investigational JAK inhibitors in psoriatic arthritis

ABSTRACT Introduction Psoriatic arthritis (PsA) is a chronic inflammatory disease affecting about one-third of subjects with psoriasis. Several treatment modalities targeting Janus Kinase pathways and intracellular inflammatory cascade are now available and under clinical investigation to treat this disease. Areas covered This review describes ongoing and recently completed phase 2 and 3 randomized clinical trials (RCTs) evaluating the efficacy and safety of approved JAK (Tofacitinib and Upadacitinib) and investigational JAK inhibitors (JAK1 inhibitors: Filgotinib and Ivarmacitinib (SHR0302); TYK2 inhibitors: Brepocitinib (PF-06700841) Deucravacitinib (BMS-986165), and NDI-034858) in PsA through February 2023. Expert opinion Current standard of care has significantly improved the quality of life in PsA. Recently approved JAK inhibitors for PsA have addressed many of the unmet needs of PsA, particularly of those with severe phenotypes. Preliminary results from several RCTs have reported good and fast efficacy and an acceptable safety profile of investigational JAK inhibitors in PsA. Additional clinical trials and long-term outcome data on these agents are necessary for increasing available therapeutic options for PsA.

Non-Physical Disease Facets in Spondyloarthritis: An ASAS Health Index-Based Analysis between Psoriatic Arthritis and Axial Spondyloarthritis.

Background: Psychosocial health is a key driver of quality of life (QoL) in axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA), but it is often overlooked in clinical practice. We aimed to analyze this aspect of QoL by using the Assessment of SpA International Society–Health Index (ASAS HI) in both SpA phenotypes. Patients and methods: One hundred and eleven patients with axSpA and 90 with PsA were consecutively recruited from two rheumatology centers. In both populations, the categories of stress handling (ASAS HI items #11 and 17) and emotional functions (ASAS HI item #13) were analyzed based on the International Classification of Functioning, Disability, and Health (ICF). A multivariate regression model was used to analyze the explanatory factors associated with positive responses to these items. Results: Thirty-four of the 90 PsA patients (37.8%) and 37/111 of the patients (33.3%) with axSpA reported a positive response to at least one of the stress-handling items. Compared to the patients with PsA, patients with axSpA were less likely to report stress-handling issues (OR 0.48, p < 0.05). Thirty-one of the 90 PsA patients (34.4%) and 44/111 of the patients (39.6%) with axSpA reported positive responses to item #13. In both groups of SpA patients, disease activity and severity (OR 6.6, p < 0.001) were independently associated with alterations in psychosocial health. Compared with those in the axSpA group, the psychosocial health items were better correlated with each other and with the ASAS HI sum score in the PsA group. Conclusions: Psychosocial health is frequently altered in SpA. Both disease activity and severity are associated with this issue. However, psychosocial factors seem to have a greater impact on QoL in PsA than in axSpA.

AN ASSESSMENT OF PREVALENCE AND QUALITY OF LIFE IN KAALANJAGA VAATHAM (PSORIATIC ARTHRITIS) PATIENTS AFTER TAKING SIDDHA TREATMENT: A CROSS-SECTIONAL STUDY

Background: Psoriatic arthritis is a chronic multi-organ inflammatory disease which impacts both physically and psychologically. The symptoms of Kaalanjaga vaatham mentioned in Siddha text Yugi vaithiya chinthamani are closely related to Psoriatic arthritis. In Ayothidoss Pandithar Hospital, National Institute of Siddha, kaalanjagapadai is one of the most commonly reported diseases. Psoriatic arthritis patients have impaired health-related –the quality of life. Therefore, this cross-sectional study was conducted to determine the prevalence of Kaalanjaga vaatham and quality of life in Kaalanjaga vaatham patients before and after taking Siddha medicines. Aim &amp; Objectives: To estimate the prevalence of Kaalanjaga vaatham in patients with Kaalanjagapadai; To evaluate the nature of quality of life in patients with Kaalanjaga vaatham before and after taking Siddha medicines. Materials and Methods: In this study, about 100 patients with Kalanjagapadai were studied to assess the prevalence of Kaalanjaga vaatham. According to the ClASsification for Psoriatic ARthritis (CASPAR) criteria, the quality of life in Kaalanjaga vaatham patients were evaluated using the Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire. Results: In the entire study population of patients with psoriasis, the total prevalence of Psoriatic arthritis was 13% (n/N = 13/100), with 69% (9/13) of Psoriatic arthritis cases were diagnosed as new cases, and the quality of life in Kaalanjaga vaatham patients were moderately improved with 52% after Siddha treatment. Conclusion: After taking Siddha medicines, the Psoriatic arthritis patients' quality of life improved significantly. Thus, early diagnosis and intervention play an essential role in enhancing the Quality of Life of Psoriatic arthritis patients.

Validity and psychometric characteristics of the self-administered comorbidity questionnaire in patients with psoriatic arthritis.

The study aimed to translate and cross-culturally adapt the self-comorbidity questionnaire (SCQ) into Turkish and investigate the validity and reliability of SCQ and its modified version (mSCQ) in psoriatic arthritis (PsA). Psoriatic arthritis quality of life (PsAQoL) and short form 36 (SF-36) were used to assess the quality of life. The physical disability was evaluated with the health assessment questionnaire (HAQ). The reliability of the SCQ scale was assessed by test-retest reliability. For construct validity, the correlations of SCQ with the HAQ, SF-36, PsAQoL, age, body mass index (BMI), disease duration, disease activity in psa (DAPSA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Psoriasis Area and Severity Index (PASI), dactylitis and enthesitis were evaluated. The mSCQ was also used by removing the items related to rheumatic conditions. For the test-retest reliability of the Turkish version of SCQ, the intraclass correlation coefficient was 0.965, p < 0.001. The SCQ and mSCQ had significant correlations with HAQ, PsAQoL, some subscales of SF-36, and age (p < 0.05), but not with disease duration, BASDAI, PASI and dactylitis (p > 0.05). Although SCQ had a low correlation with DAPSA (rho = 0.262, p = 0.031), mSCQ was not correlated with DAPSA (p > 0.05). mSCQ was significantly correlated with BMI (rho = 0.233, p = 0.016), but SCQ was not (p > 0.05). The Turkish version of SCQ had adequate reliability and validity, and the mSCQ improved the validity of the scale in patients with PsA.

The association between IL17, fatigue and quality of life in psoriatic arthritis patients

ABSTRACT Background: Psoriatic arthritis is a chronic inflammatory condition. It impacts patients both physically and psychologically. Fatigue may be an early symptom of PsA, which impairs quality of life. Objectives: To assess serum IL-17, fatigue, quality of life and function impairment in PsA patients and to correlate them with clinical disease activity. Methods: 80 consecutive PsA patients were included. Fatigue assessed by Functional Assessment of Chronic Illness Therapy-Fatigue. Quality of life assessed by Psoriatic Arthritis Quality of Life. Functional capacity assessed by health assessment questionnaire. Disease activity assessed by Disease Activity in Psoriatic Arthritis. Serum IL-17 measured by ELISA. Results: There was significant difference in FACIT-F, PsAQOL, and HAQ (p<0.001) in different disease activity subgroups. There was statistically significant correlation of disease duration with disease activity, fatigue, reduced function capacity, and quality of life impairment (p≤0.05), while no correlation with the patients' age. There was statistically significant correlation between FACIT-F, PsAQOL, HAQ, and DAPSA scores (p<0.001). Serum IL-17 was significantly correlated with clinical parameters of disease activity, fatigue, function, and quality of life impairment (p≤0.05). Conclusion: Fatigue is a common clinical symptom in psoriatic arthritis patients. It is significantly associated with IL17, quality of life, functional impairment and disease activity.

Fibromyalgia in patients with psoriatic arthritis: Relationship with enthesopathy, sleep, fatigue and quality of life.

To evaluate the relationship of fibromyalgia with enthesopathy, sleep, fatigue and quality of life in patients with psoriatic arthritis. The psoriatic arthritis patients according to CASPAR criteria were included in the study. The diagnosis of fibromyalgia was based on 2016 ACR criteria. Demographic and clinical parameters were noted. Disease activity and enthesopathy were evaluated with Disease Activity Score-28 (DAS-28) and Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), respectively. Functional assessment scales in this study were Psoriatic Arthritis Quality of Life (PsAQoL), Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF). Fibromyalgia Impact Questionnaire (FIQ) was used to assess the functional status of fibromyalgia. The Mann-Whitney U test and Spearman correlation coefficient (ρ) were used. Hierarchical multiple regression analysis used to examine the differential contributions to FIQ score. P<.05 was accepted as significant. We enrolled 50 PsA patients (31 female, 19 male) with a mean age of 49.5years (SD: 10.2) and mean disease duration 7.5years (SD: 7.5). Thirty-two patients (64% of PsA patients) fulfilled ACR criteria for fibromyalgia. The mean scores of MASES, PSQI, MAF and PsAQoL were significantly higher in patients with fibromyalgia (P<.05). The correlations between FIQ and other functional parameters were as follows; MASES (ρ=0.71, P<.0005), PSQI (ρ=0.62, P<.0005), MAF (ρ=0.60, P<.0005), PsAQoL (ρ=0.61, P<.0005). A moderate correlation was existing between FIQ and DAS-28 (ρ=0.42, P=.03). Coexistence of fibromyalgia in PsA patients is associated with the presence of enthesopathy, poor quality of life, sleep disturbance and fatigue.

Clinical characteristics, disease activity, functional status, and quality of life results of patients with psoriatic arthritis using biological and conventional synthetic disease-modifying antirheumatic drugs.

Objectives This study aims to compare the clinical characteristics, disease activity, and quality of life (QoL) of patients with psoriatic arthritis (PsA) who use biological and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) in a nationwide cohort throughout Turkey.Patients and methods A total of 961 patients (346 males, 615 females; mean age 46.9±12.2 years; range, 18 to 81 years) with PsA according to the classification criteria for PsA were included in the study. The patients’ demographic and clinical characteristics, physical examination results, Disease Activity Score 28, Disease Activity Index for Psoriatic Arthritis and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Psoriasis Area and Severity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, Hospital Anxiety and Depression Scale, Health Assessment Questionnaire, Psoriatic Arthritis Quality of Life (PsAQoL), and short form-36 scores were all recorded.Results Of the patients, 23% underwent biological DMARD (bDMARD) monotherapy, 42% underwent conventional synthetic DMARD (csDMARD) monotherapy, 10% underwent a csDMARD combination therapy, and 10% underwent a combination bDMARD and csDMARD treatment. The visual analog scale (VAS pain), patient global assessment, physician global assessment, and BASDAI scores were found to be lower among patients using combination treatment of csDMARD and bDMARD, while the swollen joint count was found to be lower among patients using bDMARD. The PsAQoL score was found to be the lowest among patients not using any medication and the highest among those using bDMARD.ConclusionIn our study, patients with PsA were successfully treated with both csDMARD and bDMARD monotherapy. When the biological treatments used for PsA were compared with csDMARD, it was found that biological treatments had a positive effect on both disease activity and the QoL. Combinations of csDMARDs and bDMARDs were preferred in cases in which the disease activity was still high or increased. Because of the highest efficacy of the combined treatment, we highly suggest increasing the number of patients on combined treatment.

FRI0619-HPR INVESTIGATION OF THE RELATIONSHIP BETWEEN BIOPSYCHOSOCIAL STATUS AND QUALITY OF LIFE, EMOTION - STATUS AND FUNCTIONALITY IN INDIVIDUALS WITH PSORIATIC ARTHRITIS.

Background:Due to the chronic processes of rheumatological diseases, patients’ biopsychosocial effects are revealed.Objectives:The aim of this study is to evaluate the biopsychosocial status of individuals diagnosed with psoriatic arthritis; to examine the relationship between quality of life, emotion - status and functionality.Methods:105 individuals were included in the study. To evaluate the biopsychosocial situation, BETY-BQ (Bilişsel Egzersiz Terapi Yaklaşimi – Biopsychosocial Questionnaire)(1); Psoriatic Arthritis Quality of Life (PsAQoL) Scale to assess quality of life; For the emotion-status assessment; Hospital Anxiety and Depression Scale (HADS-A, HADS-D); Health Assessment Questionnaire (HAQ) was used for functionality. Pearson Correlation Analysis was used in statistical analysis.Results:Descriptive data of the individuals participating in the study were recorded (Table 1).While BETY-BQ was highly correlated with PSAQoL Scale(r = 0.826, p &lt;0.001), moderate correlations were found with HADS-A and HADS-D (HADS-A (r = 0.618, p &lt;0.001), HADS-D (r = 0.507, p &lt;0.001)). Low correlation was found between BETY-BQ and HAQ (r = 286, p = 0.003) (Table 2).Table 1.Descriptive StatisticsMinimumMaximumMeanStandart DeviationAge (years)206044.9811.04Height (cm)145.00190.00165.618.88Weight (kg)4413875.5417.36VKI(kg/m2)17.8549.0027.546.02Table 2.PsAQoLHADS-AHADS-DHAQBETY-BQr 0.826**p&lt;0.001r=0.618**p&lt;0.001r=0.507**p&lt;0.001r=286**p=0.003** Correlation is significant at the 0.01 level (2-tailed)Conclusion:In this study, it was found that BETY-BQ is a scale that can be used in total to evaluate the quality of life, emotion-status level and functionality of individuals diagnosed with PsA. It was thought that BETY-BQ could be considered and preferred by clinicians when individuals with PsA should be evaluated from a biopsychosocial point of view.

P264 Burden of disease and relative impact of skin and joint disease on quality of life in PsA: analysis from a UK secondary care cohort

Abstract Background Understanding the impact of psoriatic arthritis (PsA) on an individual and how the disease evolves over time is important when determining a therapeutic strategy. However, little is known about the natural course of arthritis, psoriasis, and enthesitis, their relative impact on quality of life and how disease burden in real world cohorts compares to clinical trial populations. We set out to describe the burden of disease and impact on quality of life in an observational UK secondary care cohort. Methods Cross sectional cohorts were selected from the Bath PsA cohort, group one with early disease (within 24 months of diagnosis), groups two and three with established disease (commencing therapy with first or second line biologic Disease Modifying Anti-Rheumatic Drug- bDMARD therapy respectively; assessments both at initiation and 3 months after initiation). Results Analyses were undertaken where sufficient data was available on 154 patients eligible for entry into the early PsA cohort (group 1), 240 patients eligible for the biologic initiator cohort (group 2) and 103 for the second line biologics initiator cohort. Cohort characteristics are reported in Table 1. The burden of joint disease was high in all cohorts and approximately comparable to clinical trial populations in group 2 commencing bDMARD (mean tender joints count 22 (SD 14), swollen 7 (SD 5) cDAPSA mean 36 (SD 15)). Mean Body Mass Index (BMI) rose from overweight in early disease to obese in established disease (table 1). There was little enthesitis in any group (LEI mean &amp;lt;1). There was a significant burden of joint disease (cDAPSA), fatigue (FACT) and work disability among those 3 months post commencing bDMARD despite good clinical responses (table 1). The level of skin (PASI) and nail disease (Bath Nail score) was low but remains strongly associated with worse quality of life and the association was stronger in established disease. Conclusion We report high levels of residual joint disease, fatigue, obesity and work disability in both early and established PsA cohorts. Despite low absolute levels of residual skin and nail disease both become more strongly associated with worse quality of life in more established disease. Disclosures W. Tillett: Honoraria; Eli Lilly, Janssen, Novartis, Pfizer, UCB. Grants/research support; Abbvie, Eli Lilly, Celgene. A. Rambojun: Grants/research support; EPSRC. A. Bradley: Shareholder/stock ownership; Eli Lilly and Company Limited. Other; Employee of Eli Lilly and Company Limited. J. Mount: Shareholder/stock ownership; Eli Lilly and Company Limited. Other; Employee of Eli Lilly and Company Limited. C. Cavill: Grants/research support; Eli Lilly and Company Limited. E. Korendowych: Honoraria; Abbvie, Eli Lilly, Janssen, Novartis. Grants/research support; Eli Lilly and Company Limited. N. McHugh: Consultancies; Abbvie. Grants/research support; Eli Lilly and Company Limited.

Neuropathic Pain: Unexplored and Significant Relationship With Psoriatic Arthritis and Functional Parameters

Objectives This study aims to examine the presence of neuropathic pain (NP) in psoriatic arthritis (PsA) and its relationship with functional parameters.Patients and methods The study included 50 PsA patients (18 males, 32 females; mean age 50 years; range, 27 to 68 years) diagnosed according to The Classification Criteria for Psoriatic Arthritis. NP was assessed with PainDETECT questionnaire (PDQ). Associations of NP with quality of life (QoL), sleep and fatigue were analyzed by filling out the Psoriatic Arthritis Quality of Life (PsAQoL), Pittsburgh Sleep Quality Index (PSQI), and Multidimensional Assessment of Fatigue (MAF) scales, respectively. Group analysis was performed with independent-samples Mann-Whitney U test and Kruskal-Wallis test. Spearman’s rank correlation coefficient (rho) was used for correlations between functional parameters.Results Mean disease duration of the PsA patients was 90.2±90.8 months]. The number of patients with ambiguous NP was eight (3 males, 5 females) while likely NP was detected in 12 patients (2 males, 10 females). The median scores of visual analog scale-pain, PSQI, PsAQoL and MAF were significantly higher in patients with NP (p<0.05). The correlations between PDQ and other functional parameters were found moderate-strong calculated as follows: PSQI (rho=0.44, p=0.003), MAF (rho=0.42, p=0.005), PsAQoL (rho=0.73, p<0.0001).Conclusion The existence of NP in PsA is not rare and it has a significant relationship with impaired QoL and sleep disturbances. The assessment of NP in PsA patients is necessary to provide a holistic treatment strategy.

Serum Interleukin 23 in Psoriatic Arthritis Patients: Relation to disease activity, physical function and health related quality of life

AbstractObjective To assess interleukin 23 (IL-23) levels in the sera of psoriatic arthritis (PsA) patients and to determine the relationship of IL-23 with different disease activity indices, physical function and quality of life (QoL).Methods Fifty PsA patients and 46 matched healthy controls were included in this study. Data including a detailed history, a thorough clinical examination, skin severity based on the Psoriasis Area and Severity Index (PASI), the Disease Activity index for Psoriatic Arthritis (DAPSA) and the Composite Psoriatic Disease Activity Index (CPDAI) were obtained for all patients. Physical function was assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI) and health-related QoL was assessed using the Short Form Health Survey (SF-36), Psoriatic Arthritis Quality of Life (PsAQoL) and the Dermatology Life Quality Index (DLQI) were also assessed. Serum IL-23 levels were measured in the studied groups.Results The study included 23(46%) females and 27 (54%) males with a mean age of 42.78±12.33 years. The mean serum IL-23 level was significantly higher in PsA patients (50.89±13.86 pg/ml) than in controls (43.88±6.34 pg/ml) (p=0.006). There were significant correlations between serum IL-23 levels and different grades of DAPSA activity (p=0.007) and PASI (p=0.015). No significant correlations could be detected between serum IL-23 levels and (HAQ-DI, DLQI, SF-36 or PsAQoL). CPDAI and DAPSA were significantly correlated with DLQI, SF-36 and PsAQoL.Conclusion IL-23 is a useful biomarker for identifying joint activity or skin severity but not QoL or physical function.

The GRAPPA-OMERACT Psoriatic Arthritis Working Group at the 2018 Annual Meeting: Report and Plan for Completing the Core Outcome Measurement Set.

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis (PsA) Working Group reported at the 2018 GRAPPA annual meeting on the outcome of the OMERACT 2018 Conference in Terrigal, Australia. The working group presented the endorsement of the 66/68 joint count for the assessment of peripheral arthritis and the provisional endorsement of the PsA Impact of Disease 12 questionnaire for the assessment of PsA-specific health-related quality of life in PsA randomized controlled trials and observational studies. In this report, the group presents its plan to seek OMERACT endorsement for outcome measures that address the domains of MSK disease activity for enthesitis and dactylitis, physical function, fatigue, and structural damage following the OMERACT Filter 2.1 methodology.

Validity and reliability of the Turkish version of the Jenkins Sleep Scale in psoriatic arthritis.

The aim of this study is to investigate the validity and reliability of the Turkish version of Jenkins Sleep Scale (JSS) in psoriatic arthritis (PsA). Patients with PsA according to Classification Criteria for Psoriatic Arthritis (CASPAR) were included in the study. Data about age, sex, body mass index (BMI), disease duration (month) and joint symptom duration (month) were noted. Psoriatic Arthritis Quality of Life (PsAQoL) Scale was used to assess the quality of life, Multidimensional Assessment of Fatigue (MAF) Scale was used to evaluate fatigue, and Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. The reliability of JSS scale was determined by internal consistency (Cronbach's alpha coefficient). Face validity and construct validity (convergent and divergent validities) were evaluated. The correlation of the JSS with the PSQI, MAF scale, and PsAQoL scale was assessed for convergent validity. The correlation of the JSS with age, body mass index (BMI), duration of joint symptoms and disease duration were assessed for divergent validity. The mean age of 56 patients was 42.71 ± 11.79. The Cronbach's alpha of the JSS was 0.862. The JSS had significant correlations with PSQI (rho = 0.653, P < 0.001), MAF (rho = 0.457, P < 0.001), PsAQoL (rho = 0.496, P < 0.001). There were no significant correlations between JSS and age (rho=-0.052, P = 0.716), BMI (rho=-0.085, P = 0.550), disease duration (rho = 0.161, P = 0.276) and duration of joint symptoms (rho = 0.107, P = 0.474). The Turkish version of JSS is a valid and reliable instrument in PsA.

Psoriatic Arthritis Quality of Life questionnaire: translation, cultural adaptation and validation into Portuguese language

Psoriatic arthritis (PsA) has a strong negative impact on the quality of life of patients. The Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire is a disease-specific instrument developed to measure the quality of life in patients with PsA. The aims of this study were to culturally adapt the questionnaire for Portugal and evaluate its reliability and validity in patients with PsA. The original UK English version of the PsAQoL was translated into Portuguese by a bilingual and lay panel. Structured cognitive debriefing interviews were conducted with ten PsA patients. The Portuguese PsAQoL was subsequently applied to PsA patients followed at the Rheumatology Department of Centro Hospitalar do Baixo Vouga, E.P.E. To assess reproducibility, 30 patients with PsA completed the Portuguese PsAQoL on two occasions, 2weeks apart. A larger sample was recruited to determine internal consistency and construct validity. The Nottingham Health Profile (NHP) was used as a comparator instrument. Translation and adaptation were successful. Cronbach´s alpha for the Portuguese version of the PsAQoL was 0.91 and the test-retest reliability was 0.93. The PsAQoL could distinguish between groups of patients defined by self-reported general health status, self-reported severity of PsA and flare of arthritis. There was a positive correlation between the total score of the PsAQoL and each of the sections of the NHP. The Portuguese version of the PsAQoL was found to be relevant, understandable and easy to complete, reliable and valid.

Translation and validation of the greek Psoriatic Arthritis Quality of Life Scale.

Psoriatic arthritis (PsA) is a chronic inflammatory disease that has a significant impact on patients' quality of life (QoL). The Psoriatic Arthritis Quality of Life (PsAQoL) Scale was developed in the UK to be specific to PsA patients and adopts the needs-based model of QoL. As a disease-specific measure, the PsAQoL is superior to generic measures of QoL in terms of relevance and sensitivity. The measure, which has been adapted into 50 languages, has not previously been available for use with Greek PsA patients. The aim of the study was to produce a Greek version of the PsAQoL that was suitable for native Greek speakers and that had comparable psychometric properties to the original UK version. The adaptation of the Greek PsAQoL consisted of three stages; translation, assessment of face and content validity and analysis of its psychometric properties. The translation stage adopted the dual panel methodology -a bilingual panel followed by a lay panel- to ensure conceptual equivalence of the scale to the original version. Cognitive debriefing interviews were conducted to determine the applicability and relevance of the adapted scale to patients. Finally, a postal validation survey was conducted to assess the psychometric properties of the draft measure, using the Nottingham Health Profile (NHP) as a comparator instrument. Non-parametric statistical analyses were performed to establish the reliability and construct validity of the PsAQoL. The translation panels produced a language version that sounded natural to native Greek speakers. Interviews revealed that patients found the measure comprehensible and appropriate. Only minor grammatical changes were made to the measure following these interviews. The Greek PsAQoL demonstrated good internal consistency (Cronbach's α=0.88) and excellent test-retest reliability (r=0.98). As expected, the measure correlated moderately highly with the Physical Mobility and Pain sections of the NHP and correlated moderately with other sections, indicating convergent validity. Known group validity was established by the ability of the measure to distinguish between patients who differed according to their perceived general health and disease severity. No significant differences in PsAQoL scores were observed between males and females or older and younger patients. The Greek PsAQoL was well-received by patients and demonstrated sound psychometric properties. It forms part of a growing body of disease-specific measures that are available in Greece. It is recommended for use in routine clinical practice, international clinical trials and research studies as a valid and reliable measure of QoL in PsA patients.

Adaptation of Chinese and English versions of the Psoriatic Arthritis Quality of Life (PsAQoL) scale for use in Singapore.

BackgroundTo develop Singapore Chinese and English versions of the Psoriatic Arthritis Quality of Life (PsAQoL) scale that were equivalent to and met the same psychometric and acceptability standards as the original UK measure.MethodsTranslation of the original PsAQoL into contextualised English and Chinese versions for use in Singapore was performed by professional and lay translation panels. Ten Chinese speaking and ten English speaking local patients were interviewed to assess face and content validity. Psoriatic arthritis (PsA) patients (either Chinese or English speaking) fulfilling the Classification criteria of Psoriatic Arthritis were then invited to participate in a validation survey. Clinical variables, the Health Assessment Questionnaire (HAQ) and the Medical Outcome Short-form 36 (SF-36) were used as comparator instruments for convergent validity. A separate sample of PsA patients were invited to participate in a test-retest postal study, with two weeks between administrations.ResultsThe validation sample included 98 patients (51 % men) with a mean (SD) age of 51.5 (13.8) years. The PsAQoL had excellent internal consistency (Cronbach’s α = 0.92) and scores on the measure were moderately correlated with health status measures (pain, HAQ score, SF-36 scores) and patient and physician global assessments. The scale was able to distinguish between groups with active or inactive disease assessed by composite scores, HAQ and minimal disease activity. Test–retest reliability was excellent (r = 0.92).ConclusionsThis study provides evidence that the adapted English and Chinese versions of the PsAQoL can be used in clinical studies with PsA patients in Singapore.

Sleep quality in patients with psoriatic arthritis

The purpose of this study was to determine the effects of psoriatic arthritis (PsA) on sleep quality and investigate the association between sleep quality and clinical parameters of PsA, quality of life and psychological state in patients with PsA. Forty-one patients with PsA and 38 healthy volunteers were included in this study. In both patients and healthy controls, sleep quality was assessed by means of the Pittsburgh Sleep Quality Index (PSQI) and anxiety and depression were assessed by means of the Hospital Anxiety and Depression Scale (HADS). In addition, PsA Quality of Life (PsAQoL) Index and Psoriasis Area and Severity Index (PASI) were used on patients. Generalized pain was assessed by means of a visual analogue scale (VAS). Subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, daytime dysfunction and total PSQI scores were significantly higher in patients with PsA compared to healthy controls. Total PSQI scores significantly correlated with anxiety, generalized pain, PsAQoL scores, enthesitis and levels of C-reactive protein (CPR) and erythrocyte sedimentation rate (ESR) (P<0.05). Also, multiple regression analysis indicated that ESR level was independently associated with total PSQI score (P<0.05, R2 =0.325). Sleep quality is diminished in patients with PsA. Sleep disturbance is particularly associated with generalized pain, anxiety, enthesitis and levels of CRP and ESR in patients carrying the diagnosis of PsA.

Effect of Certolizumab Pegol on Multiple Facets of Psoriatic Arthritis as Reported by Patients: 24‐Week Patient‐Reported Outcome Results of a Phase III, Multicenter Study

ObjectiveTo examine the effect of certolizumab pegol (CZP) on patient-reported outcomes (PROs) in psoriatic arthritis (PsA) patients with and without prior tumor necrosis factor (TNF) inhibitor exposure.MethodsThe ongoing phase III RAPID-PsA trial was double blind and placebo controlled to week 24. Patients were randomized 1:1:1 to placebo every 2 weeks or CZP 400 mg at weeks 0, 2, and 4, followed by either CZP 200 mg every 2 weeks or CZP 400 mg every 4 weeks. PRO measures evaluated were the Health Assessment Questionnaire (HAQ) disability index (DI), health status (measured by the Short Form 36 [SF-36] health survey), Psoriatic Arthritis Quality of Life (PsAQOL), Fatigue Assessment Scale, patient assessment of pain (visual analog scale), and Dermatology Life Quality Index (DLQI). Post hoc analyses of PROs in patients with and without prior TNF inhibitor exposure were conducted. Change from baseline for all PROs was analyzed for the randomized population using analysis of covariance with last observation carried forward imputation.ResultsA total of 409 patients were randomized. Twenty percent had received a prior TNF inhibitor. Baseline demographics were similar between the treatment groups. At week 24, clinically meaningful differences in HAQ DI, SF-36, PsAQOL, fatigue, pain, and DLQI were observed in both CZP arms versus placebo (P < 0.001), irrespective of prior TNF inhibitor exposure. More CZP-treated patients reached SF-36 general population norms than placebo-treated patients.ConclusionBoth CZP dosing schedules provided rapid improvements in PROs across multiple disease aspects in patients with PsA. The benefits of CZP treatment for health-related quality of life were seen across generic, PsA-specific, and dermatology-specific measures and were observed in patients regardless of prior TNF inhibitor exposure.