From the Swedish Medical Center and University of Washington (UW) Medicine, Seattle, Washington; Corrona LLC, Southborough, Massachusetts; Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; The University of Texas MD Anderson Cancer Center, Houston, Texas; University of California (UC) at San Diego, La Jolla, California; University of Rochester Medical Center, Rochester; New York University (NYU) School of Medicine, New York, New York; Scott and White Health Plan, Temple, Texas, USA.
P.J. Mease, MD, Swedish Medical Center and UW Medicine; C. Karki, MPH, Corrona LLC; J.B. Palmer, PharmD, Novartis Pharmaceuticals Corporation; C.J. Etzel, PhD, Corrona LLC, and The University of Texas MD Anderson Cancer Center; A. Kavanaugh, MD, UC San Diego; C.T. Ritchlin, MD, University of Rochester Medical Center; W. Malley, MS, Corrona LLC; V. Herrera, DDS, Novartis Pharmaceuticals Corporation; M. Tran, PharmD, Scott and White Health Plan; J.D. Greenberg, MD, Corrona LLC, and NYU School of Medicine.
J Rheumatol. 2017 Aug;44(8):1151-1158. doi: 10.3899/jrheum.160963. Epub 2017 Jun 15.
Psoriatic arthritis (PsA) is commonly comorbid with psoriasis; the extent of skin lesions is a major contributor to psoriatic disease severity/burden. We evaluated whether extent of skin involvement with psoriasis [body surface area (BSA) > 3% vs ≤ 3%] affects overall clinical and patient-reported outcomes (PRO) in patients with PsA.
Using the Corrona PsA/Spondyloarthritis Registry, patient characteristics, disease activity, and PRO at registry enrollment were assessed for patients with PsA aged ≥ 18 years with BSA > 3% versus ≤ 3%. Regression models were used to evaluate associations of BSA level with outcome [modified minimal disease activity (MDA), Health Assessment Questionnaire (HAQ) score, patient-reported pain and fatigue, and the Work Productivity and Activity Impairment questionnaire score]. Adjustments were made for age, sex, race, body mass index, disease duration, and history of biologics, disease-modifying antirheumatic drug, and prednisone use.
This analysis included 1240 patients with PsA with known BSA level (n = 451, BSA > 3%; n = 789, BSA ≤ 3%). After adjusting for potential confounding variables, patients with BSA > 3% versus ≤ 3% had greater patient-reported pain and fatigue and higher HAQ scores (p = 2.33 × 10, p = 0.002, and p = 1.21 × 10, respectively), were 1.7× more likely not to be in modified MDA (95% CI 1.21-2.41, p = 0.002), and were 2.1× more likely to have overall work impairment (1.37-3.21, p = 0.0001).
These Corrona Registry data show that substantial skin involvement (BSA > 3%) is associated with greater PsA disease burden, underscoring the importance of assessing and effectively managing psoriasis in patients with PsA because this may be a contributing factor in PsA severity.
银屑病关节炎（PsA）常与银屑病并存；皮损范围是银屑病严重程度/负担的主要因素。我们评估了银屑病患者的皮肤受累程度（体表面积[BSA]＞3%与≤3%）是否会影响整体临床和患者报告的结局（PRO）。
使用 Corrona PsA/Spondyloarthritis 注册中心，评估了年龄≥18 岁、BSA＞3%与≤3%的 PsA 患者的注册时患者特征、疾病活动度和 PRO。回归模型用于评估 BSA 水平与结局[改良最小疾病活动度（MDA）、健康评估问卷（HAQ）评分、患者报告的疼痛和疲劳以及工作效率和活动障碍问卷评分]之间的关系。调整了年龄、性别、种族、体重指数、疾病持续时间以及生物制剂、改善病情抗风湿药和泼尼松使用史的因素。
这项分析纳入了已知 BSA 水平的 1240 例 PsA 患者（n=451，BSA＞3%；n=789，BSA≤3%）。在调整潜在混杂因素后，BSA＞3%与≤3%的患者报告疼痛和疲劳更严重，HAQ 评分更高（p=2.33×10，p=0.002 和 p=1.21×10，分别），更不可能达到改良 MDA（95%CI 1.21-2.41，p=0.002），整体工作障碍的可能性高 1.7 倍（1.37-3.21，p=0.0001）。
Corrona 注册中心的数据表明，广泛的皮肤受累（BSA＞3%）与更大的 PsA 疾病负担相关，这强调了评估和有效管理银屑病关节炎患者的银屑病的重要性，因为这可能是 PsA 严重程度的一个促成因素。
