Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Rheumatology and Clinical Immunology, Maasstad Hospital, Rotterdam, The Netherlands.
Scand J Rheumatol. 2021 Mar;50(2):124-131. doi: 10.1080/03009742.2020.1803398. Epub 2020 Oct 21.
This paper describes the baseline demographics, clinical characteristics, and patient-reported outcomes (PROs) according to clinical phenotype of patients with early psoriatic arthritis (PsA) for the purpose of creating a decision support system for daily clinical practice. Patients with newly diagnosed PsA were included in the Dutch south west Early Psoriatic ARthritis (DEPAR) study. No classification criteria were applied, to ensure collection of real-world data on demographics, medication, clinical characteristics, and PROs. An IT infrastructure facilitated data collection. We described 527 patients, categorized according to the clinical phenotype stated by the rheumatologist at the time of diagnosis, namely monoarthritis (15%), oligoarthritis (40%), polyarthritis (23%), enthesitis (10%), axial disease (2%), and dactylitis (10%). Overall psoriasis severity was mild and 83 patients (16%) had no psoriasis. Short-term sick leave (> 1 day per 4 weeks) was 17% and long-term sick leave (> 4 weeks) was 4%. The group with phenotype enthesitis reported the longest duration of complaints, had the highest fatigue scores, and contained the highest percentage of patients with a Hospital Anxiety and Depression Scale (HADS) anxiety score ≥ 8 and depression score ≥ 8. PsA patients presenting at outpatient clinics in the Netherlands had a mild degree of psoriasis, with impairment of quality of life and work productivity. Most patients presented with phenotype oligoarthritis. Those presenting with phenotype enthesitis more often reported scores suggestive of an anxiety or depression disorder and fatigue. It is important for attending rheumatologists to be aware of these differences when assessing patients with PsA.
本文描述了早期银屑病关节炎（PsA）患者的基线人口统计学、临床特征和患者报告的结局（PROs），旨在为日常临床实践创建决策支持系统。新诊断的 PsA 患者被纳入荷兰西南部早期银屑病关节炎（DEPAR）研究。未应用任何分类标准，以确保收集真实世界的人口统计学、药物治疗、临床特征和 PROs 数据。一个 IT 基础设施促进了数据收集。我们描述了 527 名患者，根据当时风湿病医生诊断的临床表型进行分类，即单关节炎（15%）、寡关节炎（40%）、多关节炎（23%）、附着点炎（10%）、轴性疾病（2%）和指（趾）炎（10%）。总体银屑病严重程度较轻，83 名患者（16%）无银屑病。短期病假（>每 4 周 1 天）为 17%，长期病假（>4 周）为 4%。附着点炎表型组报告的症状持续时间最长，疲劳评分最高，且有较高比例的患者汉密尔顿焦虑量表（HADS）焦虑评分≥8 和抑郁评分≥8。在荷兰门诊就诊的 PsA 患者银屑病程度较轻，但生活质量和工作效率受损。大多数患者表现为寡关节炎表型。表现为附着点炎表型的患者更常报告有焦虑或抑郁障碍和疲劳的评分。评估 PsA 患者时，主治风湿病医生注意到这些差异很重要。
