Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Rheumatology and Clinical Immunology, Maasstad Hospital, Rotterdam, The Netherlands.
Clin Exp Rheumatol. 2023 Jan;41(1):88-93. doi: 10.55563/clinexprheumatol/q8fh0a. Epub 2022 Jun 13.
Achieving low disease activity (LDA) is important in patients with psoriatic arthritis. It is of value to know if health-related quality of life (HRQoL) of patients who reached musculoskeletal low disease activity can be further improved by additionally achieving remission of their psoriasis. So, the aim of this study was to assess HRQoL in patients with active psoriasis who reached disease activity in psoriatic arthritis (DAPSA) LDA after one year of follow-up.
Data were collected from the Dutch south west Psoriatic Arthritis cohort. Musculoskeletal disease activity was measured using DAPSA. Patients who reached DAPSA-LDA after one year were divided based on reaching psoriasis remission (Psoriasis Area and Severity Index [PASI] <1). HRQoL and work productivity were compared between both groups.
After one year, 230 (44%) patients with active psoriasis at baseline reached DAPSA-LDA, of which 108 (47%) patients achieved psoriasis remission. The group of patients with active psoriasis (n=122, 53%) contained more men (p=0.023) and scored lower on the 12-item Psoriatic Arthritis Impact of Disease questionnaire (p=0.012). On the Skindex-17 psychosocial subscale, 31% experienced moderate to high impairment and on the symptoms subscale 28% experienced a lot of symptoms. Work productivity did not differ between both groups.
The majority of patients with DAPSA-LDA and active psoriasis after one year has a good HRQoL. However, a proportion of these patients still experiences considerable skin burden. We recommend rheumatologists to continue assessing and treating psoriasis to reduce skin burden in PsA patients who achieved musculoskeletal low disease activity.
实现低疾病活动度(LDA)对于患有银屑病关节炎的患者非常重要。了解达到肌肉骨骼低疾病活动度的患者的健康相关生活质量(HRQoL)是否可以通过进一步实现银屑病的缓解来进一步改善,这是有价值的。因此,本研究的目的是评估在经过一年的随访后达到疾病活动度在银屑病关节炎(DAPSA)低疾病活动度的活动期银屑病患者的 HRQoL。
数据来自荷兰西南部银屑病关节炎队列。使用 DAPSA 测量肌肉骨骼疾病活动度。在一年后达到 DAPSA-LDA 的患者根据是否达到银屑病缓解(银屑病面积和严重程度指数[PASI]<1)进行分组。比较两组之间的 HRQoL 和工作生产力。
在基线时有活动性银屑病的 230 名患者(44%)在一年后达到 DAPSA-LDA,其中 108 名患者(47%)达到银屑病缓解。活动性银屑病患者组(n=122,53%)包含更多的男性(p=0.023),并且 12 项银屑病关节炎疾病影响问卷得分较低(p=0.012)。在 Skindex-17 心理社会子量表上,31%的患者有中度至重度损伤,在症状子量表上,28%的患者有大量症状。两组之间的工作生产力没有差异。
在经过一年的 DAPSA-LDA 和活动性银屑病后,大多数患者的 HRQoL 良好。然而,这些患者中的一部分仍然存在相当大的皮肤负担。我们建议风湿病学家继续评估和治疗银屑病,以减少达到肌肉骨骼低疾病活动度的银屑病关节炎患者的皮肤负担。