Orbai Ana-Maria, Tillett William, Grieb Suzanne, Peterson Steve, Holdsworth Elizabeth A, Booth Nicola, Chakravarty Soumya D, Gossec Laure
A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA;
W. Tillett, PhD, Royal National Hospital for Rheumatic Disease, and University of Bath, Pharmacy and Pharmacology and Centre for Therapeutic Innovation, Bath, UK.
J Rheumatol. 2023 Jan;50(1):76-83. doi: 10.3899/jrheum.211302. Epub 2022 Aug 15.
To describe psoriatic arthritis (PsA) flares and their effect on patient-reported outcomes (PROs).
Cross-sectional surveys of rheumatologists/dermatologists and their patients with PsA were conducted in France, Germany, Italy, Spain, the United Kingdom, and the United States, capturing data on physician-reported patient flare status, demographics, PsA severity, and clinical outcomes. Patient-completed surveys captured data on PROs: 5-level EuroQol 5-dimension, Work Productivity and Activity Impairment questionnaire, Health Assessment Questionnaire-Disability Index, and 12-item Psoriatic Arthritis Impact of Disease questionnaire. Patients were compared by flare status using parametric and nonparametric tests. Multivariate regression was used to identify flare associations. Multivariate logistic regression adjusted for patient demographics and physician specialty assessed the effect of flare status.
Among 2238 patients (586 from the US, 1652 from Europe) managed by 572 physicians, physician-reported flare was present for 168 patients (7.5%), and self-reported flare was present for 95 patients (10% of available data). Mean (SD) flare count over 12 months was 2.2 (4.9), lasting on average 16.4 (16.2) days. Flare status was linked to worse PROs. Patients who had not flared in the last 12 months or had never flared had a higher quality of life, lower overall work impairment, and a lower degree of disability compared with patients who were currently experiencing a flare (all; < 0.01).
Actively experiencing a flare adversely affected QOL, disability, and work productivity. PsA flares should be routinely assessed and managed in clinical care.
描述银屑病关节炎（PsA）发作及其对患者报告结局（PROs）的影响。
在法国、德国、意大利、西班牙、英国和美国对风湿病学家/皮肤科医生及其PsA患者进行横断面调查，收集关于医生报告的患者发作状态、人口统计学、PsA严重程度和临床结局的数据。患者完成的调查收集了关于PROs的数据：5级欧洲五维健康量表、工作生产力和活动障碍问卷、健康评估问卷-残疾指数以及12项银屑病关节炎疾病影响问卷。使用参数检验和非参数检验按发作状态对患者进行比较。采用多变量回归来确定发作的关联因素。经患者人口统计学和医生专业调整的多变量逻辑回归评估发作状态的影响。
在由572名医生管理的2238例患者中（586例来自美国，1652例来自欧洲），医生报告有发作的患者为168例（7.5%），自我报告有发作的患者为95例（占可用数据的10%）。12个月内发作次数的平均值（标准差）为2.2（4.9）次，平均持续16.4（16.2）天。发作状态与更差的PROs相关。与当前正在发作的患者相比，在过去12个月内未发作或从未发作过的患者生活质量更高、总体工作障碍更低且残疾程度更低（均P<0.01）。
正在经历发作对生活质量、残疾状况和工作生产力有不利影响。在临床护理中应常规评估和管理PsA发作。
