银屑病关节炎主要表现对患者生活质量、功能状态和工作生产力的影响：来自美国和欧洲真实世界研究的结果。

Impact of key manifestations of psoriatic arthritis on patient quality of life, functional status, and work productivity: Findings from a real-world study in the United States and Europe.

机构信息

University of Utah and Salt Lake City Veterans Affairs, Utah, USA.

Perelman School of Medicine, Penn Medicine, Philadelphia, USA.

出版信息

Joint Bone Spine. 2023 May;90(3):105534. doi: 10.1016/j.jbspin.2023.105534. Epub 2023 Jan 25.

DOI:10.1016/j.jbspin.2023.105534

PMID:36706947

Abstract

OBJECTIVES

To determine the individual impact of key manifestations of psoriatic arthritis (PsA) on quality of life (QoL), physical function, and work disability.

METHODS

Data from the Adelphi 2018 PsA Disease-Specific Programme, a multinational, cross-sectional study of PsA patients, were used. PsA manifestations included peripheral arthritis (number of joints affected), psoriasis (body surface area [BSA]), axial involvement (inflammatory back pain [IBP] and sacroiliitis) enthesitis, and dactylitis. General, and disease-specific QoL, physical function, and work disability were measured with EQ-5D-5L, PsAID-12, HAQ-DI, and WPAI, respectively. Multivariate regression adjusting for potential confounders evaluated the independent effect of PsA manifestations on each outcome.

RESULTS

Among the 2222 PsA patients analysed, 77.0% had active psoriasis and 64.4% had peripheral arthritis; 5.9%, 6.8%, 10.2%, and 3.6% had enthesitis, dactylitis, IBP, or sacroiliitis, respectively. Mean EQ VAS scores were significantly poorer in patients with vs. without enthesitis (59.9 vs. 75.6), dactylitis (63.6 vs. 75.4), and with greater peripheral joint involvement (none: 82.5; 1-2 affected joints: 74.1; 3-6 joints: 74.2; >6 joints: 65.0). Significantly worse mean PsAID-12 scores were associated with vs. without enthesitis (4.39 vs. 2.34) or dactylitis (4.30 vs. 2.32), and with greater peripheral joint involvement (none: 1.21; 1-2 joints: 2.36; 3-6 joints: 2.74; >6 joints: 3.92), and BSA (none: 1.49; >3-10%: 2.96; >10%: 3.43). Similar patterns were observed with HAQ-DI and WPAI scores.

CONCLUSION

Most PsA manifestations were independently associated with worse general, and PsA-specific QoL, physical function, and work disability, highlighting the need for treatments targeting the full spectrum of PsA symptoms to lower the burden of disease.

摘要

目的

确定银屑病关节炎（PsA）的主要表现对生活质量（QoL）、身体功能和工作障碍的个体影响。

方法

使用来自 Adelphi 2018 年 PsA 疾病专项计划的数据，这是一项针对 PsA 患者的多国家、横断面研究。PsA 表现包括外周关节炎（受累关节数）、银屑病（体表面积[BSA]）、轴性受累（炎症性背痛[IBP]和骶髂关节炎）附着点炎和指（趾）炎。使用 EQ-5D-5L、PsAID-12、HAQ-DI 和 WPAI 分别测量一般和疾病特异性 QoL、身体功能和工作障碍。多变量回归调整潜在混杂因素评估了 PsA 表现对每种结局的独立影响。

结果

在分析的 2222 例 PsA 患者中，77.0%有活动性银屑病，64.4%有外周关节炎；分别有 5.9%、6.8%、10.2%和 3.6%的患者有附着点炎、指（趾）炎、IBP 或骶髂关节炎。与无附着点炎（59.9 对 75.6）、无指（趾）炎（63.6 对 75.4）或外周关节受累较少（无：82.5；受累 1-2 个关节：74.1；受累 3-6 个关节：74.2；受累>6 个关节：65.0）的患者相比，附着点炎或指（趾）炎患者的平均 EQ VAS 评分显著更差。与无附着点炎（4.39 对 2.34）或指（趾）炎（4.30 对 2.32）相比，与外周关节受累程度较大（无：1.21；受累 1-2 个关节：2.36；受累 3-6 个关节：2.74；受累>6 个关节：3.92）和 BSA（无：1.49；>3-10%：2.96；>10%：3.43）相比，附着点炎或指（趾）炎患者的平均 PsAID-12 评分显著更差。HAQ-DI 和 WPAI 评分也观察到类似的模式。