Disease activity in patients with psoriatic arthritis: a Moldavian study (original) (raw)
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The medical and social impact of the disease in patients with psoriatic arthritis
Archives of the Balkan Medical Union, 2021
L'impact médical et social de la maladie sur les patients atteints d'arthrite psoriasique Introduction. L'arthrite psoriasique (APs) est une maladie chronique associée à un fardeau psychologique considérable et à une altération de la qualité de vie (QdV). L'objectif de l'étude a été de déterminer le statut médical et social des patients atteints d'APs afin d'optimiser leurs prise en charge et d'augmenter leur QdV. Matériel et méthodes. Nous avons réalisé une étude transversale, dans laquelle des patients atteints d'APs ont été inclus. Les données démographiques et cliniques ont été recueillies à l'aide d'un questionnaire spécial, comprenant l'emploi et le statut professionnel, des informations concernant le diagnostic et à la durée de la maladie, le tableau clinique de la maladie.
Rheumatology International, 2020
The psoriatic arthritis impact of disease (PSAID) questionnaire has been developed to measure disease impact on patients with psoriatic arthritis. It was aimed to evaluate its validity and reliability in association with sociodemographic and clinical factors and compare it with disease activity and patient-reported outcome measures in a Turkish psoriatic arthritis population. A prospective observational study was conducted to validate the Turkish version of the PSAID. All consecutive patients with psoriatic arthritis were evaluated between January 2019 and October 2019. Demographic and clinical features were recorded. The PSAID and patient-reported outcome measures were applied to all patients. Interclass and intra-class correlation analyses were performed. Convergent validity and correlation coefficients were used for validity analyses. There were 80 patients with a mean age of 50.2 ± 9.9 years. Cronbach's α value of the PSAID and intra-class correlation were 0.799 and 0.984, respectively. The total median PSAID score was 4.7. Pain, fatigue, ability to work, functional capacity and feeling of discomfort were the five highest-scoring subscales. There was satisfactory internal consistency for each subscale of the PSAID. As disease severity increased from low to high, the PSAID scores significantly increased. There were acceptable correlations between the PSAID and other patient-reported outcome measures. The PSAID is shown to be a reliable and valid questionnaire in Turkish patients with psoriatic arthritis. Good correlation with disease activity and patient-reported outcome measures represent an opportunity to use the PSAID in clinical practice to tailor individualized treatment choices.
Arthritis and Rheumatism, 2006
ObjectiveTo compare the accuracy of existing classification criteria for the diagnosis of psoriatic arthritis (PsA) and to construct new criteria from observed data.To compare the accuracy of existing classification criteria for the diagnosis of psoriatic arthritis (PsA) and to construct new criteria from observed data.MethodsData were collected prospectively from consecutive clinic attendees with PsA and other inflammatory arthropathies. Subjects were classified by each of 7 criteria. Sensitivity and specificity were compared using conditional logistic regression analysis. Latent class analysis was used to calculate criteria accuracy in order to confirm the validity of clinical diagnosis as the gold standard definition of “case”-ness. Classification and Regression Trees methodology and logistic regression were used to identify items for new criteria, which were then constructed using a receiver operating characteristic curve.Data were collected prospectively from consecutive clinic attendees with PsA and other inflammatory arthropathies. Subjects were classified by each of 7 criteria. Sensitivity and specificity were compared using conditional logistic regression analysis. Latent class analysis was used to calculate criteria accuracy in order to confirm the validity of clinical diagnosis as the gold standard definition of “case”-ness. Classification and Regression Trees methodology and logistic regression were used to identify items for new criteria, which were then constructed using a receiver operating characteristic curve.ResultsData were collected on 588 cases and 536 controls with rheumatoid arthritis (n = 384), ankylosing spondylitis (n = 72), undifferentiated arthritis (n = 38), connective tissue disorders (n = 14), and other diseases (n = 28). The specificity of each set of criteria was high. The sensitivity of the Vasey and Espinoza method (0.97) was similar to that of the method of McGonagle et al (0.98) and greater than that of the methods of Bennett (0.44), Moll and Wright (0.91), the European Spondylarthropathy Study Group (0.74), and Gladman et al (0.91). The CASPAR (ClASsification criteria for Psoriatic ARthritis) criteria consisted of established inflammatory articular disease with at least 3 points from the following features: current psoriasis (assigned a score of 2; all other features were assigned a score of 1), a history of psoriasis (unless current psoriasis was present), a family history of psoriasis (unless current psoriasis was present or there was a history of psoriasis), dactylitis, juxtaarticular new bone formation, rheumatoid factor negativity, and nail dystrophy. These criteria were more specific (0.987 versus 0.960) but less sensitive (0.914 versus 0.972) than those of Vasey and Espinoza.Data were collected on 588 cases and 536 controls with rheumatoid arthritis (n = 384), ankylosing spondylitis (n = 72), undifferentiated arthritis (n = 38), connective tissue disorders (n = 14), and other diseases (n = 28). The specificity of each set of criteria was high. The sensitivity of the Vasey and Espinoza method (0.97) was similar to that of the method of McGonagle et al (0.98) and greater than that of the methods of Bennett (0.44), Moll and Wright (0.91), the European Spondylarthropathy Study Group (0.74), and Gladman et al (0.91). The CASPAR (ClASsification criteria for Psoriatic ARthritis) criteria consisted of established inflammatory articular disease with at least 3 points from the following features: current psoriasis (assigned a score of 2; all other features were assigned a score of 1), a history of psoriasis (unless current psoriasis was present), a family history of psoriasis (unless current psoriasis was present or there was a history of psoriasis), dactylitis, juxtaarticular new bone formation, rheumatoid factor negativity, and nail dystrophy. These criteria were more specific (0.987 versus 0.960) but less sensitive (0.914 versus 0.972) than those of Vasey and Espinoza.ConclusionThe CASPAR criteria are simple and highly specific but less sensitive than the Vasey and Espinoza criteria.The CASPAR criteria are simple and highly specific but less sensitive than the Vasey and Espinoza criteria.
Factors Associated with Severity of Disease in Psoriatic Arthritis: A Cross-Sectional Study
Romanian Journal of Rheumatology
Objectives. The objectives of this study were to evaluate the prevalence of disease severity in PsA and to assess the factors that might explain it. Methods. This was a cross-sectional study of unselected PsA patients. Severity was defined according to GRAPPA criteria of severity. Factors potentially associated with severity (demographical, clinical, laboratory variables, treatment related factors and comorbidities) were assessed by uni- and multivariate logistic regressions. Results. A total of 129 PsA patients were analysed: 77 (59.7%) women, mean±standard deviation age 53.5±11.8 years, and mean disease duration 7±7.4 years. Twenty-for patients (18.6%) had severe PsA. In the univariate regression, disease severity was associated with psoriasis duration, PsA duration, current moderate/severe skin disease, nail disease, history of corticotherapy, and total number of previous synthetic and biologic DMARDs. In the multivariate analysis, PsA severity was explained by the presence of cu...
Clinical profile of patients with psoriatic arthritis in a tertiary healthcare center
Asian Journal of Medical Sciences
Background: Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis, usually seronegative for rheumatoid factor. While many patients with PsA do well, there is a group of patients who suffer from severe disease, with progression of articular damage and increased morbidity. Aims and Objectives: This study was aimed at assessing the clinical profile of patients suffering from PsA in a tertiary care hospital. Materials and Methods: A prospective observational study was carried out with due permission of the Institutional Ethics Committee. Demographic and clinical parameters were tabulated and DAPSA and PASI scores were noted. The comparison was done using Chi-square test and paired t-tests. Outcomes were noted and comparisons were made after 3 months of observation. Results: A total of 43 patients were included in the study. Most of them belonged to the age group of 26–35 years (25.25%), followed by 36–45 years (23.26%). The mean age of the study subjects was 3...
Validation and clinical interpretability of PsAID - psoriatic arthritis impact of disease
Advances in Rheumatology
Background Psoriatic arthritis (PsA) is a chronic inflammatory disease of widely varying presentation, which determines functional and psychological impairment, with a high negative impact on patients’ quality of life. Therefore, knowing the patient’s perception of their health status is of fundamental importance for understanding the real impact of PsA. Given this context, the European League Against Rheumatism (EULAR) recently developed the Psoriatic Arthritis Impact of Disease (PsAID) - instrument to specifically assess the impact of PsA for the patient. Objective Validate the brazilian portuguese version of PsAID-12 (Psoriatic Arthritis Impact of Disease) and to verify its interpretability in clinical practice, through its relation with measures of psoriatic arthritis activity. Methods A multicenter cross-sectional study, which recruited 160 patients, who met the Classification criteria for Psoriatic Arthritis (CASPAR), in six Brazilian centers of rheumatology. Reliability was a...
The Journal of rheumatology, 2016
To study, in a real-life setting, the construct validity, the reliability, and the interpretability of the 12-item Psoriatic Arthritis Impact of Disease (PsAID-12) questionnaire in patients with psoriatic arthritis (PsA). In 144 consecutive patients with PsA (81 men and 63 women, mean age of 51.4 ± 12.8 yrs, and 77 receiving biologic treatment), the PsAID-12 and other patient-reported outcomes (PRO) were collected, such as the Dermatology Life Quality Index. Each patient underwent articular and skin assessment. Construct validity: Factor analysis revealed a 2-factor result defined as the PsAID Symptom Score and the PsAID Skin Score. In determining convergent validity, significant correlations were found between the PsAID-12 and the clinical Disease Activity index for Psoriatic Arthritis (cDAPSA; ρ = 0.867, p < 0.0001). Multivariable analysis showed that the PsAID-12 is determined by the articular disease activity (cDAPSA, p < 0.0001), severity of psoriasis (PsO; physician'...
Arthritis & rheumatology (Hoboken, N.J.), 2016
We aimed to assess whether the presence of non-specific musculoskeletal symptoms, their degree and change over time predicted the development of psoriatic arthritis (PsA) in a prospective cohort of psoriasis patients without arthritis at baseline. This prospective cohort study involved patients with psoriasis who were assessed at baseline to exclude the presence of clinical PsA. The study participants were re-assessed annually to determine if they had developed PsA. The presence of musculoskeletal symptoms and patients' scores of pain, fatigue, stiffness, physical functioning and psychological distress were recorded at each visit. These variables served as predictors for the development of PsA. Cox proportional hazard models were used to assess what symptoms predicted the development of PsA. A total of 57 of 410 psoriasis patients developed PsA since enrollment. At baseline, the presence of arthralgia in women (Hazard Ratio (HR) 2.59, p=0.02), heel pain (HR 4.18, p=0.02), high f...
Outcome measures in psoriatic arthritis
The Journal of rheumatology, 2007
Psoriatic arthritis (PsA), an inflammatory arthritis associated with psoriasis usually seronegative for rheumatoid factor, has emerged as a more common and severe disease than previously appreciated. The disease is multifaceted. Thus the assessment of PsA requires attention to peripheral joint involvement, axial disease, dactylitis, and enthesitis, as well as the skin manifestations. In addition, the assessment of patient reported features such as patient assessment of disease activity, pain, fatigue, quality of life, and the new concept of participation are important. The assessment of damage and the assessment of tissue histology are also important outcome measures. This article summarizes these features of PsA as well as current knowledge on the instruments available for the assessment of these domains.
Objective: To describe the social status and health-related quality of life of patients with psoriatic arthritis mutilans (PAM) in the Nordic countries. Method: Patients with at least one mutilated joint confirmed by radiology were studied. Disease activity involving joints and skin, physician-assessed disease activity, and patient's education and work status were recorded. Data from the 36-item Short Form Health Survey, Health Assessment Questionnaire and Dermatology Life Quality Index questionnaire were gathered and correlated with disease duration, pain, and general well-being (visual analogue scale). The controls were 58 Swedish patients with long-standing psoriatic arthritis sine PAM. Results: Sixty-seven patients were included. Patients with PAM had a protracted disease history (33 ± 14 years) and disease onset at a relatively early age (30 ± 12 years). Overall inflammatory activity at inclusion was mild to moderate. The mean number of mutilated joints was 8.2 and gross deformity was found in 16% of patients. Forty per cent were treated with biological and 32% with conventional synthetic disease-modifying anti-rheumatic drugs. Forty-two per cent had retired early or were on sick leave. Impaired functional capacity with little or no ability to perform self-care or everyday tasks was reported by 21% of the patients. Patients between 45 and 60 years of age reported the most impaired quality of life in comparison to the control group. Conclusion: PAM seriously affects social functioning. Whether early recognition of PAM and new forms of therapy can improve disease outcome and quality of life remains to be studied.