November 24, 2015
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Patients, physicians emphasize pain, function over skin conditions when evaluating psoriatic arthritis

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Patients and rheumatologists place more emphasis on pain and functional activity compared with skin symptoms when measuring the global status of psoriatic arthritis, according to research presented at the American College of Rheumatology Annual Meeting.

Researchers assessed the agreement between patient and physician global assessment (GA) of disease activity and compared the correlation of the two with the Psoriasis Area and Severity Index (PASI) in patients with psoriatic arthritis treated with Remicade (infliximab, Janssen).

Researchers used BioTRAC, an ongoing, prospect of registry of patients beginning treatment for rheumatoid arthritis, ankylosing spondylitis or psoriatic arthritis with infliximab or Simponi (golimumab, Janssen) as first biologics or having been treated with a biologic for less than 6 months. Patients treated with infliximab who enrolled in the registry between 2005 and 2012 were eligible for the analysis.

Ninety-two patients (mean age, 48.7 years; 52.2% male) with a mean disease duration of 6.8 years were included in the analysis. Mean disease parameters at baseline were PASI, 3.3; swollen joint count, 4; tender joint count, 5.9; patient GA, 5; and physician GA, 5.8 cm.

A traditional disease-modifying antirheumatic drug was used as treatment for 84.8% of patients prior to infliximab treatment.

There was a strong agreement between patient GA and physician GA overall (r = 0.632).

“The correlation of PASI with [patient] GA was low (r = 0.213), whereas it was moderate with [physician] GA (r = 0.343),” the researchers wrote. “Overall, internal consistency was poor between PASI and [patient] GA and [physician] GA although it was higher with the latter.”

There was a stronger association of physician GA with PASI using multivariate liner regression, which excluded patient GA from the model. There was a very strong correlation with pain (r = 0.885) and a strong correlation with [health assessment questionnaire-disability index] (r = 0.596) associated with patient GA and a strong correlation of pain (r = 0.652) and [health assessment questionnaire-disability index] (r = 0.52) with physician GA.

“The results of this analysis show that the association of PASI is strong with [physician] GA when compared with [patient] GA,” the researchers concluded. – by Bruce Thiel

 

Reference:

Sholter D, et al. Abstract 702. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.

 

Disclosures: Sholter reports financial ties with Janssen.