Psoriasis severity in PsA 'mostly mild,' still detrimental to health-related QoL
Click Here to Manage Email Alerts
Psoriasis is “mostly mild” in patients with psoriatic arthritis yet still impacts quality of life when measured using a dermatology-specific questionnaire, according to data published in Rheumatology.
“Because mild psoriasis in PsA patients may respond well to the applied DMARD treatment, assessment of psoriasis may not always be a priority for rheumatologists in daily practice,” Fazira R. Kasiem, MD, of Erasmus Medical Center, in Rotterdam, Netherlands, and colleagues wrote. “To date, the extent of psoriasis involvement and its impact on [health-related quality of life (HRQoL)] within PsA patients is not completely understood.”
To examine psoriasis in patients with PsA during the first year of follow-up and analyze whether its impact on health-related quality of life can be measured with a dermatology-specific questionnaire, Kasiem and colleagues studied data from the Dutch Southwest Early Psoriatic Arthritis (DEPAR) cohort. According to the researchers, DEPAR includes newly diagnosed patients with PsA who receive usual care. Focusing on data between July 2013 and March 2020, the researchers included a total of 644 patients from the cohort.
For their study, Kasiem and colleagues measured psoriasis severity using the Psoriasis Area and Severity Index (PASI), with dermatology-specific HRQoL assessed with the Skindex-17 questionnaire. According to the researchers, this questionnaire includes 17 questions that patients answer on a 5-point Likert scale. To illustrate psoriasis severity throughout the first year of follow-up, the researchers used a Sankey diagram.
In addition, the researchers performed a linear regression analysis, with hierarchical variable selection, and a zero-inflated negative binominal regression analysis to assess the association between psoriasis severity and the symptoms, as well as the psychosocial subscale of the Skindex-17, respectively.
According to the researchers, 17% of the included patients demonstrated no psoriasis (PASI = 0), while 71% had mild cases (PASI < 7), 9% were moderate (PASI =7-12) and 4% were severe (PASI > 12). Psoriasis severity remained largely stable during the first year of follow-up, they added. Lastly, PASI was “significantly associated” with both subscales of the Skindex-17 questionnaire at baseline and 1 year, the researchers wrote.
“Psoriasis severity in PsA patients is mostly mild but impacts HRQoL when measured using a dermatology-specific HRQoL questionnaire,” Kasiem and colleagues wrote. “For optimal management of PsA patients, we therefore recommend rheumatologists to additionally acquire information on the degree of psoriatic involvement and not merely ask patients about their general well-being. In our opinion, this information is valuable for the adequate assessment of HRQoL.”
Collapse
Click Here to Manage Email Alerts