Does Skin Involvement Influence PsA Severity?
A recent study found that psoriatic arthritis (PsA) involving both the skin and joints was associated with more severe disease state and worse patient reported outcomes compared with those with only joint involvement.
The retrospective study included 1201 patients with PsA treated by 410 rheumatologists who were enrolled in the 4th quarter of the 2015 Adelphi PsA disease Specific Programme, a cross-sectional survey of rheumatologists and their PsA patients from the USA and Europe. Participants were stratified based on joint and skin involvement, determined using physician-reported assessments, to investigate the associations between PsA severity and clinical outcomes, patient and physician reported outcomes, and healthcare resource utilization.
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The majority of participants (80.9%) with documented skin involvement had both joint and active skin involvement, more severe global clinical profiles, significantly worse patient global assessment scores, and higher healthcare resource utilization. Additionally, clinical symptom severity positively correlated with skin severity. Compared with participants without active skin involvement, participants with skin involvement had higher levels of pain, a greater number of concomitant conditions, and a higher number of PsA symptoms overall, with a greater percentage of these participants experiencing morning stiffness, pain on movement, and fatigue. However, physician global assessment scores of participants with active skin and joint involvement were not significantly different from those with only joint involvement.
“These results indicate that treating skin involvement should be considered along with treating joint involvement in patients with PsA,” the researchers concluded. They suggested dermatologists and rheumatologists manage the care of patients with PsA together.
Reference:
de Vlam K, Merola JF, Birt JA, et al. Skin involvement in psoriatic arthritis worsens overall disease activity, patient-reported outcomes, and increases healthcare resource utilization: an observational, cross-sectional study [published online July 6, 2018]. Rheumatol Ther. doi:10.1007/s40744-018-0120-8