Nail Involvement Leads to Poorer Outcomes in Psoriatic Arthritis

Individuals with psoriatic arthritis (PsA) with nail psoriasis had poorer quality of life and work productivity and worse disease activity than those without nail involvement, according to research that will be presented at the 2019 Annual European Congress of Rheumatology.

A limited number of real-world studies have been performed to evaluate characteristics of patients with PsA and nail psoriasis, particularly in the United States.

To investigate the impact of nail involvement, the researchers evaluated data of 2841 individuals with PsA enrolled in the Corrona Psoriatic Arthritis and Spondyloarthritis (PsA/SpA) Registry between March 2013 and October 2018.

Participants were stratified for analyses based on the presence of nail psoriasis (n=1152) and absence of nail psoriasis (n=1689) at enrollment.

Individuals with nail psoriasis had more severe psoriasis and PsA disease activity, evident by the increased body surface area affected by psoriasis, a higher number of tender and swollen joints, decreased likelihood of minimal disease activity, worse mean values on the Disease Activity index for Psoriatic Arthritis and Psoriatic Arthritis Disease Activity Score, and increased likelihood of having enthesitis and dactylitis at enrollment.

Results of descriptive analyses showed similar demographic and clinical characteristics between individuals with and without nail psoriasis. However, individuals with nail psoriasis were younger (53.1 years vs 54.4 years), were more likely to be men (51.9% vs 44.1%), and were more likely to have a history of depression (17.8% vs 13.3%) compared with those without nail psoriasis.

Individuals with nail psoriasis also had worse self-reported physical function, pain, and work and activity impairment.

“These findings emphasize the importance of identification and management of nail disease in patients with PsA,” the researchers concluded.

—Melinda Stevens

Reference:

Mease PJ, Hur P, Liu M, et al. Characterization of patients with psoriatic arthritis and nail psoriasis: data from the Corrona Psoriatic Arthritis/Spondyloarthritis (PSA/SPA) Registry [EULAR SAT0388]. Ann Rheum Dis. 2019;78(suppl 2):A1278. http://scientific.sparx-ip.net/archiveeular/index.cfm?c=a&searchfor=SAT0388&view=1&item=2019SAT0388. Accessed June 6, 2019.