Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: experience from the Corrona Registry

Objective To compare the characteristics of patients with psoriatic arthritis among patient groups stratified by degree of skin and joint involvement, and to evaluate the relationship between skin severity and joint activity.Methods Body surface area (BSA) and Clinical Disease Activity Index (CDAI)...

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Main Authors: Philip J Mease, Jeffrey D Greenberg, Carol J Etzel, William J Huster, Talia M Muram, April W Armstrong, Jeffrey R Lisse, Sabrina Rebello, Rhiannon Dodge, Mwangi James Murage, William N Malatestinic
Format: Article
Language:English
Published: BMJ Publishing Group 2019-06-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/5/1/e000867.full
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author Philip J Mease
Jeffrey D Greenberg
Carol J Etzel
William J Huster
Talia M Muram
April W Armstrong
Jeffrey R Lisse
Sabrina Rebello
Rhiannon Dodge
Mwangi James Murage
William N Malatestinic
author_facet Philip J Mease
Jeffrey D Greenberg
Carol J Etzel
William J Huster
Talia M Muram
April W Armstrong
Jeffrey R Lisse
Sabrina Rebello
Rhiannon Dodge
Mwangi James Murage
William N Malatestinic
author_sort Philip J Mease
collection DOAJ
description Objective To compare the characteristics of patients with psoriatic arthritis among patient groups stratified by degree of skin and joint involvement, and to evaluate the relationship between skin severity and joint activity.Methods Body surface area (BSA) and Clinical Disease Activity Index (CDAI) at enrolment were analysed. Patient characteristics were stratified by skin severity and joint activity. Baseline patient characteristics, clinical and disease characteristics and patient-reported outcomes were compared. The strength of the relationship of skin severity and joint activity was evaluated using methods for categorical variables (χ2 test, Cramer’s V) and continuous variables (linear regression).Results 1542 adult patients in the Corrona Psoriatic Arthritis/Spondyloarthritis Registry enrolled between 21 May 2013 and 20 September 2016 were analysed. Most patients in the BSA >3%/CDAI moderate/high subgroup had worse clinical and patient-reported outcomes. A significant (p<0.001) modest association (Cramer’s V=0.1639) between skin severity and joint activity was observed among all patients at enrolment. Patients with higher skin severity were two times more likely to have higher joint involvement (OR 2.27, 95% CI 1.71 to 3.01). A significant linear relationship between CDAI and BSA was observed. Effect modification showed this linear relationship was modified by age, gender, insurance, work status, current therapy, Health Assessment Questionnaire, Nail visual analogue scale, minimal disease activity, dactylitis count, patient-reported pain and fatigue.Conclusion Skin severity is modestly correlated with joint activity, and patients with higher skin severity are two times more likely to have increased joint involvement. Clinicians need to address both skin severity and joint activity in treatment decisions.
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spelling doaj-art-c3c9db57b5484d3b9650d774e2d7c4832025-08-20T03:13:07ZengBMJ Publishing GroupRMD Open2056-59332019-06-015110.1136/rmdopen-2018-000867Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: experience from the Corrona RegistryPhilip J Mease0Jeffrey D Greenberg1Carol J Etzel2William J Huster3Talia M Muram4April W Armstrong5Jeffrey R Lisse6Sabrina Rebello7Rhiannon Dodge8Mwangi James Murage9William N Malatestinic104 Swedish Medical Center and University of Washington, Seattle, Washington, USADepartment of Medicine, Division of Rheumatology, New York University School of Medicine, New York, New York, USACorrona, Waltham, Massachusetts, USAEli Lilly and Company, Indianapolis, Indiana, USAEli Lilly and Company, Indianapolis, Indiana, USADepartment of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USAEli Lilly and Company, Indianapolis, Indiana, USACorrona, Waltham, Massachusetts, USACorrona, Waltham, Massachusetts, USAEli Lilly and Company, Indianapolis, Indiana, USAEli Lilly and Company, Indianapolis, Indiana, USAObjective To compare the characteristics of patients with psoriatic arthritis among patient groups stratified by degree of skin and joint involvement, and to evaluate the relationship between skin severity and joint activity.Methods Body surface area (BSA) and Clinical Disease Activity Index (CDAI) at enrolment were analysed. Patient characteristics were stratified by skin severity and joint activity. Baseline patient characteristics, clinical and disease characteristics and patient-reported outcomes were compared. The strength of the relationship of skin severity and joint activity was evaluated using methods for categorical variables (χ2 test, Cramer’s V) and continuous variables (linear regression).Results 1542 adult patients in the Corrona Psoriatic Arthritis/Spondyloarthritis Registry enrolled between 21 May 2013 and 20 September 2016 were analysed. Most patients in the BSA >3%/CDAI moderate/high subgroup had worse clinical and patient-reported outcomes. A significant (p<0.001) modest association (Cramer’s V=0.1639) between skin severity and joint activity was observed among all patients at enrolment. Patients with higher skin severity were two times more likely to have higher joint involvement (OR 2.27, 95% CI 1.71 to 3.01). A significant linear relationship between CDAI and BSA was observed. Effect modification showed this linear relationship was modified by age, gender, insurance, work status, current therapy, Health Assessment Questionnaire, Nail visual analogue scale, minimal disease activity, dactylitis count, patient-reported pain and fatigue.Conclusion Skin severity is modestly correlated with joint activity, and patients with higher skin severity are two times more likely to have increased joint involvement. Clinicians need to address both skin severity and joint activity in treatment decisions.https://rmdopen.bmj.com/content/5/1/e000867.full
spellingShingle Philip J Mease
Jeffrey D Greenberg
Carol J Etzel
William J Huster
Talia M Muram
April W Armstrong
Jeffrey R Lisse
Sabrina Rebello
Rhiannon Dodge
Mwangi James Murage
William N Malatestinic
Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: experience from the Corrona Registry
RMD Open
title Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: experience from the Corrona Registry
title_full Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: experience from the Corrona Registry
title_fullStr Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: experience from the Corrona Registry
title_full_unstemmed Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: experience from the Corrona Registry
title_short Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: experience from the Corrona Registry
title_sort understanding the association between skin involvement and joint activity in patients with psoriatic arthritis experience from the corrona registry
url https://rmdopen.bmj.com/content/5/1/e000867.full
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