Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.


Comparison Between Psoriasis and Psoriatic Arthritis in An International Cohort.

Gladman1,  Dafna D., Ayearst2,  Renise, Chandran2,  Vinod, Dutz3,  Jan P., Elder4,  John T., Ritchlin5,  Christopher, Rosen2,  Cheryl

Toronto Western Hospital, University of Toronto, Toronto, ON
Toronto Western Hospital and University of Toronto, Toronto, ON
Univ of BC, Vancouver, BC
University of Michigan, Ann Arbor
University of Rochester, Rochester, NY
St. Claires Mercy Hospital, St. Johns, NF

Background/Purpose:

Genetic and longitudinal data on psoriasis and psoriatic arthritis patients will provide essential information regarding pathogenesis, risk factors and disease outcomes in these relatively prevelant and related disorders. We therefore established collaboration among several groups from Canada and the United States with the support of a New Emerging Team (NET) grant from the Canadian Institutes of Health Research (CIHR) in 2008. The overall goal of this research network is to improve outcomes for patients with psoriasis and PsA. A central aim of the initiative is to compare the clinical features in patients with psoriasis without arthritis (PsC) and patients with psoriatic arthritis (PsA) included in the database.

Methods:

A central component of the NET is that aRheumatologists collaborates with a dermatologist at each site. Five sites formed the core group, including 3 sites in Canada and 2 in the USA, and subsequently 3 other Canadian sites, and sites in Australia and Argentina were added. A web-based database was developed that includes a physician, patient and an investigation component. The physician component includes a complete history, general physical examination and detailed musculoskeletal and skin examinations. All investigators and assessors were trained with proper assessments tools as well as database structure. The patient component includes 8 instruments including the HAQ, SF-36, DLQI, fatigue severity scale, FACIT-fatigue, ASQoL, BASDAI, BASFI and a patient global assessment of disease activity (PGA). Laboratory information includes routine tests, rheumatoid factor, antinuclear factor and radiographs. PsC as well as PsA pts are recruited in each site. Descriptive statistics, t tests and chi square tests were used to analyze the data.

Results:

To date, the IPART database has accumulated 2649 patients of whom 1847 have PsA and 802 have psoriasis without arthritis. A comparison between patients with PsA and patients with psoriasis uncomplicated by arthritis demonstrated that patients with psoriasis had longer disease duration compared to PsA (17 vs 15 years p=0.03) while patients with PsA had higher PASI scores (6.4 vs 5.7, p=0.02) and more frequent nail involvement (68.4% vs 48.2% p<0.001). While hyperlipidemia was more common among patients with psoriasis (19.1% vs 14.5%, p<0.001), hypertension was more common among patients with PsA (30.1% vs 24.1%, p<0.001). Depression was slightly more prevalent among patients with psoriasis than those with PsA. No statistically significant differences in the prevalence of diabetes, cardiovascular morbidity, or cancer was noted between the two groups.

Conclusion:

An international web based database has been established to follow patients with psoriasis and PsA. Several demographic and disease related differences between patients with psoriasis and those with PsA were observed. This program will allow for the identification of patients with PsA early stages, and will provide detailed skin and joint phenotypes, outcome data and essential ascertainment data for genetic and biomarker studies.

To cite this abstract, please use the following information:
Gladman, Dafna D., Ayearst, Renise, Chandran, Vinod, Dutz, Jan P., Elder, John T., Ritchlin, Christopher, et al; Comparison Between Psoriasis and Psoriatic Arthritis in An International Cohort. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1332
DOI:

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