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Clinical Characteristics, Disease Activity, and Patient‐Reported Outcomes in Psoriatic Arthritis Patients With Dactylitis or Enthesitis: Results From the Corrona Psoriatic Arthritis/Spondyloarthritis Registry
Author(s) -
Mease Philip J.,
Karki Chitra,
Palmer Jacqueline B.,
Etzel Carol J.,
Kavanaugh Arthur,
Ritchlin Christopher T.,
Malley Wendi,
Herrera Vivian,
Tran Melody,
Greenberg Jeffrey D.
Publication year - 2017
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23249
Subject(s) - dactylitis , enthesitis , medicine , psoriatic arthritis , physical therapy , disease , psoriasis , dermatology
Objective To characterize psoriatic arthritis (PsA) patients with dactylitis or enthesitis and evaluate the associations of these manifestations with disease activity and patient‐reported outcomes. Methods Using the Corrona PsA/Spondyloarthritis Registry, patient characteristics, disease activity, and patient‐reported outcomes at registry enrollment were assessed for PsA patients ages ≥18 years with or without dactylitis or enthesitis. Regression models were used to evaluate associations of dactylitis and enthesitis with outcomes, including minimal disease activity, Health Assessment Questionnaire scores, patient‐reported pain and fatigue, and work productivity (Work Productivity and Activity Impairment questionnaire). Adjustments were made for age, sex, race, body mass index, disease duration, and history of biologic agent, disease‐modifying antirheumatic drug, and prednisone use. Results This analysis included 1,567 PsA patients (420 with enthesitis; 228 with dactylitis). Patients with versus without dactylitis or enthesitis had greater disease activity and were less likely to be in minimal disease activity ( P < 0.05). Patients with versus without enthesitis had poorer functional status as assessed by the Health Assessment Questionnaire (adjusted P = 4.15 x 10 −5 ), greater patient‐reported pain and fatigue (adjusted P < 0.0001), and greater likelihood of any impairment while working (adjusted odds ratio [ OR ] 1.57, P = 0.027), overall work impairment ( OR 1.85, P = 0.006), and activity impairment ( OR 1.77, P = 0.008). Dactylitis was associated with similar numerical trends, but differences versus patients without dactylitis did not reach statistical significance. Conclusion Enthesitis and dactylitis are associated with greater overall disease burden of PsA, underscoring the importance of identifying, assessing, and effectively managing these periarticular manifestations.