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

Philip J. Mease, Carol J. Etzel, William J. Huster, Talia M. Muram, April W. Armstrong, Jeffrey R. Lisse, Sabrina Rebello, Rhiannon Dodge, Mwangi James Murage, Jeffrey D. Greenberg, William N. Malatestinic

Research output: Contribution to journalArticle

Abstract

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 (χ 2 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.

Original languageEnglish (US)
Article numbere000867
JournalRMD Open
Volume5
Issue number1
DOIs
StatePublished - May 1 2019
Externally publishedYes

Fingerprint

Psoriatic Arthritis
Registries
Skin
Body Surface Area
Joints
Insurance Coverage
Nails
Visual Analog Scale
Fatigue
Linear Models
Pain

Keywords

  • disease activity
  • outcomes research
  • psoriatic arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis : Experience from the Corrona Registry. / Mease, Philip J.; Etzel, Carol J.; Huster, William J.; Muram, Talia M.; Armstrong, April W.; Lisse, Jeffrey R.; Rebello, Sabrina; Dodge, Rhiannon; Murage, Mwangi James; Greenberg, Jeffrey D.; Malatestinic, William N.

In: RMD Open, Vol. 5, No. 1, e000867, 01.05.2019.

Research output: Contribution to journalArticle

Mease, PJ, Etzel, CJ, Huster, WJ, Muram, TM, Armstrong, AW, Lisse, JR, Rebello, S, Dodge, R, Murage, MJ, Greenberg, JD & Malatestinic, WN 2019, 'Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: Experience from the Corrona Registry', RMD Open, vol. 5, no. 1, e000867. https://doi.org/10.1136/rmdopen-2018-000867
Mease, Philip J. ; Etzel, Carol J. ; Huster, William J. ; Muram, Talia M. ; Armstrong, April W. ; Lisse, Jeffrey R. ; Rebello, Sabrina ; Dodge, Rhiannon ; Murage, Mwangi James ; Greenberg, Jeffrey D. ; Malatestinic, William N. / Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis : Experience from the Corrona Registry. In: RMD Open. 2019 ; Vol. 5, No. 1.
@article{56f9e2e4c6f54aa38aaec44f6330439f,
title = "Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: Experience from the Corrona Registry",
abstract = "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 (χ 2 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.",
keywords = "disease activity, outcomes research, psoriatic arthritis",
author = "Mease, {Philip J.} and Etzel, {Carol J.} and Huster, {William J.} and Muram, {Talia M.} and Armstrong, {April W.} and Lisse, {Jeffrey R.} and Sabrina Rebello and Rhiannon Dodge and Murage, {Mwangi James} and Greenberg, {Jeffrey D.} and Malatestinic, {William N.}",
year = "2019",
month = "5",
day = "1",
doi = "10.1136/rmdopen-2018-000867",
language = "English (US)",
volume = "5",
journal = "RMD Open",
issn = "2056-5933",
publisher = "BMJ Publishing Group",
number = "1",

}

TY - JOUR

T1 - Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis

T2 - Experience from the Corrona Registry

AU - Mease, Philip J.

AU - Etzel, Carol J.

AU - Huster, William J.

AU - Muram, Talia M.

AU - Armstrong, April W.

AU - Lisse, Jeffrey R.

AU - Rebello, Sabrina

AU - Dodge, Rhiannon

AU - Murage, Mwangi James

AU - Greenberg, Jeffrey D.

AU - Malatestinic, William N.

PY - 2019/5/1

Y1 - 2019/5/1

N2 - 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 (χ 2 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.

AB - 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 (χ 2 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.

KW - disease activity

KW - outcomes research

KW - psoriatic arthritis

UR - http://www.scopus.com/inward/record.url?scp=85066095990&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066095990&partnerID=8YFLogxK

U2 - 10.1136/rmdopen-2018-000867

DO - 10.1136/rmdopen-2018-000867

M3 - Article

AN - SCOPUS:85066095990

VL - 5

JO - RMD Open

JF - RMD Open

SN - 2056-5933

IS - 1

M1 - e000867

ER -