A new integral enthesial-comorbididity index of psoriatic arthritis activity
- Authors: Korsakova Y.L.1, Korotaeva T.V.1, Loginova E.Y.1, Gubar E.E.1, Vorobyeva L.D.1, Glukhova S.I.1, Nasonov E.L.1,2
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Affiliations:
- Nasonova Research Institute of Rheumatology
- Sechenov First Moscow State Medical University (Sechenov University)
- Issue: Vol 95, No 5 (2023)
- Pages: 404-409
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/132957
- DOI: https://doi.org/10.26442/00403660.2023.05.202197
- ID: 132957
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Abstract
Aim. To develop an integral index of psoriatic arthritis (PsA) activity.
Materials and methods. 117 patients with PsA (M/F – 63/54) were included. Patients’ age 44±11 years, psoriasis (Ps) duration – 213±153 months, PsA duration – 73.4±78.5 months. Patients underwent standard clinical examination of PsA activity: tender (out of 68) and swollen (out of 66) joint counts (TJC, SJC), LEI, tenderness of the plantar fascia (PF), skin lesion severity (BSA), presence of nail Ps, body mass index (BMI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), DAPSA, FACIT-F. Parametric and nonparametric statistic methods, correlation and ROC analysis were used.
Results. Mean DAPSA was 38±21, TJC – 14.2±10.6, SJC – 10.6±8.3, ESR – 30.5±29.5 mm/h, CRP – 23.3±29 mg/l, LEI – 1.2±1.5, FACIT-F – 32±11, BMI – 27.4±6.2 kg/m2. The following significant positive correlations were revealed: between DAPSA and BMI, patients’ age, ESR, PsA and Ps duration, TJC, SJC, LEI, presence of PF enthesitis, skin lesion severity, presence of nail Ps. A negative correlation between FACIT-F and male sex was found. Based on the predictive model of parameters, the Entesial-Comorbid Index of PsA (ECIPsA) was created: 3.81×LEI+13.72×PF+0.54×Age-0.25×FACIT-F+7.36×BSA+7.94×PsA duration+5.5×Nail Ps+0.32×BMI-3.52, namely LEI – Leeds Enthesial Index; PF – pain in the PF; patient’s age; FACIT-F – fatigue scale; BSA<3%=0, ≥3%=1; PsA duration≤2 years=0, >2 years=1; presence of nail Ps=1, absence=0; ECIPsA≥28 corresponds with high PsA activity according to DAPSA≥28. ROC analysis of sensitivity and specificity of the prognostic model demonstrated high correctness of the index: the area under the ROC curve was 0.768, 95% confidence interval (0.624–0.913).
Conclusion. The new PsA activity index corresponds to the existing ones and takes into consideration the clinical heterogeneity and comorbidity of the disease.
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##article.viewOnOriginalSite##About the authors
Yulia L. Korsakova
Nasonova Research Institute of Rheumatology
Author for correspondence.
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0001-5968-2403
кандидат медицинских наук, старший научный сотрудник лаборатории псориатического артрита
Russian Federation, MoscowTatiana V. Korotaeva
Nasonova Research Institute of Rheumatology
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0003-0579-1131
доктор медицинских наук, начальник отд. Спондилоартритов
Russian Federation, MoscowElena Yu. Loginova
Nasonova Research Institute of Rheumatology
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0001-6875-4552
кандидат медицинских наук, старший научный сотрудник лаборатории псориатического
Russian Federation, MoscowElena E. Gubar
Nasonova Research Institute of Rheumatology
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0001-5015-7143
кандидат медицинских наук, научный сотрудник лаборатории псориатического артрита
Russian Federation, MoscowLyubov D. Vorobyeva
Nasonova Research Institute of Rheumatology
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0001-8626-8419
кандидат медицинских наук, младший научный сотрудник лаборатории псориатического артрита
Russian Federation, MoscowSvetlana I. Glukhova
Nasonova Research Institute of Rheumatology
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0002-4285-0869
кандидат физ.-мат. наук, старший научный сотрудник лаборатории эволюции ревматоидного артрита
Russian Federation, MoscowEvgeny L. Nasonov
Nasonova Research Institute of Rheumatology; Sechenov First Moscow State Medical University (Sechenov University)
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0002-1598-8360
академик РАН, доктор медицинских наук, профессор научный рук. ФГБНУ «НИИ ревматологии имени В.А. Насоновой», заведующий кафедрой ревматологии ФГБОУ ВО СибГМУ
Russian Federation, Moscow; MoscowReferences
- FitzGerald O, Ogdie A, Chandran V, et al. Psoriatic arthritis. Nat Rev Dis Primers. 2021;7(1):59. doi: 10.1038/s41572-021-00293-y
- Gupta S, Syrimi Z, Hughes DM, Zhao SS. Comorbidities in psoriatic arthritis: asystematic review and meta-analysis. Rheumatol Int. 2021;41(2):275-84. doi: 10.1007/s00296-020-04775-2
- Coates LC, Merola JF, Mease PhJ, et al. Performance of composite measures used in a trial of etanercept and methotrexate as monotherapy or in combination in psoriatic arthritis. Rheumatol. 2021;60:1137-47. doi: 10.1093/rheumatology/keaa271
- Farkas F, Ikumi N, Elmamoun M, et al. Comparison of Composite Measure Remission Targets in Psoriatic Arthritis. J Rheumatol. 2021;48(8):1272-8. doi: 10.3899/jrheum.200556
- Wervers K, Luime JJ, Tchetverikov I, et al. Comparison of disease activity measures in early psoriatic arthritis in usual care. Rheumatol (Oxford). 2019;58(12):2251-9. doi: 10.1093/rheumatology/kez215
- Mumtaz A, Gallagher P, Kirby B, et al. Development of a preliminary composite disease activity index in psoriatic arthritis. Ann Rheum Dis. 2011;70:272-7. doi: 10.1136/ard.2010.129379
- Helliwell P, FitzGerald O, Fransen J, et al. The development of candidate composite disease activity and responder indices for psoriatic arthritis (GRACE project). Ann Rheum Dis. 2013;72(2):986-91.
- Helliwell PJ, Coates LC, FitzGerald O, et al. Disease-specific composite measures for psoriatic arthritis are highly responsive to a Janus kinase inhibitor treatment that targets multiple domains of disease. Arthritis Res Ther. 2018;20(1):242. doi: 10.1186/s13075-018-1739-0
- Kumthekar A, Ogdie A. Obesity and Psoriatic Arthritis: A Narrative Review. Rheumatol Ther. 2020;7:447-56. doi: 10.1007/s40744-020-00215-6
- Ulus Y, Akyol Y, Bilgici1 A, Kuru O. The impact of the presence of fibromyalgia on fatigue in patients with psoriatic arthritis: comparison with controls. Advances Rheumatol. 2020;60:1. doi: 10.1186/s42358-019-0104-6
- Li Sh-Sh, Du N, He Shi-H, et al. Exploring the Association Between History of Psoriasis (PSO) and Disease Activity in Patients with Psoriatic Arthritis (PsA). Rheumatol Ther. 2022;9(4):1079-90. doi: 10.1007/s40744-022-00455-8
- Fragoulis GE, Nikiphorou E, McInnes IB, Siebert S. Does Age Matter in Psoriatic Arthritis? A Narrative Review. J Rheumatol. 2022;49(10):1085-91. doi: 10.3899/jrheum.210349
- Coates LC, Moverley AR, McParland L, et al. Effect of Tight Control of Inflammation in Early Psoriatic Arthritis (TICOPA): A UK Multicentre, Open-Label, Randomised Controlled Trial. Lancet. 2015;386(10012):2489-98. doi: 10.1016/S0140-6736(15)00347-5
- Коротаева Т.В., Логинова Е.Ю., Гетия Т.С., Насонов Е.Л. Результаты применения стратегии «Лечение до достижения цели» у больных ранним псориатическим артритом через 1 год после начала терапии: данные исследования РЕМАРКА. Терапевтический архив. 2018;90(5):22-9 [Korotaeva TV, Loginova EYu, Getiya TS, Nasonov E.L. Results of one-year treat-to-target strategy in early psoriatic arthritis: data of an open-label REMARCA study. Terapevticheskii Arkhiv (Ter. Arkh.). 2018;90(5):22-9 (in Russian)]. doi: 10.26442/terarkh201890522-29
- Schoels MM, Aletaha D, Alasti F, Smolen JS. Disease activity in psoriatic arthritis (PsA): defining remission and treatment success using the DAPSA score. Ann Rheum Dis. 2016;75(5):811. doi: 10.1136/annrheumdis-2015-207507
- Coates LC, Soriano ER, Corp N, et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021. Nat Rev Rheumatol. 2022;18(8):465-79. doi: 10.1038/s41584-022-00798-0
- Landewe RM, van der Heijde D. Use of multidimensional composite scores in rheumatology: parsimony versus subtlety. Ann Rheum Dis. 2021;80:280-5. doi: 10.1136/annrheumdis-2020-216999
- Chandran V, Bhella S, Schentag C, Gladman D. Functional assessment of chronic illness therapy-fatigue scale is valid in patients with psoriatic arthritis. Ann Rheum Dis. 2007;66(7):936-9. doi: 10.1136/ard.2006.065763
- Gossec L, Baraliakos X, Kerschbaumer A, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis. 2020;79:700-12. doi: 10.1136/annrheumdis-2020-217159
- Sunar I, Ataman S, Nas K, et al. Enthesitis and its relationship with disease activity, functional status, and quality of life in psoriatic arthritis: a multi-center study. Rheumatol Int. 2020;40(2):283-94. doi: 10.1007/s00296-019-04480-9
- Eder L, Farrer C, Jerome D. Is Enthesitis a Marker of Disease Severity in Early Psoriatic Arthritis? Arthritis Rheumatol. 2018;70(10). Available at: https://acrabstracts.org/abstract/is-enthesitis-a-marker-of-disease-severity-in-early-psoriatic-arthritis/ Accessed: 05.09.2022.
- Mease PJ, Etzel CJ, Huster WJ, et al. Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: experience from the Corrona Registry. RMD Open. 2019;5:e000867. doi: 10.1136/rmdopen-2018-000867
- Губарь Е.Е., Корсакова Ю.Л., Логинова Е.Ю., и др. Поражение ногтей при псориатическом артрите. Данные общероссийского регистра. Научно-практическая ревматология. 2021;59(5):563-70 [Gubar EE, Korsakova YuL, Loginova EYu, et al. Nail disease in psoriatic arthritis. Data from the Russian Psoriatic Arthritis Registry. Rheumatology Science and Practice. 2021;59(5):563-70 (in Russian)]. doi: 10.47360/1995-4484-2021-563-570
- Mease PJ, Liu M, Rebello S, et al. Association of Nail Psoriasis With Disease Activity Measures and Impact in Psoriatic Arthritis: Data From the Corrona Psoriatic Arthritis/Spondyloarthritis Registry. J Rheumatol. 2021;48(4):520-6. doi: 10.3899/jrheum.19092
- Reich K, Sullivan J, Arenberger P, et al. Effect of secukinumab on the clinical activity and disease burden of nail psoriasis: 32-week results from the randomized placebo-controlled TRANSFIGURE trial. Br J Dermatol. 2019;181(5):954-66. doi: 10.1111/bjd.17351
- Gulati AM, Semb AG, Rollefstad S, et al. On the HUNT for cardiovascular risk factors and disease in patients with psoriatic arthritis: population-based data from the Nord-Trøndelag Health Study. Ann Rheum Dis. 2016;75(5):819-24. doi: 10.1136/annrheumdis-2014-206824
- Haroon M, FitzGerald O. Psoriatic arthritis: complexities, comorbidities and implications for the clinic. Expert Rev Clin Immunol. 2016;12(4):405-16. doi: 10.1586/1744666X.2016.1139453
- di Minno MN, Peluso R, Iervolino S, et al. Obesity and the prediction of minimal disease activity: a prospective study in psoriatic arthritis. Arthritis Care Res. 2013;65(1):141-7. doi: 10.1002/acr.21711
- Корсакова Ю.Л., Коротаева Т.В., Логинова Е.Ю., и др. Взаимосвязь ожирения, кардиометаболических нарушений и активности заболевания у больных псориатическим артритом: данные Общероссийского регистра. Терапевтический архив. 2021;93(5):573-80 [Korsakova YuL, Korotaeva TV, Loginova EIu, et al. The relationship between obesity, cardiometabolic disorders and disease activity in psoriatic arthritis patients: data from the Russian register. Terapevticheskii Arkhiv (Ter. Arkh.). 2021;93(5):573-80 (in Russian)]. doi: 10.26442/00403660.2021.05.200789
- Korsakova Y, Gubar E, Loginova E, et al. The impact of number of comorbidities on achievement remission or low disease activity by DAPSA in psoriatic arthritis. Data from the Russian observational cohort. Ann Rheum Dis. 2022;81(1):871. doi: 10.1136/annrheumdis-2022-eular.3308
- Корсакова Ю.Л., Логинова Е.Ю., Коротаева Т.В., и др. Бремя прогрессирования псориатического артрита. Данные общероссийского регистра. Терапевтический архив. 2022;94(5):622-7 [Korsakova YuL, Loginova EYu, Korotaeva TV, et al. The burden of progression of psoriatic arthritis. All-Russian register data. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(5):622-7 (in Russian)]. doi: 10.26442/00403660.2022.05.201506
- Gossec L, Walsh JA, Michaud K, et al. Impact of Fatigue on Health-Related Quality of Life and Work Productivity in Psoriatic Arthritis: Findings From a Real-World Survey. J Rheumatol. 2022. doi: 10.3899/jrheum.211288.