AB0818 SKIN INVOLVEMENT IN PSORIATIC ARTHRITIS (PsA) - THE INCREMENTAL IMPACT OF PSORIASIS ON QUALITY OF LIFE, DISABILITY AND WORK PRODUCTIVITY: REAL-WORLD SURVEY IN US AND EUROPE
Authors: J. A. Walsh, A. Ogdie, K. Michaud, S. Peterson, E. Holdsworth, S. Bruce Wirta, S. Meakin, S. D. Chakravarty, A. Schubert, L. Gossec
Journal: Annals of the Rheumatic Diseases (2020)

Background: PsA involves joint and skin symptom presentation that varies across patients. Differences in patients outcomes with joint only, and joint and skin involvement have not been extensively studied in a real-world setting. Objectives: To assess prevalence of joint only, and joint and skin disease in a real-world clinical setting, and to assess incremental impact of skin symptoms on quality of life (QoL), disability and work productivity. Methods: A cross-sectional survey in patients with PsA recruited by rheumatologists and dermatologists was conducted in France, Germany, Italy, Spain, UK and US. Data were collected Jun-Aug 2018 via physician-completed patient record forms and patient self-completed forms. Patients were compared by joint and skin involvement using parametric and non-parametric tests. Multiple linear regression analyses examined impact of incremental body surface area (BSA) on patient reported outcomes (PROs). Models controlled for gender, age, time since diagnosis, employment status, biologic DMARD use, BMI, number of joints affected. Results: Of 1,909 patients (539 US, 1,370 EU), 35% of patients had joint only disease, while 26%, 23%, and 16% experienced joint disease plus 1-3%, &gt;3-10%, and &gt;10% BSA respectively (Figure 1). Patients were comparable demographically (Table 1). After controlling for demographics and number of joints involved, results showed BSA independently and significantly impacted QoL, work productivity, disability (Table 2). Table 1. Comparison of patient demographic and disease characteristics by joint and skin disease involvement Joints only (n=673 ) 1-3% (n=493 ) &gt;3-10% (n=447 ) &gt;10% (n=296 ) p-value Age, mean (SD) 49.2 (13.7) 49.2 (13.2) 47.6 (12.4) 47.6 (13.8) 0.09 Male, n (%) 379 (56.3) 260 (52.7) 248 (55.5) 155 (52.4) 0.53 BMI, mean (SD) 26.9 (4.9) 26.8 (4.6) 26.7 (4.2) 26.5 (4.7) 0.52 Caucasian, n (%) 621 (92.3) 442 (89.7) 399 (89.3) 270 (91.2) 0.41 Full-time employment, n (%) 391 (60.9) 275 (57.7) 259 (59.1) 153 (53.1) 0.01 Biologic tx, n (%) 420 (62.4) 283 (57.4) 218 (48.8) 141 (47.6) &lt;0.01 Months since diagnosis, mean (SD) 68.4 (76.2) 56.7 (68.2) 54.2 (67.3) 52.1 (75.1) &lt;0.01 Current BSA %, mean (SD) 0.0 1.7 (0.8) 6.3 (2.0) 21.3 (10.1) &lt;0.01 *66 swollen joint count, mean (SD) 1.5 (3.6) 2.1 (4.2) 7.1 (11.1) 6.9 (10.5) &lt;0.01 *68 tender joint count, mean (SD) 2.1 (4.1) 3.7 (6.4) 6.0 (7.7) 9.8 (10.0) &lt;0.01 *Calculated on available data, n=394 Table 2. Incremental impact of BSA on PROs BSA in addition to joint involvement Change in predicted PRO values P value EQ5D utility (n=656) Joint only (ref) 0.85 1-3% -0.02 0.31 &gt;3-10% -0.06 &lt;0.01 &gt;10% -0.06 &lt;0.01 EQ5D VAS (n=668) Joint only 78.14 0.74 1-3% -0.58 0.03 &gt;3-10% -3.78 0.14 &gt;10% -3.04 WPAI % overall work impairment (n=369) Joint only 15.88 0.91 1-3% +0.32 &lt;0.05 &gt;3-10% +5.11 0.01 &gt;10% +7.51 HAQ-DI (n=635) Joint only 0.32 0.41 1-3% +0.04 &lt;0.01 &gt;3-10% +0.22 &lt;0.01 &gt;10% +0.27 PsAID12 (n=642) Joint only 1.66 0.03 1-3% +0.42 &lt;0.01 &gt;3-10% +1.22 &lt;0.01 &gt;10% +1.37 α PRO key for worse outcome (range): EQ5D utility (0-1.0) = lower; EQ5D VAS (1-100) = lower; WPAI (0-100) = higher; HAQ-DI (0-3) = higher; PsAID12 (0-10) = higher Conclusion: Two thirds of this sample of actively treated PsA patients have skin involvement. Over half would be considered moderate-severe (BSA &gt;3%). After controlling for joint symptoms, results show that increasing skin involvement in PsA patients adversely impacts QoL, disability and work productivity. Disclosure of Interests: Jessica A. Walsh Grant/research support from: AbbVie, Pfizer, Janssen, Consultant of: AbbVie, Novartis, Eli Lilly and Company, UCB, Alexis Ogdie Grant/research support from: Pfizer to Penn, Novartis to Penn, Amgen to Forward/NDB, Consultant of: Abbvie, Amgen, Bristol-Myers Squibb, Celgene, Corrona, Janssen, Eli Lilly, Novartis, Pfizer, Kaleb Michaud Grant/research support from: Janssen, Steve Peterson Employee of: Janssen Research &amp; Development, LLC, Elizabeth Holdsworth Employee of: Adelphi Real World, Sara Bruce Wirta Employee of: Janssen-Cilag Sweden AB, Sophie Meakin Employee of: Adelphi Real World, Soumya D Chakravarty Shareholder of: Johnson &amp; Johnson, Employee of: Janssen Scientific Affairs, LLC, Agata Schubert Employee of: Janssen-Cilag, Laure Gossec Grant/research support from: Lilly, Mylan, Pfizer, Sandoz, Consultant of: AbbVie, Amgen, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sandoz, Sanofi-Aventis, UCB