AB0783 THE IMPACT OF SKIN ITCHING ON HEALTH RELATED QUALITY OF LIFE IN PSORIATIC ARTHRITIS OUTPATIENT CLINIC PATIENTS
Authors: G. Haugeberg, A. Kavanaugh, B. Michelsen
Journal: Annals of the Rheumatic Diseases (2020)

Background: In psoriatic arthritis (PsA) both skin and musculoskeletal involvement can contribute to reduce health related quality of life (HRQoL) (1). Although itch is considered an important symptom in psoriasis, less is known about its extent and potential impact on HRQoL in PsA. Objectives: The aim of the study was to assess the prevalence of itchy, sore, painful or stinging skin in PsA patients and also to explore the impact of these symptoms on overall HRQoL and skin related HRQoL. Methods: PsA patients were consecutively recruited from a rheumatology outpatient clinic. Data collection included variables listed in the table. Patients also answered the question: “Over the last week, how itchy, sore, painful or stinging has your skin been? With answer alternatives: Not at all (score 0), a little (score 1), a lot (score 2) and very much (score 3)”. For analysis the variable was dichotomized; ‘Not at all’ and ‘a little’ were scored as ‘not itching’, and ‘a lot’ and ‘very much’ were scored as ‘itching’. HRQoL was assessed using the 15D questionnaire and skin HRQoL using the Dermatology Life Quality Index (DLQI). Categorical variables are presented as numbers and (%) and continuous variables as mean with (SD). An association with 15D and DLQI was explored using univariate and multivariate linear regression analysis. Results: Among 125 PsA patients (63 men and 63 women), means age was 52.2 years, BMI 28.3 kg/m2, disease duration 8.9 years; 15.2% were smokers. The number and percentage (%) of PsA patients reporting their skin to be itchy, sore, painful or stinging was as follows: Not at all 25 (20.0%), a little 71 (56.8%), a lot 23 (18.4%) and very much 6 patients (4.8%). The table shows data for all PsA patients and for patients defined to have no itching or having itching skin. Total (n=125) No itching (n=96) Itching (n=29) P Age (SD), years 52.2 (10.1) 52.3 (10.1) 51.6 (10.2) 0.73 Women, n (%) 62 (49.6%) 49 (51.0%) 13 (44.8%) 0.56 BMI (SD), kg/m2 28.3 (4.3) 28.0 (4.0) 29.4 (4.9) 0.12 Smoking, n (%) 19 (15.2%) 14 (14.6%) 5 (17.2%) 0.73 Dis.dur. (SD), years 8.9 (6.7) 9.1 (6.7) 8.0 (6.9) 0.42 CRP (SD), mg /L 4.8 (8.5) 4.4 (8.5) 6.1 (8.5) 0.37 TJC68 (SD) 9.70 (11.07) 9.21 (10.32) 11.39 (13.41) 0.36 SJC66 (SD) 0.57 (0.99) 0.56 (1.00) 0.61 (0.96) 0.84 MASES (SD) 2.9 (3.1) 2.5 (2.9) 4.0 (3.7) 0.02 IGA (SD), (VAS 0-100) 14.0 (11.7) 12.9 (10.2) 17.8 (15.4) 0.12 PGA (SD), (VAS 0-100) 35.3 (24.2) 30.5 (22.6) 50.9 (22.8) &lt;0.01 Pain (SD), (VAS 0-100) 33.4 (23.4) 28.6 (21.3) 49.1 (23.6) &lt;0.01 Fatigue (SD), (VAS 0-100) 45.1 (32.0) 40.3 (31.7) 61.0 (28.1) &lt;0.01 MHAQ (SD), (0-3) 0.40 (0.35) 0.35 (0.32) 0.58 (0.39) &lt;0.01 PASI (SD), (0-72) 2.4 (3.5) 1.9 (3.2) 4.1 (4.1) 0.01 DLQI (SD), (0-30) 3.5 (3.6) 2.2 (2.3) 7.9 (3.9) &lt;0.01 15D (SD), (0-1) 0.84 (0.09) 0.86 (0.09) 0.80 (0.08) &lt;0.01 bDMARDs, n (%) 43 (34.7%) 33 (34.7%) 10 (34.5%) 0.98 csDMARDs, n (%) 73 (58.4%) 61 (63.5%) 12 (41.4) 0.03 Dis.dur.: disease duration In univariate analysis itching was found to be associated with impaired HRQoL assessed by 15D but not in adjusted analysis. In a regression model adjusting for age, gender, BMI and including variables with p&lt;0.2 in univariate analysis (MASES enthesitis score, investigator [IGA] and patients global assessment [PGA], fatigue, pain, MHAQ, Psoriasis Area Severity Index [PASI] score and itching and treatment), only female gender, PASI score and itching were independently associated with reduced skin HRQoL. Conclusion: Skin itching was frequently reported in our PsA patients (20-25%) and was also found to be associated with impaired HRQoL, in particular for skin HRQoL (DLQI). The association was independent of the extent of skin involvement (PASI). More needs to be understood about subjective skin symptoms such as itch in order to improve HRQoL in PsA. References: [1]Kavanaugh A, et al. Ann Rheum Dis 2019;9:1215-9 Disclosure of Interests: Glenn Haugeberg: None declared, Arthur Kavanaugh Grant/research support from: Abbott, Amgen, AstraZeneca, BMS, Celgene Corporation, Centocor-Janssen, Pfizer, Roche, UCB – grant/research support, Brigitte Michelsen Grant/research support from: Research support from Novartis, Consultant of: Consulting fees Novartis