SAT0318 PREVALENCE AND PREDICTORS OF DEPRESSION AMONG PATIENTS WITH ANKYLOSING SPONDYLITIS AND PSORIATIC ARTHRITIS IN A CANADIAN REAL WORLD OBSERVATIONAL COHORT: RESULTS FROM THE COMPLETE STUDIES
Authors: Louis Bessette, Majed Khraishi, Viktoria Pavlova, Jacqueline Stewart, Valencia P. Remple
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Ankylosing pondylitis (AS) and psoriatic arthritis (PsA) are chronic inflammatory diseases known to cause physical, emotional, social and psychological impairment. However, few data are available on comorbidities such as depression and the factors associated with depression. <h3>Objectives:</h3> To evaluate the prevalence of depression and to identify sociodemographic and disease-related factors associated with depression among PsA and AS patients. <h3>Methods:</h3> Patients eligible for the COMPLETE studies are anti-TNFα naïve adults with active AS or PsA requiring change in their treatment regimen. In this analysis, patients enrolled between Jul/2011 - Nov/2017, treated with adalimumab or non-biologic DMARDs were included. Depression was defined as Beck's Depression Inventory (BDI) ≥20 and/or patients treated with an antidepressant/anxiolytic at baseline (before treatment modification). Associated symptoms of depression were assessed with the BDI considering% of patients with a score of 2 or 3 (moderate to severe symptoms). Univariate and multivariate logistic regression were used to identify sociodemographic and disease-related predictors associated with depression at baseline. In addition, the correlation of the BDI score and the following parameters at baseline was assessed with the Pearson coefficient (r): age, disease duration, PsA disease specific parameters (28-tender [TJC] and swollen joint count [SJC], patient global assessment [PtGA], physician global assessment [MDGA]), and AS disease specific parameters (BASDAI, BASFI, morning stiffness, and number of extra-articular manifestations [EAMs]). <h3>Results:</h3> A total of 492 AS and 333 PsA patients were included. Mean (SD) age was 42.7 (13.2) and 51.5 (12.2) years for AS and PsA, respectively, and disease duration was 5.4 (9.1) and 14.7 (13.7) years. The prevalence of baseline depression was 24.6% for AS and 25.5% for PsA. The most commonly reported symptoms of associated with depression, were loss of energy (33.2% and 26.2%), changes in sleeping pattern (41.3% and 34.9%), fatigue (35.3% and 28.6%), and loss of interest in sex (21.7% and 21.9%), for AS and PsA, respectively. In univariate analysis (Table 1), female gender (OR=1.73), unemployment due to disability (OR=3.06) or other reasons (OR=2.38), increased BASDAI (OR=1.40), increased BASFI (OR=1.33), and increased morning stiffness (OR=1.01) were significantly associated [all P&lt;0.001 except gender (P=0.009)] with baseline depression among AS patients. For PsA, significantly associated parameters included female sex (OR=2.35; P=0.001), unemployment due to disability (OR=3.57; P&lt;0.001), increased TJC (OR=1.05; P=0.009), increased PtGA (OR=1.03; P&lt;0.001) and increased morning stiffness (OR=1.01; P=0.010). Weak correlations (P&lt;0.05) were observed between the BDI score and BASFI (r=0.425), BASDAI (r=0.375), morning stiffness (r=0.285), and number of EAMs (r=0.114) for AS; and TJC (r=0.155), MDGA (r=0.132), and PtGA (r=0.451) for PsA. In multivariate regression analysis for AS, higher BASFI (OR=1.32; P&lt;0.001), female sex (OR=1.89; P=0.007) and being unemployed due to other reasons (OR=1.91; P=0.017); and, for PsA, lower baseline disease duration (OR=0.97; P=0.018), and higher PtGA (OR=1.04; P&lt;0.001) were identified as significant independent predictors of baseline depression. <h3>Conclusion:</h3> Depression in AS and PsA patients was common in this real-world cohort. Female sex, unemployment, and higher disease activity for AS, and shorter disease duration along with higher PtGA for PsA were significant independent predictors of depression. <h3>Disclosure of Interests:</h3> Louis Bessette Grant/research support from: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Consultant for: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Speakers bureau: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Majed Khraishi Consultant for: AbbVie, Speakers bureau: AbbVie, Viktoria Pavlova Grant/research support from: UCB, Consultant for: Amgen, Abbvie, BMS, Janssen, Lilly, Merk, Novartis, Roche, UCB, Pfizer, Speakers bureau: Amgen, Abbvie, BMS, Janssen, Lilly, Merk, Novartis, Roche, UCB, Pfizer, Jacqueline Stewart Consultant for: Pfizer, Abbvie, Amgen, Celgene, Roche, Novartis, Merck, Valencia P. Remple Shareholder of: AbbVie, Employee of: AbbVie