AB0748 EVOLUTION ON HEALTH-RELATED QUALITY OF LIFE IN PSORIATIC ARTHRITIS PATIENTS
Authors: Dalifer Freites Nuñez, Leticia León, Judit Font, Alfredo Madrid García, Zulema Rosales, Lydia Abasolo, Benjamin Fernandez, Luis Rodriguez Rodriguez
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Psoriatic arthritis (PsA) is a chronic, progressive and inflammatory arthritis. It is consider a multifaceted disease, with a high impact on patient's psychological and physical well-being, with patients reporting lower health-related quality of life (HRQoL). Data of burden of disease is substantial and even though there are some studies that identify risk factors with longstanding PsA, there exists a need for properly designed studies to learn more about the evolution of HRQoL throughout the follow-up in this condition. <h3>Objectives:</h3> To analyze the evolution on HRQoL in patients with PsA and to to evaluate factors that may influence this evolution. <h3>Methods:</h3> Retrospective longitudinal observational study including incident patients diagnosed with PsA from 2007 to 2016, and followed-up until loss of follow-up or December 2017; with at least two registered visits; having received any ICD9/ICD10 diagnosis code of PsA; and with symptoms onset after 16 years of age. Patients were collected from the rheumatology outpatient clinic of a tertiary hospital (Hospital Clínico San Carlos, Madrid, Spain). Clinical information was collected from a departmental electronic health record, including demographic, clinical, comorbidities, treatment, and HRQoL related variables (measured with the Rosser Classification index). The influence of these variables in repeated measures of HRQoL was analysed using bivariate and multivariate generalized estimating equations (GEE) models nested by patient. Those variables with a p-value &lt;0.20 (plus age, gender, follow-up time, and calendar year of diagnosis) were introduced in the multivariate analysis. Bonferroni p-value threshold adjustment was carried out. <h3>Results:</h3> We included 187 patients, with a median follow-up of 3.6 years (interquarltile range: 0.8 to 6.3). 48% were women, with a median age at the onset of symptoms and diagnosis of 45 and 49 years, respectively. 86% of patients had a personal history of Psoriasis. Regarding clinical manifestations during the follow-up, 83%, 30%, 26%, and 22% of the patients presented with peripheral arthritis, inflammatory low back pain, enthesitis and dactylitis, respectively. In addition, they received treatment with nonsteroidal antiinflammatory medications (NSAIDs), oral glucocorticoids and disease-modifying antirheumatic drugs (DMARDs) 71%, 52% and 82%, respectively. 20% received biological agents. The Rosser median value at the first visit was 0.986, with an slight increase alter the first 2 years and a decline after 5 years of follow-up (Figure 1). With respect to the variables independently associated with HRQoL during follow-up, the history of osteoporotic fractures (p = 8.1x10-18) and chronic obstructive pulmonary disease (p = 5.0x10-8) were associated with a poorer quality of life. Conversely, treatment with methotrexate (p=6.4x10-5), and the use of bone-forming agents (p = 7.8x10-4) were associated with better HRQoL. History of osteoporosis and use of biphosphonates and denosumab were also associated with HRQoL, although not significantly after p-value adjustment. <h3>Conclusion:</h3> We have identified different factors associated with HRQoL during the evolution of patients with PsA. We observed that the presence of certain comorbidities were independently associated with a worse HRQoL. In addition, regarding different treatments, the use of methotrexate and bone-forming agents were independently associated with a better HRQoL. <h3>Disclosure of interests:</h3> None declared