AB1096 THE ASSOCIATION OF ULTRASOUND ASSESSMENT AND PATIENT REPORTED OUTCOMES IN SPONDYLOARTHRITIS AND PSORIATIC ARTHRITIS: A SYSTEMATIC LITERATURE REVIEW
Authors: T. Gudu, M. A. D’agostino
Journal: Annals of the Rheumatic Diseases (2020)

Background: Patient reported outcomes (PROs) reflect patients’ opinion on disease activity and impact of disease on various aspects of life. They are essential in the assessment of patients spondyloarthritis (SpA) and psoriatic arthritis (PsA), but may be influenced by several factors other than disease activity and severity. Ultrasound (US) is an objective tool to evaluate inflammation and structural damage in these conditions. Objectives: The objective of this study was to determine if and to which extent the US assessment reflects patient perspective in patients with SpA and PsA. Methods: Two separate systematic literature reviews were conducted for each disease. The research questions were formulated according to the PICO framework. The patient reported domains of health were selected from the ones included in the Core Set for SpA [1] and PsA [2] and from the ones frequently reported in clinical trials and observational studies for SpA and PsA, as well as patient self-assessment of pain at the joint level. We included articles that evaluated any kind of relationship between PROs and US assessment. Results: SpA In total, 2977 abstracts were identified, of which 12 articles were retained in the final analysis: 10 cross-sectional studies assessing disease activity state and 2 longitudinal, non-interventional trials assessing treatment response. The most frequently evaluated domains of health are depicted in table 1. The cross-sectional studies evaluating only one joint area (foot and ankle, sacroiliac joint, shoulder and hip) showed that overall there is no important association between the PROs and the US parameters. In studies evaluating multiple entheses sites there were several correlations between PROs (pain, disease activity, function, quality of life (QoL)) and US variables, i.e., US inflammatory scores and total enthesitis scores, comprising both inflammatory and structural changes (r=0.24-0.53). In the longitudinal studies there was no consistent association between PROs and US variables. PsA Out of the 1267 abstracts identified, 12 were finally included in the qualitative analysis: 5 cross-sectional studies on disease activity state and 7 longitudinal studies, of which 2 on disease activity state and 5 on treatment response. The most frequently evaluated domains of health are depicted in table 1. Overall, in the cross-sectional studies, there was no consistent association between PROs and US assessment. In the longitudinal studies on disease activity, pain and patient global assessment (PGA) were associated with US inflammatory variables (r=0.22-0.28), while disability correlated with US damage (r=0.22-0.39). Change in PGA and pain was associated with change in the global US inflammation score (r=0.28-0.35). In longitudinal studies on treatment response results were inconsistent: two studies showed that there was significant parallel trend of some PROs (function, pain and PGA) and some US entheses scores, but the other 3 studies showed no significant association. Conclusion: The association between PROs and US in SpA and PsA was rather inconsistent. Patient perspective and US examination seem to provide different, but complementary perspectives on disease assessment and both should be taken into account in SpA and PsA management. References: [1]van der Heijde, J Rheumatol 1999 [2]Orbai, An Rheum Dis 2016 Acknowledgments: Supported by PARTNER Fellowship Disclosure of Interests: None declared