AB0821 ANXIETY AND DEPRESSION IN PSORIATIC ARTHRITIS (PsA) - PREVALENCE AND IMPACT ON PATIENT REPORTED OUTCOMES: REAL-WORLD SURVEY IN THE US AND EUROPE
Authors: L. Gossec, J. A. Walsh, K. Michaud, E. Holdsworth, S. Peterson, S. Meakin, S. Bruce Wirta, S. D. Chakravarty, A. Ogdie
Journal: Annals of the Rheumatic Diseases (2020)

Background: Anxiety and depression are comorbidities among PsA patients. The impact of anxiety and depression on outcomes in PsA patients has not been characterized in a real-world clinical setting. Objectives: To describe the prevalence of anxiety and/or depression in PsA patients, assess concordance in reported anxiety and/or depression between patients and physicians, and compare clinical and patient reported outcomes (PROs) in patients who do and do not report anxiety and/or depression. Methods: A cross-sectional study of 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 and patient self-completed forms. Physicians reported patient demographic, disease characteristics and diagnosed anxiety and/or depression. Patients reported experience of PsA-related anxiety/depression, quality of life [QoL] (EQ5D-5L), work productivity (WPAI), disability (HAQ-DI), and disease impact (PsAID12). Patients were compared according to patient reported anxiety/depression using parametric and non-parametric tests. Multivariate regressions explored impact of anxiety/depression on PROs. Models adjusted for age, gender, employment status, BMI, # of joints affected, body surface area (BSA). Results: Data were collected from 688 physician-patient pairs (524 EU; 164 US). Physicians reported anxiety and/or depression in 14.2% of patients (EU 13.3%; US 16.2%), while 36.6% (EU 36.3%; US 37.8%) of patients self-reported anxiety and/or depression. 71.4% of physician-patient pairs agreed on anxiety and/or depression presence or absence (Kappa = 0.31, fair agreement). Patients with anxiety and/or depression had worse QoL more work impairment, greater disability (Table 2). Table 1. Demographic and clinical characteristics by patient-reported anxiety and/or depression No anxiety and/or depression (n=436) Anxiety and/or depression (n=252) P value Demographics Age, mean (SD) 47.7 (12.1) 49.1 (12.6) 0.13 Female, n (%) 196 (45.0) 146 (57.9) &lt;0.01 BMI, mean (SD) 26.7 (5.1) 26.9 (4.4) 0.57 Caucasian, n (%) 408 (93.3) 238 (94.4) 0.46 Working full time, n (%) 293 (68.6) 107 (44.8) &lt;0.01 Biologic tx, n (%) 257 (58.9) 160 (63.5) 0.26 Disease characteristics Days since diagnosis, mean (SD) 2090 (2204) 2532 (2813) 0.04 Current overall severity, n (%) Mild 277 (63.5) 137 (54.4) 0.02 Moderate 145 (33.3) 106 (42.1) Severe 14 (3.2) 9 (3.6) Current BSA %, mean (SD) 8.7 (12.3) 6.4 (8.2) 0.02 66 swollen joint count, mean (SD) 2.7 (3.6) 5.6 (10.4) &lt;0.01 68 tender joint count, mean (SD) 3.8 (4.3) 6.0 (6.2) &lt;0.01 Table 2. Impact of anxiety or depression on PROs* Anxiety and/or depression Change in predicted PRO value with anxiety and/or depression α P value EQ5D utility score, mean N=488 Without (ref) With 0.83 -0.10 &lt;0.01 WPAI percentage overall work impairment, mean N=262 Without With 22.3 +7.4 &lt;0.01 HAQ-DI score, mean N=480 Without With 0.53 +0.26 &lt;0.01 PsAID12 score, mean N=482 Without With 2.32 +1.78 &lt;0.01 * Adjusted for age, gender, employment status, BMI, # of joints affected and BSA 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: One third of patients self-report anxiety and/or depression. Treating physicians may not be aware of patient experience of anxiety and/or depression. Patients with anxiety and/or depression appear to have worse QoL, work productivity and disability outcomes than those without. Disclosure of Interests: Laure Gossec Grant/research support from: Lilly, Mylan, Pfizer, Sandoz, Consultant of: AbbVie, Amgen, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sandoz, Sanofi-Aventis, UCB, Jessica A. Walsh Grant/research support from: AbbVie, Pfizer, Janssen, Consultant of: AbbVie, Novartis, Eli Lilly and Company, UCB, Kaleb Michaud Grant/research support from: Janssen, Elizabeth Holdsworth Employee of: Adelphi Real World, Steve Peterson Employee of: Janssen Research &amp; Development, LLC, Sophie Meakin Employee of: Adelphi Real World, Sara Bruce Wirta Employee of: Janssen-Cilag Sweden AB, Soumya D Chakravarty Shareholder of: Johnson &amp; Johnson, Employee of: Janssen Scientific Affairs, LLC, 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