FRI0349 PSORIATIC ARTHRITIS AND CENTRAL OBESITY: STRONG ASSOCIATION WITH FUNCTIONAL DISABILITY AND A WORSE QUALITY OF LIFE
Authors: M. Lo Monaco, G. Pistone, G. Natoli, R. Daita, C. Argano, L. Calvo, R. Mallaci Bocchio, R. Scondotto, S. Corrao
Journal: Annals of the Rheumatic Diseases (2020)

Background: Psoriatic arthritis (PsA) is a chronic inflammatory arthritis associated with comorbidities like obesity, metabolic syndrome, and cardiovascular disease. Adipose tissue leads to a pro-inflammatory status in obese subjects. For this reason, central obesity may determine a worsening in both disability index or quality of life in PsA patients treated with biologic agents. Objectives: Our study aimed to evaluate the relationship between central obesity and disability index or the impact of the disease on quality of life in a real-world sample of PsA patients. Methods: A cross-sectional study was conducted. Patients with PsA were enrolled at the PsA clinic at the ARNAS Civico in Palermo (Italy) from March 2018 to December 2019. Clinical, pharmacological, anthropometric, laboratoristic variables, and patient-reported outcomes, including the Health Assessment Questionnaire (HAQ) and Psoriatic Arthritis Impact of Disease (PsAID) were evaluated. STATA 14.1 was used to perform statistical analysis. Results: A total of 143 outpatients aged 55.6 (47.7-63.7) affected by PsA, according to CASPAR criteria, were consecutively evaluated. The average years of illness were 10.8 (9.5-12.1). Patients were treated with biological therapy (81.3%), DMARDS (41.6%), small molecules (9.9%), or their combinations. Both sexes were equally represented. 71.9% of enrolled patients had central obesity (64.9% men and 78.1% women) with an average waist circumference of 104.2 (101.8 - 106.6) for women and 103.6 (100.0 -107.2) for men. Average HAQ was 1.05 (0.92 - 1.19), and data analysis showed 50.3% of patients with normal-mild functional disability, 30.1% moderate to severe disability, and 19.6% severe to very severe disability [Fig 1]. 51,7% of the sample had a high impact of the disease on life, according to the PsAID questionnaire [Fig 2]. A strong association was observed between functional disability measured by HAQ &gt;2 and central obesity [OR (95% CI) 16.94 (2.22 - 129.48); p &lt; 0.006]. Moreover, data analysis showed an association between high impact of disease on life (PsAID &gt;4) and central obesity [OR (95% CI) 3.33 (1.56 - 7.13); p&lt;0,002]. Fig 1. Functional disability on PsA patients Fig 2. Impact of disease on PsA patients quality of life Table. Week 24 Treatment-Interaction Outcomes Adjusted by Sex and BMI Conclusion: Our study demonstrated a high association between functional disability studied subjectively using the HAQ, the impact of the disease on patients’ quality of life using PsAID, and central obesity in Sicilian outpatients affected by PsA. Data suggest that therapeutic goals should not be focused on treatment but also on waist circumference reduction in order to reduce inflammation and improve patients’ functional ability and quality of life. References: [1]Labitigan M, Bahce-Altuntas A, Kremer JM et al. Higher rates and clustering of abnormal lipids, obesity, and diabetes mellitus in psoriatic arthritis compared with rheumatoid arthritis. Arthritis Care Res (Hoboken). 2014;66(4):600–7. 3. [2]Jamnitski A, Symmons D, Peters MJ et al. Cardiovascular comorbidities in patients with psoriatic arthritis: a systematic review. Ann Rheum Dis. 2013;72(2):211–6. [3]Chiara TD, Argano C, Corrao S et al. Circulating adiponectin: a cardiometabolic marker associated with global cardiovascular risk. Acta Cardiol. 2015 Feb;70(1):33-40. Disclosure of Interests: None declared