POS0978 DISEASE CONTROL IN PSORIATIC ARTHRITIS PATIENTS WITH OR WITHOUT AXIAL MANIFESTATIONS IN REAL CLINICAL PRACTICE IN SPAIN: RESULTS FROM THE MIDAS STUDY
Authors: E. De Miguel, J. Gratacos-Masmitja, A. P. Cacheda, J. M. Rodríguez-Heredia, A. Gallego, E. Beltrán, B. Font Ramos, C. Sastré, C. Sanabra
Journal: Annals of the Rheumatic Diseases (2021)

Background: MIDAS study assessed the disease activity in psoriatic arthritis (PsA) patients treated in clinical practice in Spain. Objectives: This sub-analysis compared disease activity between PsA patients with or without axial manifestations. Methods: MIDAS is an observational, non-interventional, cross-sectional, multicenter study conducted in Spain. Patients included were ≥18 years old with ≥6 months since diagnosis, were classified by CASPAR criteria and had initiated treatment ≥3 months. Disease activity was measured by Disease Activity in Psoriatic Arthritis (DAPSA) and Minimal Disease Activity (MDA). Axial involvement was defined according to the presence of inflammatory back pain assessed by rheumatologist. Results: 312 evaluable PsA patients were included in this analysis, 12.2% of which presented with axial involvement. PsA patients with axial manifestations reported longer time from onset of symptoms to diagnosis and disease duration, higher presence of concomitant diseases, HLA-B*27+ status, C-reactive protein (CRP) levels, perception of uncontrolled disease and presence of swollen and tender joints compared to patients without axial involvement. A higher proportion of PsA patients with axial manifestations were treated with a biologic compared with those without axial involvement 68.4% vs 57.3% (Table 1). Patients with axial involvement showed a higher impairment of their quality of life compared to those without axial manifestations by a worse higher mean (SD) Psoriatic Arthritis Impact of Disease 12-item questionnaire (PSAID12) score (5.0 [2.4] vs 2.7 [2.2], respectively). In terms of disease control more patients with axial manifestations presented with moderate to high disease activity (DAPSA&gt;14: 65.7% vs 36.8%, respectively) and did not meet the MDA criteria for remission (89.5% vs 42.7%, respectively) (Figure 1). Conclusion: PsA patients with axial manifestations presented with a higher burden of disease and showed a worse disease control compared to those without axial involvement. Table 1. Baseline demographic and clinical characteristics With axial manifestations (n=38 ) Without axial manifestations (n=274 ) PsA (n=312 ) Age (years), mean (SD) 53.1 (10.4) 54.1 (12.4) 54.0 (12.2) Sex (male), n (%) 17 (44.7%) 153 (55.8%) 170 (54.5%) Time since diagnosis (years), mean (SD) 13.6 (10.1) 10.1 (8.8) 10.5 (9.0) Time from onset of symptoms to diagnosis (years), mean (SD) 4.3 (6.1) 2.8 (4.8) 3.0 (5.0) Presence of concomitant diseases, mean (SD) 26 (68.4%) 166 (60.6%) 192 (61.5%) Anemia, n (%) 3 (7.9%) 7 (2.6%) 7 (2.2%) Anxiety, n (%) 6 (15.8%) 9 (3.3%) 1 (0.3%) Asthma, n (%) 2 (5.3%) 7 (2.6%) 1 (0.3%) Depression, n (%) 6 (15.8%) 1 (0.4%) 1 (0.3%) Dyslipidemia, n (%) 3 (7.9%) 8 (2.9%) 9 (2.9%) Hypertension, n (%) 3 (7.9%) 7 (2.6%) 9 (2.9%) Others (excluding skin psoriasis, uveitis, or IBD), n (%) 3 (7.9%) 17 (6.2%) 19 (6.1%) Presence of HLA-B*27+, n (%) 6 (15.8%) 28 (10.2%) 34 (10.9%) CRP levels (mg/l), mean (SD) 7.3 (11.3) 4.6 (6.5) 4.9 (7.3) Patient perceived disease control (PASS), n (%) 30 (78.9%) 228 (83.5%) 258 (83.0%) Presence of swollen (SJC≥1), n (%) 22 (57.9%) 117 (42.7%) 139 (44.6%) Presence of tender joints (TJC≥1), n (%) 14 (36.8%) 74 (27.0%) 88 (28.2%) Patients treated with biological 26 (68.4%) 157 (57.3%) 183 (58.7%) COPD, chronic obstructive pulmonary disease; CRP, C-reactive protein; HLA-B*27, human leukocyte antigen B27; IBD, inflammatory bowel disease; PASS, patient acceptable symptom state; PsA, psoriatic arthritis; SD, standard deviation; SJC, swollen joint counts; TJC, tender joint counts. Figure 1. Disease status according to clinical phenotype of PSA A ) Disease activity according to DAPSA B ) Disease activity according to MDA DAPSA, Disease Activity in Psoriatic Arthritis; MDA, Minimal Disease Activity; PsA, psoriatic arthritis. Acknowledgements: We thank to MIDAS group investigators and patients included in the study. Disclosure of Interests: Eugenio de Miguel Speakers bureau: AbbVie, Novartis, Pfizer, MSD, BMS, UCB, Roche, Grunental, Janssen, Sanofi., Paid instructor for: Janssen, Novartis, Roche, Consultant of: AbbVie, Novartis, Pfizer, Galapagos, Grant/research support from: Abbvie, Novartis, Pfizer, Jordi Gratacos-Masmitja Speakers bureau: During the course of the year I have received funding in relation to courses and / or conferences, and / or have participated as a speaker or in advisory boards from: MSD, Pfizer, AbbVie, Janssen Cilag, Novartis, Lilly and Amgen., Consultant of: During the course of the year I have received funding in relation to courses and / or conferences, and / or have participated as a speaker or in advisory boards from: MSD, Pfizer, AbbVie, Janssen Cilag, Novartis, Lilly and Amgen., Grant/research support from: During the course of the year I have received a private grand from Pfizer. I have not received any private influence in the elaboration of the contents of this talk., Ana Paula Cacheda: None declared, José M. Rodríguez-Heredia Speakers bureau: Amgen, Novartis, Sanofi, Consultant of: Amgen, Biogen, Fresenius, MSD, Janssen, Roche, Novartis, Pfizer, Sanofi, Adela Gallego Speakers bureau: During the course of the year I have received funding in relation to courses and / or conferences, and / or have participated as a speaker or in advisory boards from: MSD, Pfizer, AbbVie, Janssen, Novartis, Lilly, Amgen and Sanofi. I have not received any private influence in the elaboration of the contents of this talk., Grant/research support from: During the course of the year I have received funding in relation to courses and / or conferences, and / or have participated as a speaker or in advisory boards from: MSD, Pfizer, AbbVie, Janssen, Novartis, Lilly, Amgen and Sanofi. I have not received any private influence in the elaboration of the contents of this talk., Emma Beltrán Speakers bureau: Abbvie, Bristol, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Consultant of: Abbvie, Bristol, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Beatriz Font Ramos Employee of: Novartis employee, Carlos Sastré Employee of: Novartis employee, Cristina Sanabra Employee of: Novartis employee.