POS1061 THE ITALIAN PROSPECTIVE SIRENA STUDY: FOCUS ON EARLY PSORIATIC ARTHRITIS COHORT AND GENDER DIFFERENCES
Authors: A. Zabotti, M. M. Luchetti, C. Selmi, R. Ramonda, R. D. Grembiale, L. Dagna, S. D’angelo, G. Cafaro, S. De Vita, M. Felicetti, S. Marelli, D. Frigerio, E. Favalli
Journal: Annals of the Rheumatic Diseases (2021)

Background: Limited data on early Psoriatic Arthritis (PsA) are available 1,2 . Objectives: To describe baseline data of PsA patients naive to any DMARDs. Methods: SIRENA study is an Italian, prospective Registry of Spondyloarthritis patients diagnosed according to ASAS criteria and naïve to any DMARDs. Data on demographic and clinical characteristics of PsA cohort were collected and analysed, also by gender. Results: 203/350 (58%) subjects included in SIRENA Registry had PsA (mean age 51.9 years) and in 190/203 (94%) CASPAR classification criteria were fulfilled. In 70% of patients the diagnosis was performed within 24 months from symptom onset. At baseline, 194/203 (95.6%) had mainly peripheral manifestations, 74.4% of patients had skin psoriasis, 40% nail psoriasis, 39.3% clinical enthesitis and 25.9% dactylitis. Mean SJC66 and TJC68 were, respectively, 3 and 7.2; mean PhGA was 46.3; 14.7% of patients were in MDA. The higher tender joint count in women (mean TJC68 9.3 in women vs 5.3 in men) resulted in a higher disease activity according to DAPSA (high disease activity: 11.5% women vs 4.1% men), a higher joint VAS score (mean score 47.1 women vs 39.8 men) and a lower prevalence of MDA (8.3% women vs 20% men). We observed a higher prevalence of moderate or severe psoriasis in men (BSA≥3%: 37% men vs 27.8% women) while all PROs collected (PtGA, pain VAS score, sleep VAS score, BASFI, BASDAI, HAQ-DI, WPAI) were worse in women. The most common comorbidities were cardiometabolic (35.5%), endocrine (9.4%), and gastrointestinal disorders (7.4%). Cardiometabolic disorders were more frequently reported by men, endocrine and gastrointestinal disorders by women; depression exclusively by women. Conclusion: This analysis provides real-life data in a cohort of early PsA subjects. Relevant gender differences were observed, with women showing a higher disease activity and more joint pain and men having more severe psoriasis. Women also perceived a worse disease burden. References: [1]Theander E, et al. Ann Rheum Dis 2014; 73:407–413. [2]Nas K, et al. Mod Rheumatol 2017; 27(2):345-349. Table 1. Baseline data PsA All patients (n=203 ) Women (n=98 ) Men (n=105 ) Age (years), mean (SD) 51.9 (13.1) 51.1 (13.2) 52.7 (13.0) Men, n (%) 105 (51.7) 0 (0) 105 (100) BMI (kg/m 2 ), mean (SD) 25.9 (4.4) 25.4 (4.9) 26.4 (3.9) BMI categories^, n (%) Obese 40 (21.2) 20 (22.2) 20 (20.2) Overweight 44 (23.3) 15 (16.7) 29 (29.3) Under/normal weight 105 (55.6) 55 (61.1) 50 (50.5) Comorbidities &gt; 5% *, n (%) Cardiometabolic 72 (35.5) 28 (28.6) 44 (41.9) Endocrine disease 19 (9.4) 15 (15.3) 4 (3.8) Gastrointestinal 15 (7.4) 10 (10.2) 5 (4.8) Depression/Anxiety 8 (3.9) 8 (8.2) 0 (0) Hepatic diseases 7 (3.5) 1 (1.0) 6 (5.7) Clinical assessment CRP (mg/dl), median (min-max) 0.40 (0 – 7.12) 0.31 (0 - 5.40) 0.49 (0 - 7.12) SJC66, mean (SD) 3.0 (4.0) 3.2 (4.0) 2.7 (4.0) TJC68, mean (SD) 7.2 (8.8) 9.3 (10.3) 5.3 (6.6) Dactylitis, n/tot assessed (%) 35/135 (25.9) 12/63 (19.1) 23/72 (31.9) Enthesitis, n/tot assessed (%) 66/168 (39.3) 39/80 (48.8) 27/88 (30.7) Psoriasis skin, n (%) 151 (74.4) 68 (69.4) 83 (79.1) Psoriasis nails, n/tot assessed (%) 62/155 (40.0) 29/75 (38.7) 33/80 (41.3) Fibromyalgia, n (%) 6 (3.0) 5 (5.2) 1 (1.0) VAS, mean (SD) [range: 0-100] PhGA score 46.3 (25.8) 51.2 (25.4) 41.7 (25.4) Joint score 43.3 (26.8) 47.1 (25.2) 39.8 (27.8) Skin score 20.3 (24.0) 17.8 (23.1) 22.6 (24.8) DAPSA, mean (SD ) 22.3 (14.1) 26.8 (15.4) 18.7 (11.9) DAPSA categories ^, n (%) High disease activity 13 (7.4) 9 (11.5) 4 (4.1) Moderate disease activity 83 (47.2) 43 (55.1) 40 (40.8) Low disease activity 71 (40.3) 24 (30.8) 47 (48.0) Remission 9 (5.1) 2 (2.6) 7 (7.1) MDA °, n (%) 23 (14.7) 6 (8.3) 17 (20.0) BSA categories , n (%) 3-10% (moderate psoriasis) 35 (24.6) 13 (21.2) 22 (27.1) &gt;10% (severe psoriasis) 12 (8.5) 4 (6.6) 8 (9.9) * A patient could report one or more comorbidities. ^The sum does not add up to the total because of some missing values. ° According to Coates et al. (Ann Rheum Dis. 2010;69: 48). Disclosure of Interests: Alen Zabotti: None declared, Michele Maria Luchetti Speakers bureau: Honorary fees for conferences and workshops by Janssen, Abbvie, Novartis, Lilly, Celgene, Pfizer, Carlo Selmi Speakers bureau: Honoraria and/or speaker bureau from AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, Pfizer, Sanofi-Regeneron, Grant/research support from: Research support from Amgen, Janssen, Novartis, Pfizer, Roberta Ramonda Speakers bureau: Honoraria and speaker fees from Novartis, Abbvie, Pfizer, MSD, Janssen, Rosa Daniela Grembiale: None declared, Lorenzo Dagna Consultant of: Consultation honoraria from Abbvie, Amgen, Biogen, Celltrion, GlaxoSmithKline, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI, Salvatore D’Angelo Speakers bureau: Consulting fees and/or speakers bureau from AbbVie, Biogen, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Sanofi and UCB, Giacomo Cafaro: None declared, Salvatore De Vita: None declared, Mara Felicetti: None declared, Silvia Marelli Employee of: Janssen-Cilag SpA, Daniela Frigerio Employee of: Janssen-Cilag SpA, Ennio Favalli Speakers bureau: Consulting fees and/or speaking engagements from AbbVie, Bristol-Myers Squibb, Lilly, Merck Sharp &amp; Dohme, Pfizer, Galapagos, Sanofi-Genzyme, and UCB.