AB1549-HPR CARDIORESPIRATORY FITNESS TESTING IN PATIENTS WITH PSORIATIC ARTHRITIS
Authors: M. Kaerts, T. W. Swinnen, K. De Vlam, R. Lories, B. Neerinckx
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patients with psoriatic arthritis (PsA) have a well-known increased risk for cardiometabolic comorbidities. Studies in the general population have demonstrated that better cardiorespiratory fitness (CRF) improves cardiovascular and all-cause mortality risk. Peak oxygen uptake (VO<sub>2</sub>peak) is the gold standard measure of CRF and assessed during a maximal cardiopulmonary exercise test (CPET). The level of CRF as well as the feasibility of a maximal CPET in patients with PsA have not been comprehensively evaluated yet. <h3>Objectives:</h3> This study aimed (1) to determine the level of CRF in patients with PsA compared to reference values of the general population and (2) to assess feasibility of a maximal CPET in patients with PsA. <h3>Methods:</h3> In this cross-sectional study, patients with a clinical diagnosis of PsA (≥18 years) were included. Exclusion criteria were: (1) not being able to cycle on a stationary bike, (2) unsafety of maximal CPET according ACSM guidelines [1], (3) active infection, or (4) other uncontrolled conditions impacting CRF testing. Based on sample size calculation, 80 patients needed to be included. CRF was measured as VO<sub>2</sub>peak during a maximal CPET on a cycle ergometer and compared to mean values of the reference sedentary general population expressed as percentage predicted. [2] VO<sub>2</sub>peak below 80%predicted was considered as impaired CRF. Body composition, patient-reported disease activity and joint pain, physician-reported disease activity, pharmacological treatment, comorbidities and SCORE2-risk were evaluated. To evaluate feasibility of maximal CPET, a questionnaire monitoring patient-reported symptoms (NRS 0-10) was completed by the patients before the start of CPET and 3 days after. Patient-reported usability (NRS 0-10; usefulness, representativeness of physical ability in daily life, user friendliness and time needed) was assessed by a questionnaire 3 days after CPET. Recruitment and drop-out rate as well as the ability to reach the criteria of maximal CPET were evaluated. In this abstract, we present an interim analysis with descriptive statistics. <h3>Results:</h3> In this interim analysis, 62 patients with PsA were included. Recruitment and drop-out rate were &gt;50% and &lt;5% respectively. In Table 1, the demographic characteristics are presented. Criteria of maximal CPET were achieved in 92% of patients (n=57), of which 91% (n=52) reached their cardiocirculatory limits at the end of CPET. The mean VO<sub>2</sub>peak was 2543 ml/min (SD: 665.4) and, divided by body weight, 27.7 ml/min/kg (SD: 8.3) for men, and 1662 ml/min (SD: 404.9) and 22.6 ml/min/kg (SD: 5.5) for women. Compared to the reference values of the sedentary general population (in ml/min), the mean percentage predicted was 100% (SD: 24.1) for male patients and 106.1% (SD 24.7) for female patients. Twelve patients (19%; 9 male (24%) and 3 female (12%)) had an impaired CRF according to the 80%predicted cut-off value. Patient-reported reasons to stop the CPET were mainly dyspnea (n=20) and fatigue in the legs (n=35). Ten patients (16%) stopped CPET due to articular problems in the lower limbs. Three days after CPET, an increase in patient-reported symptoms (at least +2 points on the NRS-scale) was observed in 18% of the patients (n=11) for disease activity, in 16% (n=10) for joint pain, in 15% (n=9) for fatigue, and in 21% (n=13) for morning stiffness. Patients scored high levels of usability (mean-range 8.1-8.9; SD-range 1.3-1.9). <h3>Conclusion:</h3> Overall, the CRF of PsA patients was similar to that of the sedentary general population. CRF was impaired in 19% of the patients with PsA. Maximal CPET is feasible in patients with PsA according to patient-reported symptoms and usability-scores, recruitment and drop-out rate, and results of the CPET-procedure. <h3>REFERENCES:</h3> [1] ACSM's Guidelines for Exercise Testing and Prescription, 2018. [2] Wasserman K., Hansen JE., et al., Principles of exercise testing and interpretation, 2005. <b>Table 1.</b> Demographic characteristics Data were presented as proportions n (%) or median (interquartile range). DAPSA: Disease Activity in PSoriatic Arthritis; SCORE2: Systematic COronary Risk Estimation 2. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>