Identification and characteristics of patients with potential difficult-to-treat psoriatic arthritis: exploratory analyses of the Greek PsA registry.

Autor:	Vassilakis KD; Joint Academic Rheumatology Program, First Department of Propedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece., Papagoras C; First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece., Fytanidis N; First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece., Gazi S; Department of Rheumatology, KAT Hospital, Athens, Greece., Mole E; Department of Rheumatology, KAT Hospital, Athens, Greece., Krikelis M; Department of Rheumatology, KAT Hospital, Athens, Greece., Voulgari PV; Department of Rheumatology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Kaltsonoudis E; Department of Rheumatology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Koletsos N; Department of Rheumatology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Boumpas D; Joint Academic Rheumatology Program, 4th Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece., Katsimpri P; Joint Academic Rheumatology Program, 4th Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece., Katsifis-Nezis D; Joint Academic Rheumatology Program, 4th Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece., Dimitroulas T; 4th Department of Medicine, Aristotle University, Thessaloniki, Greece., Kougkas N; 4th Department of Medicine, Aristotle University, Thessaloniki, Greece., Boutel M; 4th Department of Medicine, Aristotle University, Thessaloniki, Greece., Sfikakis PP; Joint Academic Rheumatology Program, First Department of Propedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece., Tektonidou MG; Joint Academic Rheumatology Program, First Department of Propedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece., Gialouri C; Joint Academic Rheumatology Program, First Department of Propedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece., Bogdanos D; Department of Rheumatology and Clinical Immunology, University of Thessaly, Larissa, Greece., Simopoulou T; Department of Rheumatology and Clinical Immunology, University of Thessaly, Larissa, Greece., Koutsianas C; Joint Academic Rheumatology Program, Clinical Immunology, Rheumatology unit, 2nd Department of Medicine and Laboratory, National and Kapodistrian University of Athens Medical School, General Hospital of Athens 'Hippokration', Athens, Greece., Mavrea E; Joint Academic Rheumatology Program, Clinical Immunology, Rheumatology unit, 2nd Department of Medicine and Laboratory, National and Kapodistrian University of Athens Medical School, General Hospital of Athens 'Hippokration', Athens, Greece., Katsifis G; Rheumatology Clinic, Naval Hospital of Athens, Athens, Greece., Kottas K; Rheumatology Clinic, Naval Hospital of Athens, Athens, Greece., Konsta M; Rheumatology Unit, Sismanoglio Hospital, Athens, Greece., Tziafalia M; Rheumatology Unit, Sismanoglio Hospital, Athens, Greece., Kataxaki E; Rheumatology Department, General Hospital Elefsinas Thriaseio, Athens, Greece., Kalavri E; Department of Rheumatology, 'Asklepieion' General Hospital, Athens, Greece., Klavdianou K; Department of Rheumatology, 'Asklepieion' General Hospital, Athens, Greece., Grika EP; Department of Rheumatology, Evaggelismos Athens General Hospital, Athens, Greece., Sfontouris C; Department of Rheumatology, Evaggelismos Athens General Hospital, Athens, Greece., Daoussis D; Department of Rheumatology, Patras University Hospital, University of Patras Medical School, Patras, Greece., Iliopoulos G; Department of Rheumatology, Patras University Hospital, University of Patras Medical School, Patras, Greece., Bournazos I; Private Practice, Athens, Greece., Karokis D; Private Practice, Athens, Greece., Georganas K; Private Practice, Athens, Greece., Patrikos D; Private Practice, Athens, Greece., Vassilopoulos D; Joint Academic Rheumatology Program, Clinical Immunology, Rheumatology unit, 2nd Department of Medicine and Laboratory, National and Kapodistrian University of Athens Medical School, General Hospital of Athens 'Hippokration', Athens, Greece., Fragoulis GE; Joint Academic Rheumatology Program, First Department of Propedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.; School of Infection and Immunity, University of Glasgow, Glasgow, UK.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2024 Sep 01; Vol. 63 (9), pp. 2427-2432.
DOI:	10.1093/rheumatology/keae263
Abstrakt:	Objective: To present the characteristics of patients with potential difficult-to-treat (D2T) PsA. Methods: We used data from the Greek multicentre registry of PsA patients. D2T PsA was defined as follows: patients with at least 6 months' disease duration, who have failed to at least one conventional synthetic DMARD and at least two biologic DMARDs/targeted synthetic DMARDs with a different mechanism of action and have either at least moderate disease activity (MODA) defined as DAPSA (Disease Activity index in PSoriatic Arthritis) >14, and/or are not at minimal disease activity (MDA). Demographic and clinical characteristics were compared between D2T and non-D2T PsA patients. In two sensitivity analyses, patients classified as D2T solely according to the MODA or MDA criterion were examined separately. Results: Among 467 patients included, 77 (16.5%) were considered D2T and 390 non-D2T PsA. Compared with non-D2T, patients with D2T PsA presented more commonly with extensive psoriasis (P < 0.0001) and were more likely to have higher BMI (P = 0.023) and a history of IBD (P = 0.026). In the MODA and MDA sensitivity analyses, 7.5% and 12.5% of patients were considered D2T, respectively. In both sensitivity analyses, extensive psoriasis was again identified as an independent variable for D2T PsA (P = 0.001 and P = 0.008, respectively). Moreover, female gender (P = 0.034) in the MODA analysis and axial disease (P = 0.040) in the MDA analysis were independent variables for D2T PsA. Conclusion: Despite the availability of therapies, D2T PsA is common in real-life cohorts of patients with PsA and extensive psoriasis. High BMI, female gender, axial disease and history of IBD were also associated with D2T PsA. (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology.)
Databáze:	MEDLINE
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