AB0843 PSORIATIC ARTHRITIS PATIENTS ACHIEVING DAPSA REMISSION/LOW DISEASE ACTIVITY HAVE BETTER LONG-TERM FUNCTIONAL OUTCOMES

Autor: Charles Lubianca Kohem, Franciele de Almeida Menegat, Claiton Viegas Brenol, P. Palominos, J. V. Andrade Águas, L. Vargas Cruz, Andrese Aline Gasparin, B. Ruschel, J. Boechat Farani, J. Rabello Costa
Rok vydání: 2020
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 79:1727.2-1728
ISSN: 1468-2060
0003-4967
DOI: 10.1136/annrheumdis-2020-eular.6309
Popis: Background:Patients with psoriatic arthritis (PsA) experience substantial functional impairment, which impacts on health-related quality of life.1Evidence from randomized clinical trials (RCTs) suggests better patient-reported functional outcomes when lower disease activity is achieved.2,3,4Objectives:To evaluate the impact of achieving DAPSA remission (REM) or low disease activity (LDA) on long term function measured by HAQ-DI. To verify predictors of achieving a minimum clinically important difference (MCID) in HAQ-DI (≤ -0.35).Methods:This is a longitudinal analysis of a real-life retrospective cohort. Inclusion criteria were adult patients fulfilling CASPAR criteria for PsA with at least 4 years of follow-up in the PsA Clinic. Demographic and clinical data were extracted from electronic medical records. Comparison of HAQ-DI variation between patients with DAPSA REM/LDA and those with moderate/high disease activity was performed using generalized estimating equation (GEE), adjusted by Bonferroni test. Correlation between HAQ-DI and DAPSA was analyzed by Spearman correlation method. A multivariate hierarchical regression model was applied in order to evaluate predictors of achieving a MCID in HAQ-DI scores.Results:Seventy-three patients were included in the analysis, of which 58.9% were female, with a median (25/75th) of 8 (3-15) years since PsA diagnosis and a mean follow up time of 6.2±1.2 years. In total, 37% of patients (N=27) presented a MCID in HAQ-DI during the follow-up. Function measured by HAQ-DI was determined by PsA disease activity measured by DAPSA (interaction test: p s= 0.60; pFigure 1.Variation in HAQ-DI according to PsA disease activity measured by DAPSAFigure 2.Correlation between changes in PsA disease activity (ΔDAPSA) and changes in functional indices (ΔHAQ-DI) over three years of follow-upConclusion:In PsA, patients who maintained DAPSA REM/LDA over time had better long term functional outcomes. Higher HAQ-DI scores at baseline, non-white ethnicity and younger age were predictors for achieving a clinical significant improvement in HAQ-DI.References:[1]Mease P et al. Semin Arthritis Rheum. 2018 Dec;48(3):436-448.[2]Coates, LC et al. The Lancet. 2015 Dec; 386, 19-26.[3]Aletaha D et al. Ann Rheum Dis. 2017;76(2):418-421.[4]Kavanaugh A et al. Annals rheum Dis 2014; 73: 1689-94.Median HAQ-DIFollow-up in yearsDisclosure of Interests:Larissa Vargas Cruz: None declared, Júlia Boechat Farani: None declared, Júlia Rabello Costa: None declared, Franciele Menegat: None declared, João Victor Andrade Águas: None declared, Bruna Ruschel: None declared, Andrese Aline Gasparin: None declared, Claiton Brenol: None declared, Charles Kohem Grant/research support from: This work was sponsored by the regional society of rheumatology (Sociedade de Reumatologia do Rio Grande do Sul)., Penelope Palominos Grant/research support from: This work was sponsored by the regional society of rheumatology (Sociedade de Reumatologia do Rio Grande do Sul).
Databáze: OpenAIRE