Background Early diagnosis and management of inflammatory arthritis could prevent disease progression associated with destructive joint damage, disability, increased cardiovascular risk, and other co-morbidities. Differentiation of inflammatory arthritis at early stages of disease could be difficult due to similar clinical presentation.
Objectives To analyze differences in clinical presentation at baseline of early Psoriatic (EPsA) and Rheumatoid (ERA) Arthritis, both defined as <2 years since symptom onset.
Methods PsA (meeting CASPAR criteria) and RA (meeting 1987 ACR criteria for RA) patients were assessed prospectively at a rheumatology clinic specializing in inflammatory arthritis. Clinical assessment included Tender (TJC) and Swollen (SJC) joint count, standard joint radiography, blood tests, Health Assessment Questionnaire (HAQ), and Disease Activity Score (DAS28) which was calculated for ERA out of 28 joints. Descriptive statistics and t-test were conducted with α≤5% level of significance.
Results A total of 154 patients with EPsA (84; 54.5%) and ERA (70; 45.5%) with mean (SD) disease duration =0.93 (0.66) were included in this analysis. Gender distribution in EPsA cohort significantly differed towards men (47.6% vs. 17.1%; p<0.001) as compared to ERA cohort. Patients in EPsA were significantly younger both generally (48.04 (10.55) vs. 54.21 (14.04); p=0.002) and at the onset of arthritis (47.85 (10.66) vs. 53.30 (13.98); p=0.007). Table shows the baseline parameters for both cohorts.
As expected, patients with ERA did not have either Axial or Mixed (Axial & Peripheral joints affected simultaneously) involvements (0.0% vs. 20.2%; p<0.001 & 0% vs. 19.0%; p<0.001, respectively). Distal Interphalangeal Predominant (DIP) involvement was typical for EPsA patients (57.1% vs. 0%; p<0.001) while Proximal Interphalangeal Predominant (PIP) was common in ERA (92.9% vs. 0%; p<0.001). The most common pattern of joint involvement in both cohorts was polyarticular (59.5% in EPsA & 71.4% in ERA). HAQ scores did not differ significantly between cohorts (0.65 (0.56) vs. 0.78 (0.73); p=0.229). DAS28 was significantly higher in patients with the ERA compared to the EPsA (4.31 (1.41) vs. 3.81 (1.19); p=0.018).
Conclusions Patients with ERA had higher inflammatory activity, measured by SJC, ESR, and DAS although, both groups presented with relatively low number of inflamed joints. The disability as measured by HAQ was not significant between the cohorts.
Disclosure of Interest M. Khraishi Grant/Research support from: Dr. Khraishi received non-restricted grants from Abbott Canada and Amgen & Pfizer Canada, R. Aslanov: None Declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.