Background Little data is available on quality of life in newly diagnosed psoriatic arthritis (PsA) patients and its relation to the extent of the disease.
Objectives To describe quality of life in newly diagnosed PsA related to the extent of the disease as defined by the number of swollen joints and the presence or absence of tender enthesis.
Methods Baseline data of consecutively recruited incident PsA patients was used from the Dutch south west Psoriatic Arthritis Registry (DEPAR) study between August 2013 to November 2015. Health-related quality-of-life (HRQoL) was assessed by the 8 subscales of the Short-Form 36 (SF-36) questionnaire (0–100, higher score represents a better HRQL) and the PsA-specific quality-of-life (PsAQoL) questionnaire (0–20, lower score represents a better HRQL). Patients were classified in the three arthritis subtypes (i.e. mono-, oligo- or polyarthritis) based on evaluation of the rheumatologist. A tender enthesis was defined as having at least one tender enthesis using the Leeds Enthesitis Index (LEI) and Maastricht Ankylosing Spondylitis Enthesitis Score (MASES).
Results 209 patients with arthritis at time of inclusion completed the SF-36 questionnaire. Average age was 51.4 years (SD 13.7) and 55% were male. Of these patients 49 had monoarthritis, 92 oligoarthritis and 68 polyarthritis. At least one tender enthesis was present in 45%, 38% and 53% of the patients.
Mean scores of the subdomains in the SF-36 were similar across the different arthritis-groups, with better scores for monoarthritis compared to oligo and polyarthritis. However, when separating the groups based on the presence of a tender enthesis HRQoL decreased substantially for all groups across all subdomains of the SF-36, with a mean difference of 15 points (Figure 1). Mean scores of all subdomains were significantly lower in the tender enthesis group (n=106) compared to the non-tender enthesis group (n=131). Comparable results were observed for the PsAQoL scores (mono: 7.09 (SD 6.24) vs. 2.15 (SD 2.85); oligo: 7.11 (5.21) vs 4.18 (5.65) and 8.52 (6.04) vs 2.16 (2.90)
Conclusions Stratifying the HRQoL for the presence of tender enthesis, present in about half of newly diagnosed PsA patients, showed lower levels of health-related quality-of-life across both physical and mental scales, independent of arthritis classification, emphasizing the importance of the enthesis in PsA.
Disclosure of Interest None declared