Background Psoriatic Arthritis (PsA) is a multi-features disease requiring disease activity measures that capture not only joint disease, such as the Composite Psoriatic Disease Activity Index (CPDAI) and the Psoriatic Arthritis Disease Activity Score (PASDAS). Although both are well validated in clinical trials, little data exists on their evolvement in daily clinical care.
Objectives to describe the longitudinal evolvement of CPDAI and PASDAS and its associations with demography, disease, and DMARDs.
Methods Newly diagnosed consecutive PsA patients were recruited in 8 hospitals in the Netherlands from August 2013 to November 2015. Demographic and disease characteristics were registered. Data was analysed in the first 3 months by linear regression and over 12 months using linear mixed model with random intercept for CPDAI (0–15) and PASDAS (0–10)
Results In November 2015 281 patients had had a baseline assessment, of which 234, 198, 157 and 129 had had resp. a 3, 6, 9 and 12 month assessment. The mean age was 50.6 (SD 13.6) and 50.5% were male. In terms of arthritis subtypes, 56 (20%) had monoarthritis, 108 (39%) oligoarthritis, 80 (29%) polyarthritis and 35 (12%) were diagnosed with axial disease, dactylitis or enthesitis only.
PASDAS evolved from a mean of 4.0 points (SD 1.2, n=174) at baseline, to 3.3 (SD 1.1, n=160) at 3 months, and 2.6 (SD 1.1, n=94) at 12 months. CPDAI evolved from 5.5 (SD 2.1, n=229), to 4.4 (SD 2.0, n=213) to 2.97 (SD 1.8, n=113) resp. Associations and their course over time are described in table 1. In summary: MTX had a lowering effect on both the CPDAI and PASDAS in the multivariate analysis, while baseline scores and disease duration had a raising effect. Higher baseline PASDAS and CPDAI values in the multivariate analysis were associated with being female, the presence of oligo- or polyarthritis and tender enthesis, for CPDAI also with the presence of morning stiffness. Similar results were observed in the 3-months linear regression.
Conclusions PASDAS and CPDAI decrease over time associated with the use of Methotrexate, while higher baseline values and longer disease duration affected this negatively.
Disclosure of Interest None declared