Background Psoriatic arthritis (PsA) is a chronic systemic inflammatory disease. Affecting skin, joints, entheses and dactylitis, its impact on health-related quality-of-life (HRQoL) could be substantial.
Objectives The aim of this study was to describe HRQoL in newly diagnosed PsA patients taking into account skin involvement, swollen joints, tender enthuses and dactylitis.
Methods HRQoL was assessed by 8 subscales of the Short-Form 36 (SF-36) questionnaire (0–100, higher score represents a better HRQoL). Patients were classified in arthritis subtypes (i.e. mono-, oligo- or polyarthritis) by rheumatologist. Entheses were evaluated using the Leeds Enthesitis Index (LEI) and Maastricht Ankylosing Spondylitis Enthesitis Score (MASES; positive if tender entheses >1). Psoriasis was evaluated using the Psoriasis Area Severity Index (PASI; mild: 0–7; moderate/severe: >7) and dactylitis using the Leeds Dactylitis Index (LDI).
Results 87 patients (48 male, 39 female, mean age 47,6±15,3) with PsA (21 had monoarthritis, 49 - oligoarthrit and 17 - polyarthritis) completed the SF-36 were included in the study. Psoriasis was mild in 63 (72,41%) patients and moderate/severe in 12 (13,79%) patiients. At least one digit with dactylitis was present in 10 (11,49%) of the patients. A tender enthesis was present in 39 (44,83%) of patients. Mean scores of the subdomains in the SF-36 were similar across the different arthritis groups, with slightly worse scores for polyarthritis compared to mono- and oligoarthritis. However, when stratifying these groups for the presence of a tender enthesis, HRQoL decreased substantially for all groups across all subdomains of the SF-36, with a median difference of 12,9 points. Irrespective of joint involvement, a tender enthesis decreased the mean scores of all subdomains significantly compared to the non-tender enthesis group (p<0,05). Severity of psoriasis and presence of dactylitis did not lead to significantly different SF-36 values compared to those not affected.
Conclusions Having tender entheses impacts HRQoL severly in both its physical and mental dimensions in incident untreated PsA.
Disclosure of Interest None declared