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SAT0440 Do depression and anxiety influence the chance of remission in patients with psoriatic arthritis? real life data from the nor-dmard study
  1. B Michelsen1,2,
  2. EK Kristianslund1,
  3. KM Fageli1,
  4. E Lie1,
  5. HB Hammer1,
  6. G Haugeberg2,3,
  7. TK Kvien1
  1. 1Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo
  2. 2Dept. of Rheumatology, Hospital of Southern Norway Trust, Kristiansand
  3. 3Dept. of Rheumatology, Martina Hansens Hospital, Oslo, Norway

Abstract

Background Depression and anxiety are frequent comorbidities in psoriatic arthritis (PsA). Still, the potential influence of depression/anxiety on achievement of remission remains unexplored.

Objectives To investigate the predictive value of baseline depression/anxiety on the likelihood of achieving remission in PsA, as well as the associations between baseline depression/anxiety and the components of the remission criteria at follow-up.

Methods From the prospective multi-center observational NOR-DMARD study we included PsA patients starting first-time methotrexate/tumor necrosis factor inhibitors between year 2006 and 2012. The following criteria for depression/anxiety were assessed: 1) the Medical Outcomes Survey Short Form-36 (SF-36) Mental Health subscale (MH)≤56 and 2) SF-36 Mental Component Summary score (MCS)≤38.1 The predictive value of baseline depression/anxiety on remission at 3 and 6 months was explored in prespecified logistic regression models adjusted for age, sex, disease duration and smoking, and the associations between baseline depression/anxiety and the components of the remission criteria at follow-up in prespecified multiple linear regression models adjusted for age, sex, disease duration and smoking.

Results 805 PsA patients were included (mean (SD) age 48.0 (12.4) years, median (25th-75th percentile) disease duration 1.0 (0.07–6.8) years, 50.8% females, 28.6% current smokers). According to the SF-36MH≤56/SF-36MCS≤38 criteria 15.6/25.2% of the patients had depression/anxiety at baseline, respectively. Lower percentages of patients with vs. without baseline depression/anxiety achieved remission at 6 months (unadjusted analyses;figure). Patients with baseline depression/anxiety had consistently lower point estimates for achievement of remission at follow-up, but did not reach significance for all the analyses (adjusted analyses, table).

Table 1

Baseline depression/anxiety was associated with increased patient's global assessment and joint pain at follow-up, but not with swollen joint count or levels of acute phase reactants.

Conclusions Depression and anxiety may reduce likelihood of remission based on composite scores in PsA. These observations support a focus on depression and anxiety as comorbidities in a treat-to-target strategy and may also reflect that patient reported outcome measures are part of all these composite measures used to define remission.

References

  1. Matcham et al. BMC Musculoskelet Disord. 2016;17:224.

References

Disclosure of Interest B. Michelsen: None declared, E. Kristianslund: None declared, K. Fageli: None declared, E. Lie Consultant for: Hospira, Pfizer, UCB, Speakers bureau: AbbVie, Celgene, H. Hammer Consultant for: AbbVie, Pfizer, UCB, Roche, MSD, BMS and Novartis., Speakers bureau: AbbVie, Pfizer, UCB, Roche, MSD, BMS and Novartis., G. Haugeberg: None declared, T. Kvien Consultant for: AbbVie, Biogen, BMS, Boehringer Ingelheim, Celltrion, Eli Lilly, Epirus, Janssen, Merck-Serono, MSD, Mundipharma, Novartis, Oktal, Orion Pharma, Hospira/Pfizer, Roche, Sandoz and UCB, Speakers bureau: AbbVie, Biogen, BMS, Boehringer Ingelheim, Celltrion, Eli Lilly, Epirus, Janssen, Merck-Serono, MSD, Mundipharma, Novartis, Oktal, Orion Pharma, Hospira/Pfizer, Roche, Sandoz and UCB

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