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Abstract
Background Psoriatic arthritis (PsA) can lead to impaired physical function and work productivity due to chronic inflammation. The goal of PsA treatment is minimal disease activity (MDA) or Remission/Low Disease Activity (REM/LDA) attainment by DAPSA. But there is limited data about the association between PsA activity and work productivity in routine care. The Russian Psoriatic Arthritis Registry (RU-PsART) collected data from 25 rheumatology clinics in the Russian Federation regions.
Objectives evaluate the association between attainment of REM/LDA by DAPSA and the WPAI-SHP in PsA pts in routine care.
Methods 294 (M/F–133/161) pts with PsA, diagnosed according to CASPAR criteria, mean age 41.2±1.9 (Min 21 – Max 72) years (yrs.), PsA duration 6.1±5.3 (Min 0 – Max 31) yrs., psoriasis duration 13.6±10.7 (Min 0.2 – Max 54.8) yrs. were included in the RU-PsART after signing consent participation forms. Pts underwent evaluation of PsA activity by DAPSA and considered REM≤4, LDA≤14, moderate disease activity (MDA) ≤28, high disease activity (HDA) >28 at baseline. 175 out of 294 pts fulfilled WPAI-SHP. DAPSA and WPAI-SHP at the same time were available in 135 out of 175 pts. 87 out of 135 patients were able to work and operate. At the time of evaluation 82 out of 135 pts were taking sDMARDs, 19 out of 135 pts – bDMARDs±sDMARDs, 11 out of 135 pts – NSAID and in 23 out of 135 pts data were missing. Overall work impairment, daily activity impairment, absenteeism and presentism were calculated. M±SD,%, ORs with 95% CI were performed. All CI >1 were considered to indicate statistical significance.
Results Daily activity impairment was found in 91 out of 135 pts (67%), overall work impairment – in 64 out of 87 pts (74%), presentism – in 47 out of 87 pts (49%), absenteeism – in 31 out of 87 pts (36%). 40 pts out of 135 (29.6%) had REM/LDA and 95 out of 135 pts (62.9%) had MDA/HAD by DAPSA accordingly at the time of the assessment. Among pts with MDA/HAD daily activity impairment, overall work impairment, presentism and absenteeism were seen in significantly more cases compared to pts with REM/LDA – in 69 out of 95 pts (73%) and in 22 out of 40 pts (55%), OR 2.17 [1.0–4.69]; in 54 out of 62 pts (87%) and in 10 out of 25 pts (40%), OR 10.13 [3.40–30.16]; in 38 out of 62 pts (38%) and in 9 out of 25 pts (36%), OR 2.81 [1.07–7.38]; in 30 out of 62 pts (48%) and in 1 out of 25 pts (4%), OR 22.5 [2.86–176.80] accordingly (Fig.1).
Interrelation between WPAI-SHP and PsA activity by DAPSA. ORs with 95% CI.
Conclusions Work disability is commonly found in PsA pts in routine care. REM/LDA status by DAPSA was associated with less disability and better work productivity.
Disclosure of Interest None declared