Background Patients with psoriatic arthritis (PA) are more likely to suffer from other chronic medical conditions, associated comorbidities having significant impact upon both quality of life and survival. As disorders like the cardiovascular disease, metabolic syndrome, hepatic or renal pathologies were shown to be more prevalent in PA , assessment of comorbidities is important in these patients .
Objectives To investigate the concordance of different comorbidities scores in patients with PA.
Methods Prospective inclusion of patients diagnosed with PA according to the CASPAR (ClASsification criteria for Psoriatic ARthritis) criteria. Associated comorbidities were prospectively assessed using the Psoriatic arthritis comorbidity index (PsACI) with a cut-off of 8 points as previously defined . Also, the following comorbidities scores were completed in all patients: Charlson comorbidity index (CCI), Rheumatoid Arthritis Comorbidity Index (RACI), Rheumatic Diseases comorbidity index (RDCI), Functional comorbidity index (FCI).
Results A total of 56 patients were included: 27 (48.2%) were female, with a med (q1;q3) disease duration of 17.5 (12.7; 26.5) years for the cutaneous disease and 6.0 (4.0; 13.0) years for the articular one. At inclusion, the results of the comorbidities scores assessed were as follow: PsACI 3.2 (2.0; 6.5), CCI 1.0 (0.0; 2.0), RACI 3.5 (1.5; 6.5), RDCI 1.0 (0.0; 2.0), and FCI 2.0 (0.0; 2.0), respectively. According to PsACI, hypertension, hyperlipidemia, osteoarthritis, liver disease, and diabetes mellitus were the most frequent associated comorbidities in PA patients, in 53.6%, 44.6%, 41.1%, 37.5%, and 28.6% cases, respectively (see Table 1).
In bivariate analysis, we found significant correlations between the results of PsACI and those of the other comorbidities scores used: CCI (p<0.001, rho=0.668), RACI (p<0.001, rho=0.792), RDCI (p<0.001, rho=0.691), and FCI (p<0.001, rho=0.697), respectively.
The ability of the comorbidities scores assessed to discriminate a PsACI high value is presented in Figure 1, AUC (95%CI): CCI 0.743 (0.601- 0.886) p=0.017, RACI 0.815 (0.634 - 0.996) p=0.002, RDCI 0.818 (0.657-0.980) p=0.002, and FCI 0.837 (0.725-0.948) p=0.001, respectively.
Conclusion The composite indexes offer the advantage of reducing all associated comorbidities as long with their severity into a single score. We herein identified good correlations between the results of the comorbidities scores analyzed, PsACI, CCI, RDCI, RACI, and FCI, respectively.
References Kovitwanichkanont T, Chong AH, Foley P. Beyond skin deep: addressing comorbidities in psoriasis. Med J Aust 2020;212:528–34. doi:10.5694/mja2.50591
Miedany Y El, Gaafary M El, Youssef S, et al. Psoriatic arthritis comorbidity index: development and validation of a new specific tool for classifying prognostic comorbidity in psoriasis and psoriatic arthritis patients. Rheumatol Orthop Med 2017;2. doi:10.15761/ROM.1000117
Disclosure of Interests None declared
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