ABS0633 COMPARISON OF PSORIATIC ARTHRITIS SINE PSORIASIS AND CLASSICAL PSA PATIENTS; A MULTI-CENTER STUDY

Abstract

Background:Psoriatic arthritis (PsA) is an inflammatory disease with skin and musculoskeletal manifestations as well as systemic consequences. While patients with skin or nail lesions antedating or evolving simultaneously as rheumatologic involvement constitute the majority of cases, others are called PsA sine psoriasis.Objectives:Our objective is to evaluate the frequency of PsA sine psoriasis patients and compare them with classical PsA in terms of clinicodemographic variables, disease activity, and quality of life using data from a multicenter registry.Methods:PsA patients meeting the Classification criteria for Psoriatic Arthritis (CASPAR) registered in a multi-centre Turkish League Against Rheumatism (TLAR) Network Project were screened. Demographic and clinical data including detailed history, radiographic data, tender and swollen joint counts, body mass index (BMI), the Disease Activity Index for Psoriatic Arthritis (DAPSA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), Health Assessment Questionnaire (HAQ); Bath Ankylosing Spondylitis Functional Index (BASFI); Psoriatic arthritis quality of Life scale (PsAQoL), Short Form 36 (SF-36); Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and Fibromyalgia Rapid Screening Tool (FiRST) were retrieved from electronical records. The patients were divided into two main groups according to the onset of skin lesions and arthritis. The patients with presentation of arthritis were labeled as ‘Total PsA sine psoriasis\" and the remainder were classical PsA patients. Patients who did not ever have skin involvement were accepted as ‘current PsA sine psoriasis\". Comparisons were performed between three groups.Results:This study included 1346 PsA patients with a mean age of 47.10 (±12.32) years. Of the patients, 64.8% were women. Three groups were similar in terms of age, BMI, and gender (p>0.05). A total of 216 (16.05%) patients had presented with articular complaints prior to skin involvement and labeled as ‘PsA sine psoriasis\". Forty one (3.05%) patients still lacked psoriatic skin disease and called as ‘current sine psoriasis\" and the remainder were ‘classical PsA\". Compared to classical PsA, sine psoriasis patients tended to have significantly longer diagnostic delay, higher rate of family history of psoriatic disease and IBD, and spondylitis (p<0.001, p=0.030, p=0.005, p=0.007). They also had higher MASES, BASFI, PsAQoL, FACIT, and HAQ scores (p=0.009, p=0.027, p=0.003, p=0.003, p=0.015 respectively). The groups were similar in terms of DAPSA and BASDAI scores (p=0.108, p=0.135) (Table 1).Conclusion:The frequency of PsA sine psoriasis was 16.05% in this multi-center national study. PsA sine psoriasis patients had significantly longer diagnostic delay, higher rate of IBD, and spondylitis. These patients had similar disease activity scores depicted by DAPSA and BASDAI but lower quality of life and impaired functionality shown by PsAQoL, BASFI, SF-36, FACIT, and HAQ scores.