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26.11.2019 | Observational Research

Enthesitis and its relationship with disease activity, functional status, and quality of life in psoriatic arthritis: a multi-center study

verfasst von: Ismihan Sunar, Sebnem Ataman, Kemal Nas, Erkan Kilic, Betul Sargin, Sevtap Acer Kasman, Hakan Alkan, Nilay Sahin, Gizem Cengiz, Nihan Cuzdan, Ilknur Albayrak Gezer, Dilek Keskin, Cevriye Mülkoğlu, Hatice Resorlu, Ajda Bal, Mehmet Tuncay Duruöz, Okan Küçükakkaş, Ozan Volkan Yurdakul, Meltem Alkan Melikoglu, Yıldıray Aydın, F. Figen Ayhan, Hatice Bodur, Mustafa Calis, Erhan Capkın, Gul Devrimsel, Kevser Gok, Sami Hizmetli, Ayhan Kamanlı, Yaşar Keskin, Hilal Kocabas, Oznur Kutluk, Nesrin Şen, Omer Faruk Şendur, Ibrahim Tekeoğlu, Sena Tolu, Murat Toprak, Tiraje Tuncer

Erschienen in: Rheumatology International | Ausgabe 2/2020

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Abstract

Psoriatic arthritis (PsA) is an inflammatory arthritis with distinct phenotypic subtypes. Enthesitis is assigned as a hallmark of the disease, given its significant relations to disease activity and quality of life. Our objective is to evaluate the prevalence of enthesitis and its association with some clinical parameters, particularly quality of life, using data from a national registry. Patients with PsA meeting ClASsification criteria for Psoriatic Arthritis (CASPAR) were enrolled by means of a multi-centre Turkish League Against Rheumatism (TLAR) Network Project. The following information was recorded in web-based case report forms: demographic, clinical and radiographic data; physical examination findings, including tender and swollen joint counts (TJC and SJC); nail and skin involvement; Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte Sedimentation Rate (DAS 28-ESR); Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Maastricht Ankylosing Spondylitis Enthesitis Score (MASES); Psoriasis Area Severity Index (PASI); Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s); Health Assessment Questionnaire (HAQ); Bath Ankylosing Spondylitis Functional Index (BASFI); Health Assessment Questionnaire for the spondyloarthropathies (HAQ-s); Psoriatic arthritis quality of Life scale (PsAQoL); Short Form 36 (SF-36); Hospital Anxiety Depression Scale (HADS); Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); and Fibromyalgia Rapid Screening Tool (FiRST) scores. The patients were divided into two groups, namely with and without enthesitis, based on the triple Likert-type physician-reported statement of ‘active enthesitis’, ‘history of enthesitis’ or ‘none’ in the case report forms. Patients with active enthesitis were compared to others in terms of these clinical parameters. A total of 1130 patients were enrolled in this observational study. Of these patients, 251 (22.2%) had active enthesitis according to the clinical assessment. TJC, HAQ-s, BASDAI, FiRST and PsAQoL were significantly higher whereas the SF-36 scores were lower in patients with enthesitis (p < 0.05). Chronic back pain, dactylitis, and tenosynovitis were more frequent in the enthesopathy group (59.4%/39%, 13.1%/6.5% and 24.7%/3.4%, respectively). Significant positive correlations between the MASES score and the TJC, HAQ, DAS 28-ESR, BASDAI, FiRST and PsAQoL scores, and a negative correlation with the SF-36 score were found. When linear regression analysis was performed, the SF-36 MCS and PCS scores decreased by − 9.740 and − 11.795 units, and the FiRST scores increased by 1.223 units in patients with enthesitis. Enthesitis is an important involvement of PsA with significant relations to quality of life determined with PsAQoL and SF-36 scores. Our study found higher frequency of dactylitis and chronic back pain, and worse quality of life determined with SF-36 and PsAQoL scores in patients with enthesitis.

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Titel: Enthesitis and its relationship with disease activity, functional status, and quality of life in psoriatic arthritis: a multi-center study
verfasst von: Ismihan Sunar
Sebnem Ataman
Kemal Nas
Erkan Kilic
Betul Sargin
Sevtap Acer Kasman
Hakan Alkan
Nilay Sahin
Gizem Cengiz
Nihan Cuzdan
Ilknur Albayrak Gezer
Dilek Keskin
Cevriye Mülkoğlu
Hatice Resorlu
Ajda Bal
Mehmet Tuncay Duruöz
Okan Küçükakkaş
Ozan Volkan Yurdakul
Meltem Alkan Melikoglu
Yıldıray Aydın
F. Figen Ayhan
Hatice Bodur
Mustafa Calis
Erhan Capkın
Gul Devrimsel
Kevser Gok
Sami Hizmetli
Ayhan Kamanlı
Yaşar Keskin
Hilal Kocabas
Oznur Kutluk
Nesrin Şen
Omer Faruk Şendur
Ibrahim Tekeoğlu
Sena Tolu
Murat Toprak
Tiraje Tuncer
Publikationsdatum: 26.11.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Rheumatology International / Ausgabe 2/2020
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-019-04480-9

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