Evaluation of changes in skin and joint outcomes and associated treatment changes in PsA: Experience from the Corrona PsA/SpA Registry
Abstract
Objective To characterize skin severity and joint activity outcomes and associated treatment changes in patients with PsA through 12 months of follow-up after enrollment in the Corrona Psoriatic Arthritis/ Spondyloarthritis (PsA/SpA) Registry.
Methods Patients ≥18 years of age with a diagnosis of PsA and a history of PsO between 3/21/13 and 9/30/16 were enrolled (n=647). Demographics, clinical features, and treatment characteristics were collected and stratified by skin severity and joint activity. Change in joint and skin from enrollment to the 12-month visit was classified by change in category of CDAI or BSA. Tests of association evaluated the relationship between changes in therapy and changes in skin severity and joint activity.
Results Patients with improvement in both joint activity and skin severity saw the largest median reduction in both CDAI and BSA, while those who worsened in both had the greatest median increase in both CDAI and BSA. The majority of PsA patients (>50%) had no change in skin severity regardless if they had reduced therapy (50%), no therapy changes (54%), or increased therapy (56%; p=0.5875). However, there was a significant association between changes in therapy and changes in joint activity (p<0.0001). Patients who increased therapy were more likely to have improvement in joint activity (32% of these patients) compared to patients who reduced therapy (22%) or had no therapy changes (11%).
Conclusion The clinical implication for our findings suggests the assessment and incorporation of both skin and joint components may be advisable.