PT  - JOURNAL ARTICLE
AU  - Philip J.  Mease
AU  - Carol J.  Etzel
AU  - William J.  Huster
AU  - April W.  Armstrong
AU  - Talia M.  Muram
AU  - Jeffrey Lisse
AU  - Sabrina Rebello
AU  - Rhiannon Dodge
AU  - Mwangi J.  Murage
AU  - Jeffrey D.  Greenberg
AU  - William N.  Malatestinic
TI  - Evaluation of Changes in Skin and Joint Outcomes and Associated Treatment Changes in Psoriatic Arthritis (PsA): Experience from the Corrona PsA/SpA Registry
AID  - 10.3899/jrheum.190422
DP  - 2020 May 01
TA  - The Journal of Rheumatology
PG  - jrheum.190422
4099  - http://www.jrheum.org/content/early/2020/11/26/jrheum.190422.short
4100  - http://www.jrheum.org/content/early/2020/11/26/jrheum.190422.full
AB  - Objective To characterize skin severity and joint activity outcomes and associated treatment changes in patients with psoriatic arthritis (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 psoriasis between March 21, 2013, and September 30, 2016, 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 Clinical Disease Activity Index (CDAI) or body surface area (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 < 0.001). Patients who increased therapy were more likely to have improvement in joint activity (32%) 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.