Quality of life
Assessing the Impact of Psoriatic Arthritis on Patient Function and Quality of Life: Lessons Learned from Other Rheumatologic Conditions

https://doi.org/10.1016/j.semarthrit.2008.01.003Get rights and content

Objectives

To identify and describe measures that can be used to assess the impact of psoriatic arthritis (PsA) on patient functioning and health-related quality of life (HRQOL).

Methods

A literature search of the PubMed database to identify papers describing assessment tools for quality of life and function in rheumatic diseases.

Results

Many tools have been developed that can be used to assess the impact of rheumatic disease on patient functioning and HRQOL. Although several disease-specific tools have been developed for rheumatoid arthritis, ankylosing spondylitis, and psoriasis, few have been developed specifically for PsA, a condition that affects both skin and joints. However, several have been adopted from their use in other conditions and used in clinical trials, such as the Health Assessment Questionnaire and Short Form 36 and have shown good performance characteristics. The Psoriatic Arthritis Quality of Life questionnaire, a recently developed disease-specific instrument, has good internal consistency, validity, and reliability. Initiatives are underway by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis to evaluate Psoriatic Arthritis Quality of Life responsiveness to treatment in clinical trials, in addition to other projects intended to improve the assessment of quality of life and function in PsA. These efforts are influenced by “lessons learned” from assessment tools in rheumatoid arthritis, ankylosing spondylitis, and psoriasis.

Conclusions

Assessing the impact of PsA and its treatment on patient function and quality of life is critical to improving patient outcomes, and therefore, valid and reliable tools that can be easily used in both clinical trials and clinical practice are being developed and refined.

Section snippets

Methods

The PubMed database and recent meeting abstracts were searched to find articles relevant to the assessment of patient function and HRQOL in PsA and related conditions. The following search terms were included: rheumatoid arthritis, spondyloarthropathy, ankylosing spondylitis, psoriatic arthritis, and psoriasis for title; combined with the terms quality of life, patient-reported outcomes, function, physical, psychosocial, psychological, depression, fatigue, employment, and work for abstract. The

Impact of Disease

Psoriatic arthritis is characterized by inflammatory arthritis and enthesitis occurring in patients with psoriasis. Psoriasis is present in about 1 to 5% of the general population of North America and Europe (4, 5). Extensive telephone surveys of psoriasis patients conducted in the United States and Europe reveal a diagnosis of PsA in 11 to 30% of patients (6, 7). The average age of onset is age 40 years (8), and the condition occurs equally among men and women (9). Clinically, PsA involves

Discussion

A number of recent studies have demonstrated improvements in function and HRQOL with treatment in patients with PsA (Table 5). Most data are derived from major placebo-controlled trials of biologic therapies, but data are also available from 2 trials of nonbiologic agents. Patients with PsA treated with leflunomide 20 mg/d for 24 weeks demonstrated greater improvement in clinical measures, function (HAQ), and quality of life (DLQI) compared with placebo controls (160). Although combination

Acknowledgments

The author thanks Debra Stamper, PhD and Rick Davis, MS, RPh, who provided medical writing services on behalf of Amgen Inc.

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    Dr. Mease has received research grant support, consulting fees, and speaker honoraria from Abbott, Amgen, BiogenIDEC, Bristol Myers Squibb, Centocor, Genentech, and Wyeth. He has received consulting fees from UCB.

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