The burden of psoriatic arthritis in the biologics era: data from the Belgian Epidemiological Psoriatic Arthritis Study.

OBJECTIVES

To characterize the frequency of PsA subtypes, estimate the severity based on damage and inflammation and estimate the impact of PsA on patients' health-related quality of life.

METHODS

We conducted a longitudinal observational study in 17 academic and non-academic centres in Belgium. Patients with PsA fulfilling Classification Criteria for Psoriatic Arthritis were recruited. Three visits were scheduled: at baseline (T0), at 1 year (±1 month; T1) and at 2 years (±1 month; T2) of follow-up. Demographics, clinical data and patient-reported outcome measures were collected at T0, T1 and T2. X-rays of the hands and feet were collected yearly (T0, T1 and T2). X-rays of the spine were collected at T0 and T2. Here we report on the burden of disease based on the clinical data and patient-reported outcomes.

RESULTS

A total of 461 patients were recruited; 73.5% had combined peripheral and axial involvement and 13.7% had hip involvement. Plaque psoriasis was predominant (83.9%). At inclusion, 42.7% and 58.8% had no tender or swollen joints, respectively. Dactylitis and enthesitis were still present in 13.7% and 24.1% of the patients, respectively. Patients was treated with DMARDs (68%) and/or anti-TNF (44.2%). Forty-three per cent of the patients had a state of minimal disease activity and 62% considered the actual state as satisfactory. The mean HAQ score was 0.7%, with 32.5% of patients having a normal score (<0.3).

CONCLUSION

Despite the availability of different treatment options, including biologics (anti-TNF), a substantial number of patients have active disease and have a high disease burden.