Reumatología Clínica

Reumatología Clínica

Volume 10, Issue 1, January–February 2014, Pages 25-31
Reumatología Clínica

Original article
Health-related quality of life in psoriatic arthritis patients in SpainCalidad de vida relacionada con la salud de pacientes con artritis psoriásica en España

https://doi.org/10.1016/j.reuma.2013.05.006Get rights and content

Abstract

Purpose

To describe the demographic and clinical characteristics, including health-related quality-of-life (HRQL), in patients with psoriatic arthritis (PsA).

Methods

287 patients from 18 Spanish centres were assessed. PsA severity was measured using the following criteria: (1) Psoriasis Area and Severity Index (PASI score 0–72, from low to high severity); (2) number of swollen and tender joints; and (3) Health Assessment Questionnaire (HAQ score 0–3 from low to high impairment in daily activities). HRQL assessment was performed using the following criteria: (a) EuroQol-5D (EQ-5D scores 1–3, with a higher score representing a worse HRQL), Visual Analogue Scale (VAS score 0–100, with a higher score representing a better HQRL) and (b) Short Form-36 (SF-36 score 0–100, with a higher score representing a better HRQL).

Results

24.7% of patients were treated with infliximab. In the two groups, 55.7% of the patients were male with a mean age of 52.40 ± 12.53 years. The average number of swollen joints was higher in patients not receiving biological therapy than in those receiving treatment (2.98 vs. 1.54). The mean PASI score was 3.73 ± 5.83, and there was no difference between groups.

HAQ scores were higher in patients receiving infliximab than in those not receiving treatment (0.93 vs. 0.70). The mean EQ-5D scores in the two groups indicated a poorer status based on pain and inability to perform usual/daily activities. HRQL measured by VAS score mean was 60.41 ± 20.08, and there was no difference between the groups. The domains in the SF-36 suggesting poorer functioning in the two groups were the physical role (50.76 ± 43.43), physical pain (49.35 ± 25.69) and the overall physical component (37.88 ± 10.87).

Conclusions

PsA is associated with an impaired HRQL characterised by physical pain and poorer functioning in daily activities.

Resumen

Objetivo

Describir las características clínicas y demográficas, así como la calidad de vida relacionada con la salud (CVRS), en pacientes con artritis psoriásica (APs).

Métodos

Se evaluó a 287 pacientes procedentes de 18 centros españoles. La gravedad de la APs se midió mediante: (1) Psoriasis Area and Severity Index (PASI 0-72, de menor a mayor gravedad); (2) número de articulaciones inflamadas y dolorosas, y (3) Cuestionario de Evaluación de Salud (HAQ), cuyas puntuaciones van de 0 a 3, de baja a gran afectación en las actividades diarias. La CVRS se midió mediante: (a) el cuestionario EuroQol-5D (las puntuaciones del EQ-5D van de 1 a 3; a valores más altos, peor CVRS) y la Escala Visual Analógica (EVA, donde las puntuaciones van de 0 a 100; a valores más altos, mejor HQRL), y (b) SF-36, donde las puntuaciones van de 0 a 100; a valores más altos, mejor CVRS.

Resultados

El 24,7% de los pacientes fueron tratados con infliximab. En los 2 grupos, la edad media fue de 52,40 + 12,53 años y un 55,7% fueron varones. El número medio de articulaciones inflamadas fue mayor en los pacientes que no recibieron infliximab (2,98 vs. 1,54). La media de las puntuaciones en el PASI fue de 3,73 ± 5,83, sin diferencias entre grupos.

Las puntuaciones en el HAQ fueron mayores en los pacientes con infliximab (0,93 vs. 0,70). Las puntuaciones medias de EQ-5D en los 2 grupos que indican peor estado de salud fueron: el dolor y la incapacidad para realizar actividades diarias. La CVRS medida por la puntuación media de la EVA fue 60,41 ± 20,08, sin diferencias entre grupos. En el SF-36, las dimensiones con valores más bajas en los 2 grupos fueron: función física 50,76 ± 43,43, dolor corporal 49,35 ± 25,69 y el componente físico general 10,87 ± 37,88.

Conclusiones

La APs se asocia a un deterioro de la CVRS caracterizada por dolor corporal y peor funcionamiento en las actividades diarias.

Section snippets

Study design

A cross-sectional, observational, multi-centre study was conducted involving 18 centres in Spain. Information on patient clinical characteristics and HRQL was collected by a dermatologist and rheumatologist working together in each centre. The study was approved by the Clinical Research Ethics Committee for all of the participating centres, and informed consent was signed by all of the subjects in the study. The recruitment period was from January to March 2007.

The patient inclusion criteria

Characteristics of the patients with psoriatic arthritis

The study included 287 patients with psoriatic arthritis, with 71 (24.7%) patients receiving infliximab. The patient demographics are shown in Table 1. The mean (±SD) age was 52.4 (±12.5) years, and the mean weight was 76.5 (±15.1) kg. Additionally, 56% of the patients were male. Of the 287 patients, 16 (6%) lived alone. No significant differences were found in the demographic characteristics between the patients receiving or not receiving infliximab.

No significant differences were found between

Discussion

To our knowledge, our study is the first one performed in Spain to measure HRQL only in psoriatic arthritis. Other publications23, 24 included a mixed psoriasis and psoriatic arthritis population and did not categorise the results by disease.

The most important impairment observed in the study was related to work and daily activities. The main problem communicated by the patients was the impairment that arthropathy causes on normal daily living. Patients sometimes feel unable to perform some

Protection of human and animal subjects

The authors declare that the procedures followed were in accordance with the regulations of the responsible Clinical Research Ethics Committee and in accordance with those of the World Medical Association and the Helsinki Declaration.

Confidentiality of data

The authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in

Funding

This study received an unconditional grant from Schering-Plough. The authors had independence from the funding body with respect to study design, analysis and interpretation of the data, report writing, and submission of the manuscript for publication.

Conflict of interest

The authors declare no conflict of interest.

Acknowledgements

The authors thank Eliazar Sabater and Covadonga Torres of Pharmacoeconomics and Outcomes Research Iberia (PORIB) for their assistance with the statistical analysis and manuscript writing.

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