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Disease Characteristics, Quality of Life, and Work Productivity by Enthesitis Site: Real-world Data From the US Corrona Psoriatic Arthritis/Spondyloarthritis Registry

Author

J Rheumatol. 2020 Jun 1;jrheum.191117. doi: 10.3899/jrheum.191117. Online ahead of print.

Philip J Mease 1Mei Liu 1Sabrina Rebello 1Winnie Hua 1Robert R McLean 1Peter Hur 1Alexis Ogdie 1

Author Information

1 This study was sponsored by Corrona, LLC. Corrona, LLC, has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Crescendo, Eli Lilly and Company, Genentech, Gilead, GSK, Janssen, Merck, Momenta Pharmaceuticals, Novartis, Ortho Dermatologics, Pfizer Inc., Regeneron, Roche, Sun, and UCB. The design and conduct of the study were a collaborative effort between Corrona, LLC, and Novartis, and financial support for the study was provided by Novartis. Novartis participated in the interpretation of data and review and approval of the manuscript. P.J. Mease, MD, MACR, Swedish Medical Center/Providence St. Joseph Health and University of Washington, Seattle, Washington; M. Liu, PhD, S. Rebello, MPH, W. Hua, MS, R.R. McLean, DSc, MPH, Corrona, LLC, Waltham, Massachusetts; P. Hur, PharmD, MBA, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; A. Ogdie, MD, MCSE, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. PJM has received research grants from Celgene, Novartis, AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Pfizer, and UCB; consulting fees from Celgene, Corrona, Novartis, AbbVie, Amgen, Bristol Myers Squibb, Galapagos, Gilead, Janssen, Eli Lilly, Merck, Pfizer, Sun, and UCB; and speakers bureau fees from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Genentech, Janssen, Pfizer, and UCB. M. Liu, S. Rebello, WH, and RRM are employees of Corrona, LLC. PH is an employee of Novartis Pharmaceuticals Corporation. AO has received consulting fees from Amgen, AbbVie, Bristol Myers Squibb, Celgene, Eli Lilly, Novartis, and Pfizer, and has received grant support from the National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Psoriasis Foundation, Rheumatology Research Foundation, Pfizer, and Novartis. Address correspondence to Dr. P. Mease, Seattle Rheumatology Associates, 601 Broadway, Suite 600, Seattle, WA 98122, USA. Email: pmease@philipmease.com. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication May 14, 2020.

Abstract

Objective: To assess the effect of clinical enthesitis by body site in patients with psoriatic arthritis (PsA).

Methods: Adults with PsA enrolled in the Corrona Psoriatic Arthritis/Spondyloarthritis Registry (March 2013-March 2018) were included. Enthesitis at enrollment was assessed by the Spondyloarthritis Research Consortium of Canada Enthesitis Index and classified by affected sites (upper, lower, or both). Disease activity (e.g., Clinical Disease Activity Index, Clinical Disease Activity Index for PsA), patient-reported outcomes (PRO; e.g., patient-reported pain and fatigue), and work productivity were compared between those with and without enthesitis using t- or Wilcoxon rank-sum tests for continuous variables and chi-square or Fisher exact tests for categorical variables. The association of enthesitis with disease activity and PRO measures versus no enthesitis was modeled using multivariable-adjusted linear or logistic regression.

Results: Of 2003 patients with PsA, 391 (19.5%) had enthesitis: 80 (20.5%) in upper sites only; 137 (35.0%) in lower sites only; and 174 (44.5%) in both. Regardless of location, disease activity and PRO were worse in patients with versus without enthesitis. In adjusted models, the presence of enthesitis at any site was significantly associated with worse disease activity versus no enthesitis. Enthesitis in lower or both upper and lower sites was associated with higher pain and fatigue scores and greater work impairment versus no enthesitis.

Conclusion: Patients with clinical enthesitis had worse disease activity regardless of enthesitis location versus those without enthesitis, and patients with enthesitis in lower or both upper and lower sites had worse pain, fatigue, and work impairment.