PMID- 37656147 OWN - NLM STAT- MEDLINE DCOM- 20231229 LR - 20240106 IS - 1502-7732 (Electronic) IS - 0300-9742 (Linking) VI - 53 IP - 1 DP - 2024 Jan TI - Psoriatic arthritis: improvement in outcomes but persistent sex difference - 5-year follow-up study of a Norwegian outpatient clinic population. PG - 10-20 LID - 10.1080/03009742.2023.2247703 [doi] AB - OBJECTIVE: This study aimed to explore long-term changes in disease activity and remission rates, and potential sex-related differences in these outcomes, in psoriatic arthritis (PsA) patients treated in an outpatient clinic. METHOD: This prospective longitudinal cohort study included 114 patients. The Disease Activity Index for Psoriatic Arthritis (DAPSA), clinical DAPSA (cDAPSA), 28-joint Disease Activity Score (DAS28), Simplified and Clinical Disease Activity Indices (SDAI, CDAI), Boolean remission for PsA, and minimal and very low disease activities (MDA, VLDA) were assessed. For group characteristics, parametric statistics and linear regression were used. RESULTS: At 5 year follow-up, improvement was noted for multiple measures reflecting disease activity and patient-reported outcomes. Statistically significant increases in remission rates were observed using DAS28 (+21.2%), CDAI (+9.7%), and cDAPSA (+7.6%), but not SDAI, DAPSA, Boolean remission, MDA, or VLDA. During the study period, the proportion of patients treated with biological disease-modifying anti-rheumatic drugs (bDMARDs) increased from 37.7% to 48.3% (p = 0.007). At baseline, women reported higher pain and fatigue, and had higher tender joint counts, DAPSA, cDAPSA, SDAI, CDAI, and DAS28 than men. Despite higher mean baseline C-reactive protein, men more often achieved remission, regardless of the definition applied. A higher proportion of men than women was treated with bDMARDs (baseline: 46.6% vs 28.6%; follow-up: 58.6% vs 33.9%). CONCLUSION: This study adds evidence supporting recent improvements in PsA outcomes. Women had higher disease activity and were less likely to achieve remission than men. Despite progress in achieving remission goals, there is still room for improvement in therapeutic approaches for PsA patients. FAU - Losinska, K AU - Losinska K AUID- ORCID: 0000-0003-2801-6584 AD - Division of Rheumatology and Immunology, University Hospital, Krakow, Poland. FAU - Michelsen, B AU - Michelsen B AUID- ORCID: 0000-0003-0103-2840 AD - Research Department, Sorlandet Hospital, Kristiansand, Norway. FAU - Kavanaugh, A AU - Kavanaugh A AUID- ORCID: 0000-0001-6942-5830 AD - Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, CA, USA. FAU - Korkosz, M AU - Korkosz M AUID- ORCID: 0000-0002-1749-9739 AD - Division of Rheumatology and Immunology, University Hospital, Krakow, Poland. AD - Department of Rheumatology and Immunology, Jagiellonian University Medical College, Krakow, Poland. FAU - Haugeberg, G AU - Haugeberg G AUID- ORCID: 0000-0002-9279-5191 AD - Department of Internal Medicine, Sorlandet Hospital, Kristiansand, Norway. AD - Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway. LA - eng PT - Journal Article DEP - 20230901 PL - England TA - Scand J Rheumatol JT - Scandinavian journal of rheumatology JID - 0321213 RN - 0 (Antirheumatic Agents) SB - IM MH - Humans MH - Male MH - Female MH - *Arthritis, Psoriatic/drug therapy MH - Follow-Up Studies MH - Treatment Outcome MH - Longitudinal Studies MH - Prospective Studies MH - Sex Characteristics MH - Remission Induction MH - *Antirheumatic Agents/therapeutic use MH - Ambulatory Care Facilities MH - Norway/epidemiology MH - Severity of Illness Index EDAT- 2023/09/01 12:42 MHDA- 2023/12/29 06:43 CRDT- 2023/09/01 10:35 PHST- 2023/12/29 06:43 [medline] PHST- 2023/09/01 12:42 [pubmed] PHST- 2023/09/01 10:35 [entrez] AID - 10.1080/03009742.2023.2247703 [doi] PST - ppublish SO - Scand J Rheumatol. 2024 Jan;53(1):10-20. doi: 10.1080/03009742.2023.2247703. Epub 2023 Sep 1.