Evaluation of Clinical Diagnosis of Axial Psoriatic Arthritis (PsA) or Elevated Patient-reported Spine Pain in CorEvitas' PsA/Spondyloarthritis Registry

Objective. To determine the presence of axial symptoms in patients with psoriatic arthritis (PsA) and examine differences between those with or without a diagnosis of axial PsA (axPsA). Methods. Patients with PsA at their Corevitas' (formerly Corrona) Psoriatic Arthritis/Spondyloarthritis Registry enrollment visit were stratified into 4 mutually exclusive groups based on axial manifestations: physician-diagnosed axPsA only (Dx(+)Sx(-)), patient-reported elevated spine symptoms only (Dx(-)Sx(+); defined as Bath Ankylosing Spondylitis Disease Activity Index >= 4 and spine pain visual analog scale >= 40), physician-diagnosed and patient-reported manifestations (Dx(+)Sx(+)), and no axial manifestations (Dx(-)Sx(-)). Patient characteristics, disease activity, and patient-reported outcomes (PROs) at enrollment in each axial manifestation group were compared with the Dx(-)Sx(-) group. Associations of patient characteristics with the odds of having axial manifestations were estimated using multinomial logistic regression (reference: Dx(-)Sx(-)). Results. Of 3393 patients included, 226 (6.7%) had Dx(+)Sx(-), 698 (20.6%) had Dx(-)Sx(+), 165 (4.9%) had Dx(+)Sx(+), and 2304 (67.9%) had Dx(-)Sx(-). Patients with Dx(-)Sx(+) or Dx(+)Sx(+)were more frequently women and had a history of depression and fibromyalgia (FM) vs patients who had Dx(-)Sx(-). Patients with Dx(+)Sx(-) or Dx(+)Sx(+) were more frequently HLA-B27 positive than those with Dx(-)Sx(-). FM was significantly associated with increased odds of Dx(+)Sx(-) or Dx(+)Sx(+). Disease activity and PROs were worse in patients with Dx(-)Sx(+) or Dx(+)Sx(+) than in those with Dx(-)Sx(-). Conclusion. Patients who had self-reported elevated spine symptoms, with or without physician-diagnosed axPsA, had worse quality of life and higher disease activity overall than patients without axial manifestations, suggesting an unmet need in this patient population.

Automated summary

The study aimed to evaluate the presence of axial symptoms in patients with psoriatic arthritis (PsA) and examine the differences between patients with or without a diagnosis of axial PsA. It found that patients who reported elevated spine symptoms, regardless of whether they had a diagnosed axial PsA or not, had a worse quality of life and higher disease activity, indicating an unmet need in this patient population.