AB0947 CORRELATION BETWEEN ENTHESITIS AND CLINICAL PHENOTYPE PSORIASIS, NAIL PSORIASIS AND DURATION PSORIASIS IN PATIENTS WITH PSORIATIC ARTHRITIS

Abstract

BackgroundPsoriatic arthritis (PsA) is a disease with multidimentional manifestations in patients who have psoriasis (PsO). Enthesitis is an important component of PsA and may be a primary pathological feature driving other manifestations of the disease. [1] Psoriasis and psoriatic nail dystrophy are also important predictors of PsA. Skin and joint disease may indeed arise from the same underlying process at the same time, with patients developing similar inflammatory lesions in the skin and entheses, while the speed of detection of these lesions is different and allows skin changes to be detected earlier. [2]Objectivesto evaluate correlation between enthesitis and clinical phenotype psoriasis, nail psoriasis and duration psoriasis in patients with psoriatic arthritis.Methods187 (M/F=97 (50.2%)/90(48.8%) PsA pts fulfilling the CASPAR criteria were included. Mean age 45.6±11.7 years (yrs), DAPSA 21.05±21.03, median (Me) PsA duration 88 [16;421] mo. All pts underwent standard clinical examinations. Analysis were performed in 2 groups: enthesitis positive (42.3%) and enthesitis negative (57.7%), for assess enthesitis in PsA pts used Leeds Enthesitis Index (LEI), modified LEI (LEI and plantar fascia), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES).ResultsWhen 79 (42.3%) pts with enthesitis and 108 pts (57.7%) without enthesitis were compared. In pts with enthesitis had more duration PsO – 275,6±153,4 vs 227,4±139,5, p=0,03. The duration of PsA, both groups were comparable (p=0,9). Also in pts with enthesitis had more nail PsO - 66,6% vs 45% (p=0,005). BSA in both group were comparable, but in pts with enthesitis had more inverse PsO – 6,94% vs 3%, gluttate PsO – 4% in pts without enthesitis with phenotype PsO did not have, and combination plaque and inverse PsO – 51,3% vs 31% (p=0,0056). Moreover, significant but weak positive correlations between the LEI score and duration PsO and nail PsO. Аssessment of the correlation modified LEI score and MASES score showed significant positive correlations with duration PsO, nail PsO and phenotype PsO. (Table 1).Table 1.Correlation between LEI, modified LEI, MASES and parameters PsO.ParametersLEIModified LEIMASESrprprpDuration psoriasis0,30,0010,30,010,340,03BSA0,050,40,060,40,070,3Nail psoriasis0,30,0010,35<0,00010,320,01Phenotype psoriasisPlaque psoriasis--0,530,0010,610,001Plaque+inverse psoriasis--0,650,0010,620,001Inverse psoriasis--0,700,020,660,03Gluttate psoriasis--0,630,0010,630,001ConclusionIn our cohort PsA pts reported that with enthesitis is associated with duration PsO, nail psoriasis and phenotype PsO. These finding should be considered in the turn of improved screening, earlier diagnosis, timely treatment initiation and, eventually, should improve overall disease outcomes.References[1]McGonagle D G, Helliwell P, Veale D. Enthesitis in psoriatic disease. Dermatology. 2012;225:100–109. DOI: 10.1159/000341536[2]Simon D, Tascilar K, Kleyer A at al. Association of structural entheseal lesions with an increased risk of progression from psoriasis to psoriatic arthritis. Arthritis & Rheumatology. 2022;74(2):253-262. DOI 10.1002/art.4123Disclosure of InterestsNone declared