Nav: Home

New comorbidity tool predicts risk of hospitalisation and death in psoriatic arthriti

June 09, 2016

London, United Kingdom, June 9, 2016: The results of a study presented today at the European League Against Rheumatism Annual Congress (EULAR 2016) showed that a newly developed method of evaluating the impact of different comorbidities in patients with Psoriatic Arthritis (PsA) can be used to prospectively identify those PsA patients at greater risk of hospitalisation and premature death. In addition to helping predict the future use of resources and identify targets to reduce costs, application of this new PsA-comorbidity index may ultimately improve outcomes for PsA patients.

"To date, no disease-specific models had been developed to identify those comorbidities with the greatest impact on PsA patients' health status," said Dr Yasser El Miedany of the Department of Rheumatology, Darent Valley Hospital, UK. "We have now developed and validated a PsA-comorbidity index (PsACI), which will enable clinicians to prospectively include comorbidities assessment and management in their standard practice.

"Once our research has been published, we suggest this new tool is included as part of the patient-reported outcome measures used in standard clinical practice. By making PsACI available to rheumatologists worldwide, we hope it will prove an effective guide to optimising the management of Psoriatic Arthritis," Dr Yasser El Miedany concluded.

PsA, an inflammatory arthritis associated with joint pain and swelling which can lead to joint damage and long-term disability, is a common complication of psoriasis. Psoriasis occurs in 1-3% of the population, and the estimated prevalence of PsA among psoriasis patients varies widely from 6-42%, due to heterogeneity in study methods and the lack of widely accepted classification or diagnosis criteria. Due to dual skin and joint involvement, patients with PsA experience further impairment and consequently a lower quality of life compared with patients with psoriasis alone.

Besides skin and joint involvement, PsA is associated with multiple comorbidities, including metabolic syndrome (hyperlipidaemia, hypertension, diabetes mellitus, and obesity), other autoimmune diseases (e.g. inflammatory bowel disease), and lymphoma. In addition, this burden of physical comorbidities,

which increases with the severity of the psoriasis and with the presence of severe PsA, increases mortality.2

A retrospective multicentre analysis of 1,707 PsA patients, monitored over a 10-year period, assessed the impact of different comorbidities on predicting future death and hospitalisation. To develop a morbidity index score, different cut-off values were identified to delineate patients at different stages of risk of hospitalisation and death.

Those PsA patients who had a higher incidence of comorbid conditions and were at higher risk of hospitalisation were men, with older age at disease onset, and a high BMI at baseline (p < 0.05). The most prevalent comorbidities strongly associated with a 10-year risk of death or hospitalisation in PsA patients were: cardiovascular (seven different comorbidities), osteoporosis, falls, depression / anxiety, diabetes mellitus, renal and liver diseases, lung and GI problems, as well as infection (p < 0.001).

A Multidimensional Disease Severity score as an independent predictor of disease status (based on 5 different indicators of disease activity (DAPSA, PASI , Functional disability score, enthesitis and ESR /CRP ) was shown to be significantly associated with the 10-year risk of death or hospitalisation (p=0.002). Male gender, cardiovascular disease, evidence of a risk of falls, diabetes, infection, anxiety, and this MDR score were all significant independent factors affecting the outcome of the disease at 10 years.

The PsA comorbidity index weighted according to analysis of the above variables produced a score that ranged from 0 to 36, with a cut-off point of 14.5 associated with a sensitivity of 97.5% and a specificity of 87%.

Abstract Number: OP0091
-end-
NOTES TO EDITORS:

For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress

Press Office in the London Suite at ExCel London during EULAR 2016 or on:

Email:eularpressoffice@cohnwolfe.com

Onsite tel: +44 (0) 7725 915 492 / +44 (0) 7786 171 476

Twitter: @EULAR_Press

Youtube: Eular Pressoffice

About EULAR

The European League Against Rheumatism (EULAR) is an umbrella organisation which represents scientific societies, health professional associations and organisations for people with Rheumatic Musculoskeletal Diseases (RMD) throughout Europe.

EULAR aims to promote, stimulate and support the research, prevention, and treatment of RMD and the rehabilitation of those it affects.

EULAR underlines the importance of combating rheumatic diseases not only by medical means, but also through a wider context of care for rheumatic patients and a thorough understanding of their social and other needs. EULAR is supported in this mission by its 45 scientific member societies, 36 PARE (People with Arthritis/Rheumatism in Europe) organisations, 22 HPR (Health Professionals in Rheumatology) associations and 23 corporate members.

The EULAR Annual European Congress of Rheumatology is the foremost international medical meeting announcing the latest research on rheumatic and musculoskeletal diseases. EULAR 2016 is expected to attract over 14,000 delegates from around 120 countries. Most if not all professions working in the vast field of RMD will be represented.

To find out more about the activities of EULAR, visit: http://www.eular.org

References

1. EULAR 2016; London: Abstract OP0091

2. Ayala F. Clinical presentation of psoriasis. Reumatismo. 2007;59(1):40-5

3. Feldman SR, Zhao Y, Shi L, et al. Economic and Comorbidity Burden Among Moderate-to-Severe Psoriasis Patients with Comorbid Psoriatic

Arthritis. Arthritis Care Res. 2015; 67: 708-717 doi: 10.1002/acr.22492

European League Against Rheumatism

Related Diabetes Articles:

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).
Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.
People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.
Diabetes, but not diabetes drug, linked to poor pregnancy outcomes
New research indicates that pregnant women with pre-gestational diabetes who take metformin are at a higher risk for adverse pregnancy outcomes -- such as major birth defects and pregnancy loss -- than the general population, but their increased risk is not due to metformin but diabetes.
New oral diabetes drug shows promise in phase 3 trial for patients with type 1 diabetes
A University of Colorado Anschutz Medical Campus study finds sotagliflozin helps control glucose and reduces the need for insulin in patients with type 1 diabetes.
More Diabetes News and Diabetes Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...