title: Clinical Characteristics, Disease Activity, and Patient-Reported Outcomes in Psoriatic Arthritis Patients With Dactylitis or Enthesitis: Results From the Corrona Psoriatic Arthritis/Spondyloarthritis Registry.
abstract: To characterize psoriatic arthritis (PsA) patients with dactylitis or enthesitis and evaluate the associations of these manifestations with disease activity and patient-reported outcomes.
  
  
  
  Using the Corrona PsA/Spondyloarthritis Registry, patient characteristics, disease activity, and patient-reported outcomes at registry enrollment were assessed for PsA patients ages ≥18 years with or without dactylitis or enthesitis. Regression models were used to evaluate associations of dactylitis and enthesitis with outcomes, including minimal disease activity, Health Assessment Questionnaire scores, patient-reported pain and fatigue, and work productivity (Work Productivity and Activity Impairment questionnaire). Adjustments were made for age, sex, race, body mass index, disease duration, and history of biologic agent, disease-modifying antirheumatic drug, and prednisone use.
  
  
  
  This analysis included 1,567 PsA patients (420 with enthesitis; 228 with dactylitis). Patients with versus without dactylitis or enthesitis had greater disease activity and were less likely to be in minimal disease activity (P < 0.05). Patients with versus without enthesitis had poorer functional status as assessed by the Health Assessment Questionnaire (adjusted P = 4.15 x 10-5), greater patient-reported pain and fatigue (adjusted P < 0.0001), and greater likelihood of any impairment while working (adjusted odds ratio [OR] 1.57, P = 0.027), overall work impairment (OR 1.85, P = 0.006), and activity impairment (OR 1.77, P = 0.008). Dactylitis was associated with similar numerical trends, but differences versus patients without dactylitis did not reach statistical significance.
  
  
  
  Enthesitis and dactylitis are associated with greater overall disease burden of PsA, underscoring the importance of identifying, assessing, and effectively managing these periarticular manifestations.
authors.affiliation: Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Mease
authors.affiliation: Corrona, Southborough, Massachusetts.
authors.forename: Chitra
authors.initials: C
authors.lastname: Karki
authors.affiliation: Novartis Pharmaceuticals, East Hanover, New Jersey.
authors.forename: Jacqueline B
authors.initials: JB
authors.lastname: Palmer
authors.affiliation: Corrona, and The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Etzel
authors.affiliation: University of California at San Diego, La Jolla.
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
authors.affiliation: University of Rochester Medical Center, Rochester, New York.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Ritchlin
authors.affiliation: Corrona, Southborough, Massachusetts.
authors.forename: Wendi
authors.initials: W
authors.lastname: Malley
authors.affiliation: Novartis Pharmaceuticals, East Hanover, New Jersey.
authors.forename: Vivian
authors.initials: V
authors.lastname: Herrera
authors.affiliation: Scott& White Health Plan, Temple, Texas.
authors.forename: Melody
authors.initials: M
authors.lastname: Tran
authors.affiliation: Corrona and New York University School of Medicine, New York.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Greenberg
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D000070676:Enthesopathy / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005384:Finger Joint / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D057566:Self Report; D016896:Treatment Outcome