THE IMPACT OF PSORIASIS ON WELLBEING AND CLINICAL OUTCOMES IN JUVENILE PSORIATIC ARTHRITIS

Jie Man (Jasmine) Low, Kimme Hyrich, Coziana Ciurtin, Flora McErlane, Lucy R. Wedderburn, CAPS Principal Investigators, Nophar Geifman, Stephanie Shoop-Worrall

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Juvenile psoriatic arthritis (JPsA) has varied clinical features that are distinctive to other juvenile idiopathic arthritis (JIA) categories. This study investigates whether such features impact patient-reported and clinical outcomes.

Methods: Children and young people (CYP) were selected if recruited to the Childhood Arthritis Prospective Study, a UK multicentre JIA inception cohort, between January 2001 and March 2018. At diagnosis, patient/parent-reported outcomes (as age-appropriate) included the parental global assessment (10cm VAS), functional ability (CHAQ), pain (10cm VAS), health-related quality of life (CHQ psychosocial score), mood/depressive symptoms (MFQ) and parent psychosocial health (GHQ). Three-year outcome trajectories have previously been defined using active joint counts, physician and parent global assessments (PGA, PaGA respectively).

Patient-reported outcomes and outcome trajectories were compared in i) CYP with JPsA versus other JIA categories, ii) CYP within JPsA, with and without psoriasis via multivariable linear regression.

Results: There were no significant differences in patient-reported outcomes at diagnosis between CYP with JPsA and non-JPsA. Within JPsA, those with psoriasis had more depressive symptoms (coefficient=9.8, 95% CI=0.5 to 19.0) than those without psoriasis at diagnosis. CYP with JPsA had 2.3 times the odds of persistent high PaGA than other ILAR categories, despite improving joint counts and PGA (95% CI 1.2, 4.6).

Conclusion: CYP with psoriasis at JPsA diagnosis report worse mood, supporting a greater disease impact in those with both skin and joint involvement. Multidisciplinary care with added focus to support wellbeing in children with JPsA plus psoriasis may help improve these outcomes.
Original languageEnglish
JournalRheumatology
Publication statusAccepted/In press - 10 Jul 2023

Keywords

  • Juvenile idiopathic arthritis
  • paediatric/juvenile rheumatology
  • spondylarthropathies (including psoriatic arthritis)
  • depression
  • quality of life

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