Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (6): 1014-1018. doi: 10.19723/j.issn.1671-167X.2019.06.006

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Cross-sectional study on clinic behavior and therapeutic status of patients with psoriatic arthritis in multi-center

Yu-hui LI1,Bo SU2,Fu-an LIN3,Ya-nan FEI4,Xiao-xia YU5,Wen-qiang FAN6,Hai-ying CHEN7,Xue-wu ZHANG1,Yuan JIA1,()   

  1. 1. Department of Rheumatology & Immunology, Peking University People’s Hospital, Beijing 100044, China
    2. Department of Endocrinology, General Aerospace Hospital, Beijing 100012, China
    3. Department of Rheumatology & Immu-nology, People’s Hospital of Jianyang City, Jianyang 641400, Sichuan, China
    4. Department of Rheumatology & Immunology, Haidian Hospital of Beijing, Beijing 100080, China
    5. Department of Rheumatology & Immunology, Integrated Traditional Chinese and Western Medicine Hospital of Cangzhou City, Cangzhou 006100, Hebei, China
    6. Department of Rheumatology & Immunology, Central Hospital of Xinxiang City, Xinxiang 453000, Henan, China
    7. Department of Rheumatology & Immunology, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
  • Received:2019-09-09 Online:2019-12-18 Published:2019-12-19
  • Contact: Yuan JIA E-mail:jiayuan1023@sina.com
  • Supported by:
    Supported by the National Natural Science Foundation of China(81801617);Research and Development Fund of Peking University People’s Hospital(RDY2018-01);Research and Development Fund of Peking University People’s Hospital(RS2018-02)

Abstract:

Objective: To investigate and analyse the features of treatment behavior and standardized therapeutic status of patients with psoriatic arthritis (PsA).Methods: Out patients diagnosed with PsA in People’s Hospital of Peking University, Haidian Hospital, People’s Hospital of Jianyang City, Central Hospital of Xinxiang City, Integrated Traditional Chinese and Western Medicine Hospital of Cangzhou City, The Third Hospital of Hebei Medical University from February to June 2018 were enrolled in this investigation. The data including gender, age of onset, course of disease, site of first consulting department, time of the first visit and definite diagnosis, follow-up interval, and use of conventional disease modifying anti-rheumatic drugs (cDMARDs) and biological DMARDs (BioDMARDs) were collected and analyzed.Results: In the cross-sectional study, 133 PsA patients were investigated. The mean age of onset was (47±11) years, the male to female ratio was 1.3:1, and mean disease duration was (16±8) years. Rheumatology department was the most common site of first hospital visit (37.6%, 50/133). Orthopedics department and dermatological department were visited by 24.1% (32/133) and 23.3% (31/133), respectively. Ratio of definite diagnosis was the highest in rheumatology department which was 78% (39/50). The ratio of definite diagnosis of dermatological department was the second highest, which was 19.4% (6/31). The mean definite diagnosed time was 7.6 months since the first visit of PsA patients, and diagnosed time was the shortest in rheumatology department, which had statistical significance. 37% PsA patients were treated appropriately in 3 months, 17.3% PsA patients were treated in 3-6 months and 40.2% patients with PsA visited their doctor more than once a year. 48.8% patients hadn’t received standardized treatment before visit, and one third patients never received the therapy of DMARDs. Methotrexate was the most commonly used cDMARDs (58.3%), followed by leflunomide (20.5%) and BioDMARDs (19.7%), and biologicals were tumor necrosis factor antagonists.Conclusion: In this multi-center study, the first visit department of PsA patients was widely distributed, and most patients were definitely diagnosed in Rheumatology Department. The time of their first visit and definite diagnosis were delayed due to multi factors. Nearly half of the patients did not receive standardized treatment.

Key words: Psoriatic arthritis, Cross-sectional study, Follow-up, Disease modifying anti-rheumatic drugs (DMARDs), Biologics

CLC Number: 

  • R593

Figure 1

Initial admission department and ratio of definite diagnosis of patients with PsA"

Table 1

The diagnostic time of 133 patients with PsA"

Department Diagnostic time/months Inter-quartile range/months
Rheumatology 4.4 0-11.2
Orthopedics 10.4 2.1-21.3
Dermatology 10.5 1.2-22.1
General medicine 11.2 2.3-24.9

Table 2

The follow-up interval of 127 patients with PsA"

Follow-up interval/months n %
≤3 47 37.0
- 6 22 17.3
-12 7 5.5
>12 51 40.2

Table 3

Constituent ratio of drugs used by 127 patients with PsA"

Drugs Past medication Present medication
n % n %
MTX 74 58.3 50 39.4
LEF 26 20.5 23 18.1
Biologics 25 19.7 17 13.4
TGW 13 10.2 11 8.7
SASP 11 8.7 10 7.9
IGU 3 2.4 8 6.3
CsA 3 2.4 2 1.6

Table 4

Analysis of programmed drugs administration of 127 patients with PsA outside hospital"

Use of DMARDs n %
Appropriately used 65 51.1
1 DMARD 31 24.4
<6-month 8 6.3
≥6-month 23 18.1
≥2 DMARDs 34 26.8
<6-month 7 5.5
≥6-month 27 21.3
Inappropriately used 22 17.3
Never used 40 31.5
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