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Cross-sectional study on clinic behavior and therapeutic status of patients with psoriatic arthritis in multi-center
Received date: 2019-09-09
Online published: 2019-12-19
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)
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.
Yu-hui LI , Bo SU , Fu-an LIN , Ya-nan FEI , Xiao-xia YU , Wen-qiang FAN , Hai-ying CHEN , Xue-wu ZHANG , Yuan JIA . Cross-sectional study on clinic behavior and therapeutic status of patients with psoriatic arthritis in multi-center[J]. Journal of Peking University(Health Sciences), 2019 , 51(6) : 1014 -1018 . DOI: 10.19723/j.issn.1671-167X.2019.06.006
| [1] | Congi L, Roussou E . Clinical application of the CASPAR criteria for psoriatic arthritis compared to other existing critieria[J]. Clin Exp Rheumatol, 2010,28(3):304-310. |
| [2] | Villani AP, Rouzaud M, Sevrain M , et al. Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: Systematic review and meta-analysis[J]. J Am Acad Dermatol, 2015,73(2):242-248. |
| [3] | Ogdie A, Weiss P . The epidemiology of psoriatic arthritis[J]. Rheum Dis Clin North Am, 2015,41(4):545-568. |
| [4] | Zeng QY, Chen R, Darmawan J , et al. Rheumatic diseases in China[J]. Arthritis Res Ther, 2008,10(1):R17. |
| [5] | Leung YY, Ho KW, Li EK , et al. Predictors of functional deterioration in Chinese patients with psoriatic arthritis: a longitudinal study[J]. BMC Musculoskelet Disord, 2014,15:284. |
| [6] | Gossec L, Smolen JS, Ramiro S , et al. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update[J]. Ann Rheum Dis, 2016,75(3):499-510. |
| [7] | Taylor W, Gladman D, Helliwell P , et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study[J]. Arthritis Rheum, 2006,54(8):2665-2673. |
| [8] | Husted JA, Gladman DD, Farewell VT , et al. Health-related quality of life of patients with psoriatic arthritis: a comparison with patients with rheumatoid arthritis[J]. Arthritis Rheum, 2001,45(2):151-158. |
| [9] | Adams R, Walsh C, Veale D , et al. Understanding the relationship between the EQ-5D, SF-6D, HAQ and disease activity in inflammatory arthritis[J]. Pharmacoeconomics, 2010,28(6):477-487. |
| [10] | Singh JA, Strand V . Spondyloarthritis is associated with poor function and physical health-related quality of life[J]. J Rheumatol, 2009,36(5):1012-1020. |
| [11] | Javitz HS, Ward MM, Farber E , et al. The direct cost of care for psoriasis and psoriatic arthritis in the United States[J]. J Am Acad Dermatol, 2002,46(6):850-860. |
| [12] | Singh JA, Strand V . Health care utilization in patients with spondyloarthropathies[J]. Rheumatology (Oxford), 2009,48(3):272-276. |
| [13] | Gladman DD . Mortality in psoriatic arthritis[J]. Clin Exp Rheumatol, 2008,26(5 Suppl 51):S62-S65. |
| [14] | Gladman DD . Early psoriatic arthritis[J]. Rheum Dis Clin North Am, 2012,38(2):373-386. |
| [15] | Singh JA, Guyatt G, Ogdie A , et al. 2018 American College of Rheumatology/national psoriasis foundation guideline for the treatment of psoriatic arthritis[J]. Arthritis Rheumatol, 2019,71(1):5-32. |
| [16] | Coates LC, Gossec L, Ramiro S , et al. New GRAPPA and EULAR recommendations for the management of psoriatic arthritis[J]. Rheumatology, 2017,56(8):1251-1253. |
| [17] | Smolen JS, Aletaha D, Bijlsma JW , et al. Treating rheumatoid arthritis to target: recommendations of an international task force[J]. Ann Rheum Dis, 2010,69(4):631-637. |
| [18] | Kiltz U, Smolen J, Bardin T , et al. Treat-to-target (T2T) recommendations for gout[J]. Ann Rheum Dis, 2016,76(4):632-638. |
| [19] | van Vollenhoven RF, Mosca M, Bertsias G , et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force[J]. Ann Rheum Dis, 2014,73(6):958-967. |
| [20] | Schoels M, Knevel R, Aletaha D , et al. Evidence for treating rheumatoid arthritis to target: results of a systematic literature search[J]. Ann Rheum Dis, 2010,69(4):623-643. |
| [21] | Stoffer MA, Schoels MM, Smolen JS , et al. Evidence for treating rheumatoid arthritis to target: results of a systematic literature search update[J]. Ann Rheum Dis, 2016,75(1):16-22. |
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