Comorbidities associated with poor treatment response in patients with PsA
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medwireNews: Psoriatic arthritis (PsA) patients with comorbidities have higher disease activity and worse treatment response than those without comorbidities, study results presented at the Annual European Congress of Rheumatology (EULAR) 2017 suggest.
“Comorbidites are of high relevance in this disease,” with severe comorbidities such as cardiovascular disease, diabetes, and depression occurring in patients with PsA, study lead Lars Erik Kristensen (Copenhagen University Hospital, Denmark) told the press in Madrid, Spain.
In an analysis of registry data, the researchers found that 191 patients with PsA and Charlson Comorbidity Index (CCI) scores of 2 points or more were significantly less likely to achieve at least a 20% improvement in ACR criteria (ACR20) after 6 months of treatment than 1066 PsA patients with CCI scores of 0, at 31% versus 40%.
Furthermore, patients with a CCI score of 2 or more were significantly more likely to discontinue treatment than those without comorbidities (hazard ratio=1.72), and those with comorbidities had significantly higher measures of disease activity at baseline, with tender joint counts of 8 versus 6 and Disease Activity Score at 28 joints based on C-reactive protein (DAS28-CRP) measurements of 4.9 versus 4.4.
Taken together, these findings suggest that the presence of comorbidities is associated with higher disease activity, shorter treatment adherence, and reduced clinical response rates among patients with PsA, meaning that “we really should improve our focus on comorbidities,” concluded Kristensen.
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