The impact of psoriasis on wellbeing and clinical outcomes in juvenile psoriatic arthritis.

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

Journal

Rheumatology (Oxford, England)
ISSN: 1462-0332
Titre abrégé: Rheumatology (Oxford)
Pays: England
ID NLM: 100883501

Informations de publication

Date de publication:
19 Jul 2023
Historique:
received: 03 12 2022
revised: 05 06 2023
accepted: 10 07 2023
medline: 19 7 2023
pubmed: 19 7 2023
entrez: 19 7 2023
Statut: aheadofprint

Résumé

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. 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 (10 cm VAS), functional ability (CHAQ), pain (10 cm 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. 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 = 0.5-19.0) 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). 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.

Identifiants

pubmed: 37467079
pii: 7226516
doi: 10.1093/rheumatology/kead370
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Medical Research Council
ID : MR/R013926/1
Pays : United Kingdom

Investigateurs

Nophar Geifman (N)
Stephanie J W Shoop-Worrall (SJW)

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology.

Auteurs

Jie Man Low (JM)

Centre for Epidemiology Versus Arthritis, Manchester Academic Health Sciences Centre, The University of Manchester, UK.

Kimme L Hyrich (KL)

Centre for Epidemiology Versus Arthritis, Manchester Academic Health Sciences Centre, The University of Manchester, UK.
National Institute for Health Research Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.

Coziana Ciurtin (C)

UCL Division of Medicine, University College London, UK.
Centre for Adolescent Rheumatology Versus Arthritis, at UCL UCLH and GOSH.

Flora McErlane (F)

Department of Paediatric Rheumatology, Newcastle Hospitals NHS Foundation Trust, UK.

Lucy R Wedderburn (LR)

Centre for Adolescent Rheumatology Versus Arthritis, at UCL UCLH and GOSH.
UCL GOS Institute of Child Health, University College London, UK.
Department of Paediatric Rheumatology, Great Ormond Street Hospital, UK.
NIHR Biomedical Research Centre at Great Ormond Street Hospital, UK.

Classifications MeSH