AB0731 Musculoskeletal but Not Skin Disease Activity Influence Rheumatologists Decision To Change Dmards or Biologic Therapy in Psoriatic Arthritis

BackgroundPsoriatic arthritis (PsA) is a systemic inflammatory disease mainly characterised by arthritis, dactylitis, enthesitis and skin involvement. Recently issued therapeutic guidelines (1) suggest that treatment decisions should be driven by as many manifestations of disease as possible.ObjectivesThe aim of this study was to determine, in a multicentre Italian cohort of PsA patients, which clinical or patient reported disease outcome influence physician decision to change DMARD or biologic treatment.Methods173 consecutive patients with PsA (103 males and 70 females, mean age 52±12 years) were enrolled in a longitudinal observational study. Seven tertiary referral clinics with expertise in PsA and SpA were involved. Detailed clinical examination, including ACR joint count, presence or absence of dactylitis and enthesitis, PASI, were recorded. Patient perception of disease was evaluated by means of global, joint and skin specific VAS scales. Detailed treatment information were also recorded. According to study protocol clinical assessment was performed at baseline and after twelve weeks in order to identify two distinct groups: changed and unchanged DMARD or biologic therapy.ResultsA higher number of tender joints (p