Comorbidity Tool May Predict Psoriatic Arthritis Hospitalization

Specialty pharmacies may be able to better monitor comorbid conditions in psoriatic arthritis patients.

A new psoriatic arthritis (PsA)-comorbidity index has the potential to identify PsA patients at greater risk of hospitalization and premature death, according to a study presented at the European League Against Rheumatism Annual Congress (EULAR 2016).

“To date, no disease-specific models had been developed to identify those comorbidities with the greatest impact on PsA patients' health status,” said researcher Yasser El Miedany. “We have now developed and validated a PsA-comorbidity index (PsACI), which will enable clinicians to prospectively include comorbidities assessment and management in their standard practice.”

The study author’s noted that PsACI should be included as part of a patient reported outcome measures used in standard clinical practice.

“By making PsACI available to rheumatologists worldwide, we hope it will prove an effective guide to optimizing the management of psoriatic arthritis,” Miedany said.

Researched used a retrospective multicenter analysis of 1707 patients with PsA who were monitored for 10 years, assessing the impact different comorbidities had on predicting future hospitalizations or mortality. Different cut-off values were identified to delineate patients at different stages of risk in order to create a morbidity index score.

The results of the study found that men who were of older age at disease onset with high BMI at baseline (p<0.05) had a higher incidence of comorbid conditions, and were at a higher risk of hospitalization. Comorbidities that were strongly associated with a 10-year risk of death or hospitalization for PsA patients included: cardiovascular, osteoporosis, falls, anxiety and depression, renal and liver diseases, diabetes, lung and GI issues, and infection (p<0.001).

For an independent predictor of disease status, researchers used a Multidimensional Disease Severity score, which was significantly associated with the 10-year risk of hospitalization or death (p=0.002).

Independent factors that affected the outcome of the disease at 10 years were male, cardiovascular disease, evidence of risk of falls, infection, diabetes, anxiety, and MDR score.