Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2019 Sep;78(9):1215-1219.
doi: 10.1136/annrheumdis-2018-215003. Epub 2019 May 21.

The contribution of joint and skin improvements to the health-related quality of life of patients with psoriatic arthritis: a post hoc analysis of two randomised controlled studies

Arthur Kavanaugh  1 , Alice Gottlieb  2 , Akimichi Morita  3 , Joseph F Merola  4   5 , Chen-Yen Lin  6 , Julie Birt  6 , Catherine L Shuler  6 , Matthew M Hufford  6 , Diamant Thaçi  7
Affiliations
Clinical Trial

The contribution of joint and skin improvements to the health-related quality of life of patients with psoriatic arthritis: a post hoc analysis of two randomised controlled studies

Arthur Kavanaugh et al. Ann Rheum Dis. 2019 Sep.

Abstract

Objective: Determine the contribution of joint and skin improvements to health-related quality of life (HRQoL) in patients with psoriatic arthritis (PsA).

Methods: SPIRIT-P1 and SPIRIT-P2 are phase 3 trials investigating ixekizumab, an interleukin-17A antagonist, in the treatment of patients with active PsA. Patients were randomised to ixekizumab or placebo. Outcomes included the Disease Activity Index for Psoriatic Arthritis (DAPSA), the Psoriasis Area and Severity Index (PASI), the European Quality of Life-Five Dimensions (EQ-5D) Visual Analogue Score (VAS), the 36-Item Short-Form Health Survey (SF-36) and the Work Productivity and Activity Impairment (WPAI) Questionnaire. The contribution of joint and skin improvements to HRQoL was modelled using a smoothing spline method and depicted with response surface graphics.

Results: In this integrated analysis, 402 patients with PsA had baseline psoriasis of ≥3% of body surface area. We applied response surface modelling to this patient data set to investigate the relationship between DAPSA, PASI and HRQoL improvements at week 24. The greatest improvement in EQ-5D VAS was associated with the largest per cent improvements in both DAPSA and PASI together, rather than DAPSA or PASI alone. Similar observations were made in domains of SF-36 and WPAI.

Conclusion: Optimal improvements in patients' HRQoL were dependent on successful treatment of both joint and skin symptoms.

Keywords: health-related quality of life; psoriasis; psoriatic arthritis; treatment.

PubMed Disclaimer

Conflict of interest statement

Competing interests: AK has been a consultant for Eli Lilly and Company. AG has received consulting or advisory board honoraria, speaking honoraria and/or grants from Abbvie, BMS, Celgene Corporation, Dermira, Eli Lilly and Company, Incyte Corporation, Janssen Biotech, Janssen-Ortho, LEO Pharma, US, Lilly ICOS LLC, Novartis, Sun Pharmaceuticals and UCB. AM has received grant support and lecture fees from AbbVie, Esai, Kyowa Hakko Kirin, Leo Pharma, Maruho, Mitsubishi Tanabe Pharma, Novartis and Torii Pharmaceutical and lecture fees from Celgene, Eli Lilly Japan and Janssen Pharmaceutical. JFM has received consulting fees, speaking fees and/or honoraria from AbbVie, Eli Lilly, Novartis, Pfizer, UCB, Celgene, Sanofi, Regeneron, Merck, Biogen Idec and Janssen, and has served as a paid consultant for investment analysis companies Cowen Group and GLG. CYL, JB and MMH are full-time employees and shareholders of Eli Lilly and Company. CLS is a former employee and shareholder of Eli Lilly and Company. DT has been a consultant and advisor and has received speaking fees and grants, and served as an investigator in clinical trials for the following companies: AbbVie, Almirall, Amgen, Biogen Idec, BMS, Boehringer Ingelheim, Celgene, Dignity, Dermavant, Eli Lilly, Galapagos, GSK, Galderma, LEO Pharma, Janssen-Cilag, MSD, Novartis, Pfizer and Regeneron.

Figures

Figure 1
Figure 1
Response surface modelling. (A) Three-dimensional scatterplot and (B) response surface of scatterplot estimated by smoothing spline method of skin (y-axis, PASI—percent improvement), joint (x-axis, DAPSA—percent improvement) and HRQoL (z-axis, EQ-5D—change from baseline) improvement at week 24. A colour spectrum is applied to health-related quality of life (blue (least improvement) to red (greatest improvement)). DAPSA, Disease Activity Index for Psoriatic Arthritis; EQ-5D, European Quality of Life-Five Dimensions; PASI, Psoriasis Area and Severity Index; VAS, Visual Analogue Score.
Figure 2
Figure 2
Impact of joint and skin improvements on patient health-related quality of life as measured by EQ-5D VAS. Heat maps depict change from baseline in EQ-5D VAS at week 24, with a range from least improvement (blue) to greatest improvement (red). Joint and skin improvements measured by per cent improvements from baseline DAPSA and PASI scores at week 24, respectively. Patients with baseline psoriasis of ≥3% (A) and ≥10% BSA (B) are depicted in the left and right panels, respectively. BSA, body surface area; DAPSA, Disease Activity Index for Psoriatic Arthritis; EQ-5D, European Quality of Life-Five Dimensions; PASI, Psoriasis Area and Severity Index; VAS, Visual Analogue Score.
See this image and copyright information in PMC

References

    1. Ritchlin CT, Colbert RA, Gladman DD. Psoriatic arthritis. N Engl J Med 2017;376:957–70. 10.1056/NEJMra1505557 - DOI - PubMed
    1. 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. Arthritis Rheum 2001;45:151–8. 10.1002/1529-0131(200104)45:2<151::AID-ANR168>3.0.CO;2-T - DOI - PubMed
    1. Kotsis K, Voulgari PV, Tsifetaki N, et al. . Anxiety and depressive symptoms and illness perceptions in psoriatic arthritis and associations with physical health-related quality of life. Arthritis Care Res 2012;64:1593–601. 10.1002/acr.21725 - DOI - PubMed
    1. Michelsen B, Fiane R, Diamantopoulos AP, et al. . A comparison of disease burden in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis. PLoS One 2015;10:e0123582 10.1371/journal.pone.0123582 - DOI - PMC - PubMed
    1. Sokoll KB, Helliwell PS. Comparison of disability and quality of life in rheumatoid and psoriatic arthritis. J Rheumatol 2001;28:1842–6. - PubMed

Publication types

MeSH terms