Abstract Number: 2854
Delay Between the Onset of Psoriasis and Arthritis in PsA Patients from
the PsART International Cohort
Koray Tascilar , 1 Sibel Zehra Aydin , 2 Servet Akar , 3 Kenan Aksu , 4 Sibel Bakirci , 5 Ozun Bayindir , 6 Meryem Can , 7
Gozde Cetin , 8
Muhammet Çınar , 9 Ediz Dalk ç
ı ıl , 10 Atalay Dogru , 11 Abdulsamet Erden , 12 Emine Duygu Ersözlü , 13
Şükran Erten , 14 Timuçin Ka ifo lu ş ğ , 15 Gezmiş Kimyon , 16 Orhan Küçük ahin ş , 17 Ahmet Omma , 18 Cem Ozisler , 19
Soner Senel , 20 Dilek Solmaz , 21 Emine Figen Tarhan , 22 Ilaria Tinazzi , 23 Sule Yavuz , 24
Sema Yılmaz , 25 and Umut Kalyoncu 26 ,
1 Department of Internal Medicine 3 – Rheumatology and Immunology, Friedrich- Alexander- University Erlangen-
Nürnberg, University Hospital Erlangen, Erlangen, Germany, Erlangen, Bayern, Germany, 2 University of Ottawa
Faculty of Medicine, Rheumatology,Ottawa Hospital Research Institute, 1967 Riverside Drive, Ottawa, ON, K1H 7W9,
CANADA, Ottawa, Canada, 3 Izmir Katip Celebi University, Faculty of Medicine, Division of Rheumatology, İzmir, Turkey,
4 Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, 5 Antalya Education and Research
Hospital, Antalya, Turkey, 6
Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey,
7 Marmara University, Division of Rheumatology, Istanbul, Turkey, Istanbul, Turkey, 8 Kahramanmaras Sutcu Imam
University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, 9
University of Medical
Sciences, Ankara, Turkey, 10 Uluda University, Bursa, Turkey, ğ 11 Suleyman Demirel University, Department of Internal
Medicine, Division of Rheumatology, Isparta, Turkey, 12
Hacettepe University, Ankara, Turkey, 13
Adana State Hospital,
Adana, Turkey, 14 Y r
ıldı ım Beyazıt University, Ankara, Turkey, 15 Eskişehir Osmangazi University, Faculty of Medicine,
Department of Internal Medicine, Division of Rheumatology, Eski ehir, Turkey, ş 16
Mustafa Kemal University, Hatay,
Turkey, 17 Liv Hospital, Ankara, Turkey, 18 Ankara Numune Education and Research Hospital, Department of Internal
Medicine, Division of Rheumatology, Ankara, Turkey, 19 Diskapi Yildirim Beyazit Education and Research Hospital,
Department of Internal Medicine, Division of Rheumatology, Ankara, 20 Division of Rheumatology, Erciyes University
School of Medicine, Kayseri, Turkey, Kayseri, Turkey, 21 Izmir Katip Celebi University, Faculty of Medicine, Department
of Internal Medicine, Division of Rheumatology, zmir, Turkey, İ 22 Mugla Sitki Kocman University, Department of
Internal Medicine, Division of Rheumatology Mugla,, Mugla, Turkey, 23 Sacro Cuore Don Calabria Hospital, Unit of
Rheumatology, Verona, Italy, 24 Uppsala University, Istanbul, Turkey, 25 Division of Rheumatology, Selcuk University
School of Medicine, Konya, Turkey, Konya, Turkey, 26 Hacettepe University Department of Rheumatology, Ankara,
Turkey
SESSION INFORMATION
Session Date: Tuesday, November 12, 2019
Session Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical VI: Psoriatic Arthritis Clinical Studies
Session Type: ACR Abstract Session
Session Time: 4:30PM–6:00PM
Background/Purpose : Psoriatic arthritis is a heterogenous disorder not only with respect to patterns and compo-nents of musculoskeletal involvement but also with respect to types of skin involvement and the timing of joint and skin disease. The interrelationships between characteristics of skin psoriasis, arthritis and the timing of arthritis are not well studied; we therefore sought to explore these in a large international cohort.
Methods : PsART- international is a web- based registry of PsA patients under routine care in Turkey, Italy and Canada including detailed disease history about type and onset of skin and joint disease. We extracted data on demographic characteristics, family history of psoriatic disease (regardless of skin or arthritis) , types of skin psoriasis, site of skin psoriasis onset, and components of psoriatic arthritis ever observed. For descriptive purposes we tabulated patient characteristics in three groups; arthritis- rst, psoriasis- rst and synchronous, the latter indicating the onset of skin and joint disease within 12 months. The primary analysis outcome was the absolute time elapsed in months after skin disease to arthritis (negative values indicating arthritis onset before psoriasis). We constructed a linear regression model for this primary outcome using demographic, skin disease and arthritis characteristics to explore the associ-ations. Pr nted by [W ley Onl ne L brary - 078.190.043.140 - /do /epdf/10.1002/art.41 108] at [1 1/06/2021].
Pr nted by [W ley Onl ne L brary - 078.190.043.140 - /do /epdf/10.1002/art.41 108] at [1 1/06/2021].
Results : We included 1631 patients; 71 had arthritis rst, 309 had synchronous onset and 1251 had psoriasis rst. Data shows that the age of psoriasis onset and not that of arthritis determined whether arthritis or psoriasis would be the rst to appear (Table- 1). Results of the regression analysis shows that the model intercept, delay of arthritis after psoriasis when other independent variables are set to their baseline values, is 65 months, pustular psoriasis is asso-ciated with onset of arthritis circa 2 years earlier than the intercept interval whereas nail involvement, plaque psoriasis or family history of psoriasis are associated with an increased delay from psoriasis to arthritis, by approximately 2 years- each (Table- 2). Adding all types of articular involvement into the model did not cause a material change in the point estimates however reduced the precision of terms for skin psoriasis type (data not shown).
Conclusion : The age of psoriasis determines whether arthritis or psoriasis starts rst in PsA patients. Pustular pso-riasis is associated with a shorter time interval after psopso-riasis to arthritis while nail involvement, plaque psopso-riasis and psoriatic family history are associated with a longer interval.
Disclosure : K. Tascilar , None; S. Aydin , None; S. Akar , Abbvie, 2, 5, Amgen, 2, 5, MSD, 2, 5, Novartis, 2, 5, P zer,
2, 5, 8, Roche, 2, 5, UCB, 2, 5; K. Aksu , None; S. Bakirci , None; O. Bayindir , None; M. Can , None; G. Cetin , None;
M. Çınar , None; E. Dalkılıç , None; A. Dogru , None; A. Erden , None; E. Ersözlü , None; Ş. Erten , None; T. Kaş ğifo lu ,
None; G. Kimyon , None; O. Küçükşahin , None; A. Omma , None; C. Ozisler , None; S. Senel , None; D. Solmaz ,
None; E. Tarhan , None; I. Tinazzi , None; S. Yavuz , None; S. Yılmaz , None; U. Kalyoncu , UCB, 5.
Abstract Number: 2855
Clinically Relevant Patient Clusters Identifi ed by Machine Learning
Tools in a Large Database from the Secukinumab Psoriatic Arthritis
Clinical Development Program
Iain McInnes , 1 Matthias Kormaksson , 2 Effi e Pournara , 3 Gregory Ligozio , 2 Luminita Pricop , 4 Peter Nash , 5
Bruce Kirkham , 6 Kristian Reich , 7 and Christopher Ritchlin 8 , 1 Institute of Infection, Immunity & Infl ammation, University
of Glasgow, Glasgow, United Kingdom, 2
Novartis Pharmaceutical Corporation, New Jersey, NJ, 3
Novartis Pharma AG,
Basel, Basel- Stadt, Switzerland, 4 Novartis Pharmaceuticals Corporation, East Hanover, NJ, 5 University of Queensland,
Brisbane, Queensland, Australia, 6
Guy ’ s & St Thomas’ NHS Foundation Trust, London, England, United Kingdom,
7 University Medical Center Hamburg- Eppendorf, Hamburg, Germany; Skinfl ammation®, Hamburg, Germany;
Dermatologikum Berlin, Berlin, Germany, Hamburg, Germany, 8
Division of Allergy, Immunology and Rheumatology, Center for Musculoskeletal Research, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA, Rochester, NY
SESSION INFORMATION
Session Date: Tuesday, November 12, 2019
Session Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical VI: Psoriatic Arthritis Clinical Studies
Session Type: ACR Abstract Session
Session Time: 4:30PM–6:00PM
Background/Purpose : Identifying clinically relevant patient phenotypes amidst the variability and heterogeneity of the clinical manifestations of psoriatic arthritis (PsA) is currently challenging. Using machine- learning (ML) techniques could be the rst critical step towards better understanding of disease pathotypes, and support progression towards
precision medicine. 1 Clusters of PsA patients based on presence/absence of disease domains were identi ed using
ML from the secukinumab FUTURE trials program.
Methods : Hierarchical clustering was performed on the composite using “1- correlation” as the dissimilarity metric and Ward ’ s agglomeration method for pairwise grouping; a dendrogram was used to visualize and assess the re-sulting groupings. Pairwise correlations were explored in various clinical domains of PsA including dactylitis, NAPSI,
Pr nted by [W ley Onl ne L brary - 078.190.043.140 - /do /epdf/10.1002/art.41 108] at [1 1/06/2021].
