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AB0821 ANXIETY AND DEPRESSION IN PSORIATIC ARTHRITIS (PsA) - PREVALENCE AND IMPACT ON PATIENT REPORTED OUTCOMES: REAL-WORLD SURVEY IN THE US AND EUROPE
Journal article   Open access   Peer reviewed

AB0821 ANXIETY AND DEPRESSION IN PSORIATIC ARTHRITIS (PsA) - PREVALENCE AND IMPACT ON PATIENT REPORTED OUTCOMES: REAL-WORLD SURVEY IN THE US AND EUROPE

L Gossec, J. A Walsh, K Michaud, E Holdsworth, S Peterson, S Meakin, S Bruce Wirta, S. D Chakravarty and A Ogdie
Annals of the rheumatic diseases, v 79(Suppl 1), pp 1714-1714
Jun 2020
DOI: https://doi.org/10.1136/annrheumdis-2020-eular.5953
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1136/annrheumdis-2020-eular.5953View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Background:Anxiety and depression are comorbidities among PsA patients. The impact of anxiety and depression on outcomes in PsA patients has not been characterized in a real-world clinical setting.Objectives:To describe the prevalence of anxiety and/or depression in PsA patients, assess concordance in reported anxiety and/or depression between patients and physicians, and compare clinical and patient reported outcomes (PROs) in patients who do and do not report anxiety and/or depression.Methods:A cross-sectional study of patients with PsA recruited by rheumatologists and dermatologists was conducted in France, Germany, Italy, Spain, UK and US. Data were collected Jun-Aug 2018 via physician-completed and patient self-completed forms. Physicians reported patient demographic, disease characteristics and diagnosed anxiety and/or depression. Patients reported experience of PsA-related anxiety/depression, quality of life [QoL] (EQ5D-5L), work productivity (WPAI), disability (HAQ-DI), and disease impact (PsAID12). Patients were compared according to patient reported anxiety/depression using parametric and non-parametric tests. Multivariate regressions explored impact of anxiety/depression on PROs. Models adjusted for age, gender, employment status, BMI, # of joints affected, body surface area (BSA).Results:Data were collected from 688 physician-patient pairs (524 EU; 164 US). Physicians reported anxiety and/or depression in 14.2% of patients (EU 13.3%; US 16.2%), while 36.6% (EU 36.3%; US 37.8%) of patients self-reported anxiety and/or depression. 71.4% of physician-patient pairs agreed on anxiety and/or depression presence or absence (Kappa = 0.31, fair agreement). Patients with anxiety and/or depression had worse QoL more work impairment, greater disability (Table 2).Table 1.Demographic and clinical characteristics by patient-reported anxiety and/or depression No anxiety and/or depression(n=436)Anxiety and/or depression(n=252)P valueDemographics Age, mean (SD)47.7 (12.1)49.1 (12.6)0.13Female, n (%)196 (45.0)146 (57.9)<0.01BMI, mean (SD)26.7 (5.1)26.9 (4.4)0.57Caucasian, n (%)408 (93.3)238 (94.4)0.46Working full time, n (%)293 (68.6)107 (44.8)<0.01Biologic tx, n (%)257 (58.9)160 (63.5)0.26Disease characteristics Days since diagnosis, mean (SD)2090 (2204)2532 (2813)0.04Current overall severity, n (%) Mild277 (63.5)137 (54.4)0.02Moderate145 (33.3)106 (42.1) Severe14 (3.2)9 (3.6) Current BSA %, mean (SD)8.7 (12.3)6.4 (8.2)0.0266 swollen joint count, mean (SD)2.7 (3.6)5.6 (10.4)<0.0168 tender joint count, mean (SD)3.8 (4.3)6.0 (6.2)<0.01Table 2.Impact of anxiety or depression on PROs* Anxiety and/or depressionChange in predicted PRO value with anxiety and/or depression αP valueEQ5D utility score, mean N=488Without (ref) With0.83 -0.10<0.01WPAI percentage overall work impairment, mean N=262Without With22.3 +7.4<0.01HAQ-DI score, mean N=480Without With0.53 +0.26<0.01PsAID12 score, mean N=482Without With2.32 +1.78<0.01* Adjusted for age, gender, employment status, BMI, # of joints affected and BSAα PRO key for worse outcome (range): EQ5D utility (0-1.0) = lower; EQ5D VAS (1-100) = lower; WPAI (0-100) = higher; HAQ-DI (0-3) = higher; PsAID12 (0-10) = higher. Conclusion:One third of patients self-report anxiety and/or depression. Treating physicians may not be aware of patient experience of anxiety and/or depression. Patients with anxiety and/or depression appear to have worse QoL, work productivity and disability outcomes than those without.Disclosure of Interests:Laure Gossec Grant/research support from: Lilly, Mylan, Pfizer, Sandoz, Consultant of: AbbVie, Amgen, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sandoz, Sanofi-Aventis, UCB, Jessica A. Walsh Grant/research support from: AbbVie, Pfizer, Janssen, Consultant of: AbbVie, Novartis, Eli Lilly and Company, UCB, Kaleb Michaud Grant/research support from: Janssen, Elizabeth Holdsworth Employee of: Adelphi Real World, Steve Peterson Employee of: Janssen Research & Development, LLC, Sophie Meakin Employee of: Adelphi Real World, Sara Bruce Wirta Employee of: Janssen-Cilag Sweden AB, Soumya D Chakravarty Shareholder of: Johnson & Johnson, Employee of: Janssen Scientific Affairs, LLC, Alexis Ogdie Grant/research support from: Pfizer to Penn, Novartis to Penn, Amgen to Forward/NDB, Consultant of: Abbvie, Amgen, Bristol-Myers Squibb, Celgene, Corrona, Janssen, Eli Lilly, Novartis, Pfizer

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