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• W4379521699 abstract "Background Psoriatic Arthritis (PsA) is an immune-mediated disease that additionally to the predominant skin and musculoskeletal features, comorbidities such as metabolic syndrome are common. This type of comorbidities increases significantly the burden of the disease, reduces quality of life, and affects negatively the clinical response to the treatment. Ageing adds another variable to this composite as there appears to be evidence of clinical, genetic, and histopathological differences between early and late-onset PsA. Objectives To compare the socio-demographics and clinical data in PsA patients with a younger-onset (YOPsA) and late-onset (LOPsA) of disease and to evaluate disease activity and function at presentation and during a follow-up of two years. Methods A multicenter cohort study including adult PsA patients with peripheral involvement registered in the Rheumatic Diseases Portuguese Register (Reuma.pt) up to December 2022 was performed. Patients were divided into 2 groups according to the onset age of PsA: YOPsA (<50 years) and LOPsA (≥50 years). Univariate analysis was performed followed by multivariate analysis. Results A total of 543 [YOPsA, 301 (55.4%); LOPsO, 242 (44.6%)] patients with peripheral PsA were included. Demographic and clinical data is represented in Table 1. Compared to patients with LOPsA, PsA patients with early onset showed more frequently dactylitis and nail involvement (p<0.001). Regarding the comorbidities, there was a higher frequency of arterial hypertension, dyslipidemia, diabetes mellitus and hyperuricemia in LOPsA patients (p<0.05). After 2 years of follow-up, LOPsA patients had a worse Disease Activity Score-28 with Erythrocyte Sedimentation Rate (DAS-ESR) (2.8 vs 2.5, p=0.006), higher Patient Global Assessment (PGA) (40.5 vs 35, p=0.05), higher levels of C -Reactive Protein (CRP) (0.9 vs 0.7, p=0.038) and ESR (18.9 vs 14.2, p=0.001) and higher Health Assessment Questionnaire (HAQ) (0.7 vs 0.5, p=0.005). LOPsA patients were treated with more biologic DMARDs (p<0.0001). Adjusting for age, the late onset of PsA was associated with the presence of traditional cardiovascular risk factors. Table 1. YOPsA (n=301) LOPsA (n=242) p Current age, years (mean±SD ) 48.2±9.3 68.4±7.7 <0.001 Sex (M/F), n 165/136 135/106 0.516 Age of diagnosis, years (mean±SD ) 37.8±7.9 58.7±6.5 <0.001 Disease duration, years (mean±SD ) 10.5±5.2 9.7±4.6 0.193 Comorbidities, n (% ) Arterial Hypertension 38 (12.6) 69 (28.5) <0.001 Dyslipidemia 29 (9.6) 61 (25.2) <0.001 Diabetes Mellitus 11 (3.7) 38 (15.7) <0.001 Obesity 8 (2.7) 9 (3.7) 0.468 Hyperuricemia 2 (0.7) 10 (4.1) 0.007 Smoking status, n (% ) 41 (13.6) 26 (10.7) 0.013 Psoriasis, n (% ) 211 (70.1) 165 (68.2) 0.425 Nail involvement, n (% ) 85 (28.2) 36 (14.9) <0.001 Axial involvement, n (% ) 76 (25.2) 59 (24.4) 0.919 Dactylitis (ever), n (% ) 102 (33.9) 44 (18.2) <0.001 Enthesitis (ever), n (% ) 78 (25.9) 47 (19.4) 0.093 Positivity HLA-B27, n (% ) 30 (10) 25 (10.3) 0.084 Family history, n (% ) 55 (18.3) 42 (17.4) 0.909 Type of clinical pattern, n (% ) 0.001 Asymmetric oligoarthritis 93 (31) 69 (28.5) Symmetric polyarthritis 162 (53.8) 154 (63.6) Predominant distal interphalangeal joint 22 (7.3) 1 (0.4) Mutilans arthritis 3 (1.0) 4 (1.7) DAS28-CRP at baseline, mean±SD 3.6±1.4 3.6±1.1- 0.909 DAS28-ESR at baseline, mean±SD 3.9±1.4 3.9±1.3 0.339 ESR at baseline, mean±SD 29.3±28.1 14.2±14.8 0.061 CRP at baseline, mean±SD 2.1±3.5 2.3±2.6 0.115 PGA at baseline, mean±SD 52.1±27.8 58.1±21.4 0.365 HAQ at baseline, mean±SD 0.6±0.7 0.7±0.6 0.531 DAS28-CRP, mean±SD* 2.4±1.1 2.4±1.1 0.339 DAS28-ESR, mean±SD* 2.5±1.4 2.8±1.3 0.006 ESR, mean±SD* 14.2±14.8 18.9±16.6 0.001 CRP, mean±SD* 0.7±1.5 0.9±3.55 0.038 PGA, mean±SD* 35.0±25.8 40.5±26.9 0.05 HAQ, mean±SD* 0.5±0.7 0.7±0.6 0.005 Therapeutic, n (% ) cDMARDs 202 (67.1) 178 (73.5) 0.084 bDMARDs 84 (27.9) 117 (48.3) <0.001 *after two years of follow-up Conclusion Our study suggests that the age at onset of PsA seems to be an important covariate that might affect the clinical and laboratory manifestations of the disease and its clinical outcomes. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests None Declared." @default.
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• W4379521699 date "2023-05-30" @default.
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• W4379521699 title "POS0884 THE REAL IMPACT OF AGE ON PSORIATIC DISEASE: A PORTUGUESE MULTICENTER COHORT STUDY" @default.
• W4379521699 doi "https://doi.org/10.1136/annrheumdis-2023-eular.5089" @default.
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