Due to the possible impact of psoriasis (PsD) in daily life, psoriatic arthritis may also cause significant damage to the patient's work and quality of life.
clinical data
data from a recent trial in patients with PsA for methotrexate (MTX) monotherapy, or etanercept (ETN) monotherapy, or MTX+ETN combined treatment, confirming that compound clinical measurements can be more sensitive to quantifying changes in disease activity and injury and patient quality of life. data from PsA patients participated in trials that those achieving disease activity in psoriatic arthritis (DAPSA) remission (REM) or low disease activity (LDA) and MDA have better improvement advantages than those with more aggressive PsA, thus confirming the usefulness of not only these clinical indicators to assess disease activity and response to treatment, but also health-related outcomes. Data from two randomized clinical trials were evaluated to establish the psychometric properties of the Numerical Fatigue Rating Scale (NRS). The authors demonstrated their effectiveness and responsiveness in patients with PsA, thus supporting their application in clinical trials and routine clinical practice. As expected, fatigue improved after decreased disease activity; interestingly, fatigue NRS improved by 3 points, representing a significant clinical change in PsA evaluation. However, validation of patients with low levels of disease activity remains needed. Summary Comprehensive clinical indicators help to assess disease activity and injury, and tend to be related to health-related results; NRS may provide a good assessment of fatigue in patients with PsA. The connection between Questions of life PsA and fatigue is well known. A study in Asia not only confirmed that the prevalence of fatigue in PsA patients is high, but also significantly correlated with DAPSA and psoriasis area and severity index (PASI) scores, which shows that optimal control of disease activity can improve fatigue in these patients. Similarly, a cross-sectional survey of DANBIO-registered PsA patients confirmed that disease activity appears to have a significant effect on fatigue, disease duration, and chronic pain, associated with central pain sensitivity or joint injury rather than inflammation. The effect of sleep quality may often be observed in PsA. A multicenter study in Spain investigated sleep disorder in patients with Ax-SpA and PsA, and the results showed that mood disorders (especially depression), poor quality of life and active diseases appeared to be risk factors for the development of insomnia. Instead, data from a multicenter observational study highlighted that pain and anxiety are the main determinants of PsA sleep disorders, independent of disease activity. Baviere and his colleagues showed that the type of comorbidity seems to have a greater impact on the quality of life of PsA patients than the number of comorbidities; in particular, anxiety seems to harm mental health. Summary Disease activity, disease duration and chronic pain seem to have a significant impact on the occurrence of fatigue in patients with PsA; sleep disorders in PsA may be related to mood disorders; whether disease activity plays an important role in its development is unclear.
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