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Effect of ethnicity on disease activity and physical function in psoriatic arthritis in a multiethnic Asian population

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Abstract

Geographic differences in manifestation of psoriatic arthritis (PsA) could be related to differences in genetic or environmental factors. We aimed to compare the disease activity and functional status using validated outcome measures among patients with PsA of different ethnicities living in the same environment. We performed a cross-sectional study on consecutive patients with PsA classified by the Classification Criteria for Psoriatic Arthritis (CASPAR) criteria from a single center. Sociodemographic data, clinical variables, and patient-reported outcomes were collected using a standardized protocol. Disease activities were assessed by validated composite scores: clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA), Composite Psoriatic Disease Activity Index (CPDAI), and minimal disease activity (MDA). Physical function was assessed with Health Assessment Questionnaire (HAQ) and the Medical Outcome Study Short-Form 36 (SF36) physical function subscales. Linear regression analyses were performed to identify variables associated with disease activities and physical function. Ninety-eight patients (51.5%, men) with mean (±SD) age and duration of PsA of 51.5 ± 13.8 and 5.5 ± 8.4 years were recruited. Indian was overrepresented compared with the national distribution of ethnicities. Compared to Chinese, Indian patients were more likely to be using biological therapies, have higher tender joint count, and worse enthesitis. Higher proportion of Indians had higher disease activity categories measured by cDAPSA, CPDAI, and MDA and had poorer physical function. In the multivariable analysis, ethnicity was significantly associated with HAQ and SF36-PF. Compared to Chinese, Indians with PsA living in the same environment had worse disease activity and physical function measured by validated outcomes.

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Acknowledgments

We thank all the patients who have participated in the study.

Author contributions

YYL and NLL conceptualized and designed the study; YYL and NLL acquired the data; YYL and WF performed the data analysis; all authors interpreted the data. YYL drafted the manuscript, and all authors approved the final version of manuscript. YYL (katyccc@hotmail.com) takes responsibility for the integrity of the work as a whole.

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Authors and Affiliations

  1. Department of Rheumatology and Immunology, Singapore General Hospital, The Academia, level 4, 20 College Road, Singapore, 169856, Singapore

    Ying Ying Leung, Warren Fong, Nai Lee Lui & Julian Thumboo

  2. Duke-NUS Medical School, Singapore, Singapore

    Ying Ying Leung, Warren Fong & Julian Thumboo

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  1. Ying Ying Leung
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  2. Warren Fong
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  3. Nai Lee Lui
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  4. Julian Thumboo
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Correspondence to Ying Ying Leung.

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Funding

This study was funded by the SingHealth Duke-NUS Academic Medical Centre through the Medicine Academic Clinical Programme Grant: Nurturing Clinician Scientist Scheme.

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Leung, Y.Y., Fong, W., Lui, N.L. et al. Effect of ethnicity on disease activity and physical function in psoriatic arthritis in a multiethnic Asian population. Clin Rheumatol 36, 125–131 (2017). https://doi.org/10.1007/s10067-016-3460-1

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  • DOI: https://doi.org/10.1007/s10067-016-3460-1

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