Evaluation of Clinical Diagnosis of Axial Psoriatic Arthritis (PsA) or Elevated Patient-reported Spine Pain in CorEvitas' PsA/Spondyloarthritis Registry.

Objective: To determine the presence of axial symptoms in patients with psoriatic arthritis (PsA) and examine differences between those with or without a diagnosis of axial PsA (axPsA).

Methods: Patients with PsA at their Corevitas' (formerly Corrona) Psoriatic Arthritis/Spondyloarthritis Registry enrollment visit were stratified into 4 mutually exclusive groups based on axial manifestations: physician-diagnosed axPsA only (DxSx), patient-reported elevated spine symptoms only (DxSx; defined as Bath Ankylosing Spondylitis Disease Activity Index ≥ 4 and spine pain visual analog scale ≥ 40), physician-diagnosed and patient-reported manifestations (DxSx), and no axial manifestations (DxSx). Patient characteristics, disease activity, and patient-reported outcomes (PROs) at enrollment in each axial manifestation group were compared with the DxSx group. Associations of patient characteristics with the odds of having axial manifestations were estimated using multinomial logistic regression (reference: DxSx).

Results: Of 3393 patients included, 226 (6.7%) had DxSx, 698 (20.6%) had DxSx, 165 (4.9%) had DxSx, and 2304 (67.9%) had DxSx. Patients with DxSx or DxSx were more frequently women and had a history of depression and fibromyalgia (FM) vs patients who had DxSx. Patients with DxSx or DxSx were more frequently HLA-B27 positive than those with DxSx. FM was significantly associated with increased odds of DxSx or DxSx. Disease activity and PROs were worse in patients with DxSx or DxSx than in those with DxSx.

Conclusion: Patients who had self-reported elevated spine symptoms, with or without physician-diagnosed axPsA, had worse quality of life and higher disease activity overall than patients without axial manifestations, suggesting an unmet need in this patient population.