Comparison of disability and quality of life in rheumatoid and psoriatic arthritis

February 6, 2002

J Rheumatol 2001 Aug;28(8):1842-6

Comparison of disability and quality of life in rheumatoid and psoriatic

arthritis.

Sokoll KB, Helliwell PS.

Department of Rheumatology, St Luke's Hospital, Bradford, UK.

OBJECTIVE: There is controversy about the severity of peripheral

psoriatic arthritis (PsA) compared to rheumatoid arthritis (RA). Early

reports found PsA to be a milder disorder, excepting the mutilans form.

Recent reports suggest that PsA can be as severe as RA. We compared

severity, disability, and quality of life in patients with PsA and RA

matched primarily for disease duration. METHODS: Data relating to the

extent and severity of disease were recorded in a hospital clinic

setting. Recent radiographs of hands and feet were read blinded to

diagnosis, and information on function and quality of life was collected

with the Health Assessment Questionnaire (HAQ) and EuroQol-5D,

respectively. RESULTS: Forty-seven patients were matched for disease

duration (median PsA 5 yrs, RA 7 yrs). The male/female ratio was 24/23

for PsA, 16/31 for RA, and median ages were 45 and 51 years,

respectively. Patients with RA had significantly more joint involvement

of metacarpophalangeal joints and wrists, whereas distal interphalangeal

joints, spine, sternoclavicular joints, and sacroiliac joints were

significantly more involved in PsA. No difference was found regarding

Ritchie Articular Index, inflammatory markers, HAQ score, or EuroQol-5D.

Patients with RA had significantly more damage on radiographs of hands

and feet: median (range) Larsen score hands PsA 8 (0-91), RA 38 (0-125);

feet PsA 4 (0-34), RA 11(0-56). Patients with RA were taking

significantly more disease modifying drugs. CONCLUSION: Peripheral joint

damage is significantly greater in RA than in PsA after equivalent

disease duration, but function and quality of life scores are the same

for both groups. The additional burden of skin disease in PsA may

account for this.

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