AB0474 LATE ONSET VS. EARELY ONSET PSORIATIC ARTHRITIS: IS THERE DIFFERENCES? DATA FROM AN ALGERIAN OBSERVATIONAL STUDY (2024)

Abstract

Background: With extension of longevity in older individuals, Late-onset Psoriatic Arthritis (PsA) becomes more prevalent in this population witch presents more disability and a greater number of comorbidities. In this study,we analyse whether late-onset versus earlier-onset PsA patients show different clinical features, as well as different treatment and comorbidites.

Objectives: The objective is to evaluate the association of the age at onset of PsA symptoms with the differents characteristics of the disease.

Methods: In this Observational study, we include all patients with a diagnosis of PsA. According to the age of PsA onset, this population study was divided into two groups (early-onset: ≤40 years old and late-onset: ≥60 years old). All disease features were stratified and compared using the Student’s t-test or the chi-square/Fisher test. Binary logistic regression was performed to determine the factors associated with late-onset PsA.

Results: Seventy six (76) patients with dignosis of PsA were included; among them 46 (60.5%) early-onset PsA (EO-PsA) and 30(39.47%) having late-onset PsA (LO-PsA). There was a significant higher rate of women in the LO-PsA group [25 (54.3%) vs. 20 (66.6%)]. In patients with LO-PsA, erosive polyarticular or oligoarticular patterns are more frequent compared with EO-PsA [EO-PsA23 (50%); LO-PsA 19 (63.3%)]. A lower presence of enthesitis was found in patients with LO-PsA [15 (32.6%)vs 6 (20%)] as well as sacroilitis [12 (26%) vs 4 (13.3%)].Laboratory findings show elevated C-reactive protein in EO-PsA [23 (50%); LO-PsA 10 (33.3%)]. The LO-PsA group showed higher activity in DAPSA score [12 (26%) vs 15(50%)], However, BASDAI average score did not show any variability between 2 groups [1.9 vs.1.6)]. The radiographic indices showed worse results in patients with LO-PsA with Sharp V.H average score [36.4 vs 87.6] and Total BASRI average score [1.3 vs 2.01]. Regarding the comorbidities, there was a higher frequency of heart disease [2 (4.3%) vs. 10 (33.3%)] and diabetes [6 (13.04%) vs. (40%)] among patients with LO-PsA PsA. No differences were found in terme of drugs used for the management of LO-PsA subjects and young patients. In multivariated analysis, Late-onset PsA is associated with being women (OR 4.1, 95% CI: 1.4, 12.1) with higher frequency of arthritis (OR 2.9, 95% CI: 1.8, 8.7) and greater structural damage (sharp) (OR 4.1, 95% CI: 1.1, 7.9).

Conclusion: This study highlights that age of onset of PsA was associated with different characteristics of the disease. Patients with late-onset PsA were more frequently woman with more comorbidities,higher frequency of arthritis, greater structural damage and increased disease activity. Enthesitis and Sacroiliitis were found less frequently in the late-onset group. Treatments taken were not associated significantly with age of onset. These charcteristics depending on age at onset of PsA symptoms can be used to predict the evolution and the prognosis of the disease and to individualize more personalized follow-up.

Acknowledgements: NIL.

Disclosure of Interests: None declared.