2330: Correlation of Comorbidities with Psoriatic Arthritis Duration in Elderly Veterans - A Retrospective Cohort Study

Background/Purpose: Psoriasis and psoriatic arthritis (PsA) are associated with several comorbid conditions including metabolic disease, chronic kidney disease as well as mental health disorders. However, limited studies have been conducted on the impact of duration of PsA on comorbidities, and long-term change in practice to manage these comorbidities and improve patient care.

The objective of this study is to determine the prevalence of comorbidities in patients with PsA in a cohort of elderly veterans and determine the correlation of prevalence of comorbidities with the duration of PsA.

Methods: Our cohort included PsA patients from PULSAR (Program to Understand Long-term Outcomes in Spondylarthritis) registry and VA Sacramento Medical Center. The duration of PsA disease was identified by age of onset of PsA noted in the databases and categorized as < 5 years, 6-10 years, 11-15 years, 16-20 years and >20 years. Various comorbidities were identified via ICD-10 codes (hypertension, hyperlipidemia, diabetes mellitus, gout and mental health disorders) and studied in these patients and classified according to the duration of PsA (Table 1).

Results: There were 220 patients available for study. PsA disease duration was as follows: < -5 years (73, 33.2%), 5-10 years (35,15.9%), 11-15 years (40,18.18%), 16-20 years (20, 9%) and more than 20 years (52, 23.6%). The prevalence of comorbidities in each of these groups was then calculated as listed in (Table 1). On subsequent comparison amongst the groups, as noted in Figure 1, the prevalence of hypertension increased with longer disease duration. A similar trend was not noted for the rest of the comorbidities. However, comorbidities that contribute to CVD risk were prevalent in one third to almost half of the PsA cohort, regardless of disease duration (Figure 1).

Conclusion: In this study, the prevalence of hypertension increased with PsA duration. Prevalence of the other comorbidities did not correlate with disease duration. Given the increased cardiovascular disease risks in PsA patients, our findings emphasize the need for hypertension control in PsA patients of longer disease duration. In addition, our findings demonstrate that PsA patients are at increased risk for several comorbidities, especially metabolic syndrome and mental health disorders irrespective of the duration of disease. So, preventive measures should be taken early in the disease course to screen and comprehensively manage these comorbidities and underlying psychosocial issues.