Impaired mobility drives disability in psoriatic arthritis – An observational study from Karnataka Psoriatic Arthritis Cohort (KPsAC) Shobha V, Kodishala C, Chandrashekara S, Kumar S, Haridas V, Rao V, Jois R, Daware M, Singh YP, Singhai S, Dharmanad B G, Chebbi P, Subramanian R, Kamath A, Karjiigi U, Jain VK, Dharmapalaiah C, Prasad S, Srinivas C, Ramya J, Pinto B, Nazir B, Harshini, Mahendranath,

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Impaired mobility drives disability in psoriatic arthritis – An observational study from Karnataka Psoriatic Arthritis Cohort (KPsAC) Vineeta Shobha¹, Chanakya Kodishala¹, S Chandrashekara², Sharath Kumar³, Vikram Haridas⁴, Vijay Rao⁵, Ramesh Jois⁶, Manisha Daware⁷, Yogesh Preet Singh⁵, Shweta Singhai⁸, BG Dharmanad⁶, Pramod Chebbi⁹, R Subramanian¹⁰, Ashwini Kamath¹¹, Uma Karjiigi¹², Vikramraj K Jain¹³, Chethana Dharmapalaiah¹⁴, Shiva Prasad¹⁵, C Srinivas¹⁶, J Ramya¹, Benzeeta Pinto¹, Beenish Nazir², Harshini¹⁷, Mahendranath¹⁸ ¹ Department of Clinical Immunology and Rheumatology, St. John's Medical College Hospital, Bengaluru, India ² Chanre Rheumatology and Immunology Research Centre, Bengaluru, India ³ Columbia Asia Hospital, Bengaluru, India ⁴ Arthritis Specialty Clinic, Hubli, India ⁵ Department of Rheumatology, Manipal Hospitals, Bengaluru, India ⁶ Vikram Hospital, Bengaluru, India ⁷ Narayana Health City, Bengaluru, India ⁸ Sakra Hospital, Bengaluru, India ⁹ SDM Medical College, Dharwad, India ¹⁰ JSS Medical College, Mysore, India ¹¹ Yenepoya Specialty Hospital, Managlore, India ¹² Department of Rheumatology, Apollo Hospital, Bengaluru, India ¹³ Department of Clinical Immunology and Rheumatology, Mahaveer Jain Hospital, Bengaluru, India ¹⁴ Department of Rheumatology, Aster CMI Hospital, Bengaluru, India ¹⁵ Apollo BGS Hospital, Mysore, India ¹⁶ Fortis Hospital, Bengaluru, India ¹⁷ Sparsh Hospital, Bengaluru, India ¹⁸ Samarpan Health Centre, Bengaluru, India Correspondence Address: Vineeta Shobha, Department of Clinical Immunology and Rheumatology, St John's Medical College Hospital, Sarjapur Road, Bengaluru - 560 034, Karnataka India Source of Support: None, Conflict of Interest: None DOI: 10.4103/injr.injr_285_21

Introduction: Psoriatic arthritis (PsA) is a chronic inflammatory disease with significant functional impairment. Health Assessment Questionnaire-Disability Index (HAQ-DI) is a reliable and validated outcome measure for a variety of arthritides including PsA. Objective: The objective of this study was to assess the disability as an outcome measure in PsA using the Indian version of HAQ (I-HAQ). Methods: The I-HAQ was administered to PsA patients diagnosed as per the Classification Criteria for PsA. The I-HAQ comprises 12 questions (nine basic and three advanced activities of daily living (ADLs), on the standard HAQ format) relevant to the Indian population. Results: In the 549 participants, the mean I-HAQ was 0.31 (0.45) and 48.2% had mild-to-moderate disability (I-HAQ>0–1). Female gender, older age, higher skin, joint scores, and Disease Activity Index for PsA were associated with some disability (I-HAQ>0). Symmetric polyarthritis (0.34) and spondyloarthritis (0.32) had a significantly higher disability compared to other subsets. Analyzing the individual questions of I-HAQ, squatting in the toilet or sitting cross-legged on the floor (r = 0.78), walking 3 km (r = 0.77), and climbing a flight of stairs (r = 0.74) correlated maximally to the total I-HAQ. ADL which was affected most frequently was “climbing a flight of stairs.” I-HAQ was significantly lower in patients who had been on disease-modifying antirheumatic drugs for 6 months or more (P = 0.0001). Conclusions: The Indian version of HAQ-DI could be efficiently employed to assess outcomes in our cohort. Nearly half of the cohort had mild-to-moderate disability suggesting a high burden of inflammation. Higher joint activity scores are strongly associated with disability.

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    -  Shobha V
    -  Kodishala C
    -  Chandrashekara S
    -  Kumar S
    -  Haridas V
    -  Rao V
    -  Jois R
    -  Daware M
    -  Singh YP
    -  Singhai S
    -  Dharmanad B G
    -  Chebbi P
    -  Subramanian R
    -  Kamath A
    -  Karjiigi U
    -  Jain VK
    -  Dharmapalaiah C
    -  Prasad S
    -  Srinivas C
    -  Ramya J
    -  Pinto B
    -  Nazir B
    -  Harshini
    -  Mahendranath

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