Patients with psoriatic arthritis (PsA) who started on a diet intervention study were more likely to experience metabolic abnormalities in higher prevalence, Lihi Eder, MD, said during her research presentation at ACR Convergence on November 13.

Dr Eder is an associate professor of medicine at University of Toronto, and a clinician-scientist at Women’s College Research Institute in Toronto, Ontario, Canada.

The link between PsA, obesity, and related metabolic abnormalities, has been well established. However, Dr Eder said, with the Dietary Intervention in PsA (DIPSA) randomized controlled trial, the researchers sought to identify the role of diet as an adjunct therapy in PsA. The 3 goals of the controlled trial were to describe the prevalence of cardiometabolic abnormalities; assess the participants’ adherence to healthy eating recommendations;, and understand the impact of diet on disease activity.

The investigators compared the efficacy of Mediterranean diet and DASH-low caloric diet vs. standard of care as a supplemental therapy among patients with PsA who were overweight or obese with body mass index (BMI) greater than 25.

The 32 final participants had a Disease Activity in Psoriatic Arthritis (DAPSA) score of more than 10; were on stable therapy; agreed to have their cardiometabolic abnormalities assessed by medical history, physical examination, and laboratory tests; and completed a 24-hour cycle of normal food and beverage consumption during 3 separate weekdays. The healthy eating index (HEI)-2015 was then calculated in which 0 was low and 5-10 was high.

Dr Eder noted that patients with PsA who started a diet intervention study experienced a high prevalence of metabolic abnormalities. The average age of the participants was 53.3 years; 71.9% were women. The mean DAPSA score was 23.6, with a mean tender joint count of 6.6 and swollen joint count of 1.1. While most patients battled with obesity (71.9%), some had dyslipidemia (41.9%), hypertension (37.5%), and/or metabolic syndrome (46.9%).

Dr Eder noted that women had higher adherence scores than men, Dr Eder noted. The mean adherence score for HEI-2015 was 59.3, higher than the baseline of 50 specified at the beginning of the study. These scores were not vastly different between groups according to age and level of education.

From the individual HEI-2015 food groups, the lowest adherence scores were for whole grain and total sodium consumption. The investigators also found a significant correlation between lower sugar, lower fatigue levels, and lower Psoriatic Arthritis Impact of Disease scores, and between greater whole fruit consumption and lower swollen joint count. Dr Eder mentioned a correlation between unsaturated and saturated fatty acids and higher enthesitis score, although that would require more research to establish a stronger association, she said.
 

“The DIPSA study will determine the role of dietary interventions as adjunct therapy in PsA,” Dr Eder said.

—Priyam Vora

Reference:
Eder L. Poster 1007. Metabolic disorders and abnormal dietary patterns and their association with psoriatic arthritis activity: The dietary intervention in PsA (DIPSA) study. Presented at: American College of Rheumatology Convergence. November 13, 2022.