Dr Haberman characterized a cohort of patients with psoriatic arthritis to evaluate how race, ethnicity, and sex may inform features of clinical presentation, comorbidities, disease course and outcomes.

Rebecca Haberman, MD, is an assistant professor of medicine at the NYU Grossman School of Medicine in New York. Dr Haberman is also the associate director of the Psoriatic Arthritis Center and the assistant director of the Orthopedic Hospital Arthrits Clinic.

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Transcript:

Hi. I'm Rebecca Haberman. I am a rheumatologist at NYU, and we are here in San Diego at ACR in 2023. And I will discuss a couple of my key points about the presentation that I gave here on racial and ethnic determinants of psoriatic phenotype and disease activity.

So psoriatic arthritis is often thought of a disease of white individuals. And this is really manifested and seen in the tested and seen in the fact that most phase 3 clinical trials for psoriatic arthritis are over 90% made up of white individuals, some even more than 95%. And this doesn't reflect the demographics of psoriatic disease. Although the prevalence is higher in white individuals, it's still common in black individuals, Hispanic individuals, Asian individuals.

There hasn't been that much work done in looking at this, but in the few studies that have been done before, we do see that there may be a difference in how these patients present. So, in our home, which is New York City, we have a very wide diverse unique cohort. We looked at our patients and asked the question of, does race and or ethnicity really impact how our patients are presenting.

What we found is that patients who were nonwhite, and that included Hispanic individuals as well, were younger, they were more likely to have diabetes. In terms of their disease activity, although they had similar numbers of swollen joints, they actually had higher numbers of tender joints, meaning that their experience of disease may be different. When we looked at a subset of those patients who were not on any medication, so they were new presenters to us, patients who were nonwhite also had more skin activity for their psoriasis and higher rapid scores or patient reported outcomes.

Of course, one of the big caveats of this work is that you can't just say nonwhite as a group.

Within that group, it's very diverse in and of itself and have likely a different immunologic baseline assessment to these differences. So, we did look specifically at Hispanic individuals as well since we had that is the biggest cohort of patients and found that they had also higher rates of tender their joints and of skin disease.

Interestingly, they had higher rates of radiographic axial disease, which was something that was surprising to us. We also looked at Asian individuals individually, and they actually had no differences in terms of their disease activity or phenotype compared to white individuals. And unfortunately, we didn't have enough Black individuals to look at this group specifically.

In addition, we also looked at men versus women, and we found that women, even though they had similar disease activity, were on the same number of medications, had higher rapid threes or patient reported outcomes. They also had higher levels of depression and anxiety, which may be why they're reporting worse disease, although we may not see that on exam.

So all in all, we were able to see that there are differences between different racial, ethnic, and also sex-based differences groups in psoriatic arthritis, which really need to be examined and more to understand why they're happening and how we can address it better to make sure that everyone is getting the care that they need. Thank you so much for your attention.

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