Regional variations in psoriatic arthritis: Insights from a nationwide multicenter analysis in Türkiye
Erkan Kılıç1
, Gamze Kılıç2, İbrahim Tekeoğlu3, Betül Sargın4, Sevtap Acer Kasman5, Hakan Alkan6, Nilay Şahin7, Gizem Cengiz8, Nihan Cüzdan9, İlknur Albayrak Gezer1, Dilek Keskin11, Cevriye Mülkoğlu12, Hatice Reşorlu13, İsmihan Sunar14, Ajda Bal15, Mehmet Tuncay Duruöz5, Okan Küçükakkaş16, Ozan Volkan Yurdakul17, Meltem Alkan Melikoğlu18, Yıldıray Aydın3, Fikriye Figen Ayhan19, Hatice Bodur20, Mustafa Çalış8, Erhan Çapkın2, Gül Devrimsel21, Kevser Orhan22, Sami Hizmetli23, Ayhan Kamanlı3, Yaşar Keskin17, Hilal Ecesoy24, Öznur Kutluk25, Nesrin Şen26, Ömer Faruk Şendur27, Sena Tolu28, Murat Toprak29, Tiraje Tuncer25, Kemal Nas3
1Rheumatology Clinic, Kanuni Training and Research Hospital, Trabzon, Türkiye
2Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
3Department of Physical Medicine and Rehabilitation, Division of Rheumatology and Immunology, Sakarya University Faculty of Medicine, Sakarya, Türkiye
4Rheumatology Clinic, Aydın State Hospital, Aydın, Türkiye
5Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Marmara University Faculty of Medicine, İstanbul, Türkiye
6Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Türkiye
7Department of Physical Medicine and Rehabilitation, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
8Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Erciyes University Faculty of Medicine, Kayseri, Türkiye
9Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Hatay Mustafa Kemal University Faculty of Medicine, Hatay, Türkiye
10Department of Physical Medicine and Rehabilitation, Selçuk University Faculty of Medicine, Konya, Türkiye
11Department of Physical Medicine and Rehabilitation, Kırıkkale University Faculty of Medicine, Kırıkkale, Türkiye
12Department of Physical Medicine and Rehabilitation, Health Sciences of University, Ankara Training and Research Hospital, Ankara, Türkiye
13Department of Physical Medicine and Rehabilitation, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Türkiye
14Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Ankara University Faculty of Medicine, Ankara, Türkiye
15Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
16NMC Speciality Hospital-Dubai Investment Park, Dubai, UAE
17Department of Physical Medicine and Rehabilitation, Bezmiâlem Foundation University Faculty of Medicine, İstanbul, Türkiye
18Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Atatürk University Faculty of Medicine, Erzurum, Türkiye
19Department of Physical Medicine and Rehabilitation, Atılım University Faculty of Medicine, Ankara, Türkiye
20Department of Physical Medicine and Rehabilitation, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye
21Department of Physical Medicine and Rehabilitation, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Türkiye
22Rheumatology Clinic, Ankara Bilkent City Hospital, Ankara, Türkiye
23Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Cumhuriyet University Faculty of Medicine, Sivas, Türkiye
24Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Karamanoğlu Mehmetbey University, Karaman, Türkiye
25Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University Faculty of Medicine, Antalya, Türkiye
26Rheumatology Clinic, Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, Türkiye
27Department of Physical Medicine and Rehabilitation, Medicana International İzmir Hospital, İzmir, Türkiye
28Department of Physical Medicine and Rehabilitation, Medipol University Faculty of Medicine, İstanbul, Türkiye
29Department of Physical Medicine and Rehabilitation, Yüzüncü Yıl University Faculty of Medicine, Van, Türkiye
Keywords: Arthritis, differences, geographic locations, psoriatic, regional, spondyloarthritis.
Abstract
Objectives: The study aimed to investigate and compare clinical features, disease activity, and the overall disease burden among psoriatic arthritis (PsA) patients across seven distinct geographic regions in Türkiye.
Patients and methods: A multicenter cross-sectional study involving 1,134 PsA patients from 25 referral centers across seven regions was conducted. Demographic and clinical characteristics, comorbidities, joint involvement, extra-articular manifestations, and disease activity measures were evaluated across regions.
Results: A total of 1134 PsA patients from seven different geographic regions in Türkiye participated in this study. The highest number of participants was from the Marmara region (n=409), with subsequent representation from Central Anatolia (n=370), Aegean (n=139), Mediterranean (n=60), Black Sea (n=60), Eastern Anatolia (n=60), and Southeastern Anatolia (n=36) regions. There were significant variations in demographic profile, including age, body mass index, age of disease onset, educational status, comorbidities, and family history of both psoriasis and PsA. Clinical features, such as enthesitis, dactylitis, uveitis, and joint involvement, demonstrated significant variation across regions. Additionally, disease activity measures, including pain, patient and physician global assessments, acute phase reactants, disease activity indices, quality of life, and functional status, displayed considerable regional differences.
Conclusion: This nationwide study revealed substantial regional diversity in demographic data, clinical characteristics, disease activity, and quality of life among PsA patients in Türkiye. These findings stress the need to customize treatment approaches to address regional needs and to conduct further research to uncover reasons for disparities. It is crucial to enhance region-specific approaches to improve patient care and outcomes for PsA.
Citation: Kılıç E, Kılıç G, Tekeoğlu İ, Sargın B, Acer Kasman S, Alkan H, et al. Regional variations in psoriatic arthritis: Insights from a nationwide multicenter analysis in Türkiye. Arch Rheumatol 2024;39(3):340-349. doi: 10.46497/ ArchRheumatol.2024.10591.
The study protocol was approved by the Sakarya University Local Ethics Committee (date: 28.1.2018, no: 25.01.2018/42). The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from each patient.
Significant contributions to the conceptualization and design of the study were made: E.K., G.K., K.N., ‹.T.; Participated in data analysis: E.K., G.K.; The initial manuscript was drafted: E.K., G.K. All authors critically revised the manuscript for important intellectual content. The final version for publication received approval from all authors. Full responsibility for the integrity and accuracy of all aspects of the work is assumed by all authors. All authors were involved in the acquisition of data and its interpretation.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The data that support the findings of this study are available from the corresponding author upon reasonable request.