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Öğe Beyond expectations: disease duration and psychological burden in psoriatic arthritis(Springer Heidelberg, 2023) Kilic, Gamze; Kilic, Erkan; Tekeoglu, Ibrahim; Sargin, Betul; Cengiz, Gizem; Balta, Nihan Cuzdan; Alkan, HakanThis study aims to investigate the relationship between disease duration and psychological burden in PsA and to identify the risk factors associated with psychological distress. Patients with PsA who met CASPAR classification criteria enrolled by Turkish League Against Rheumatism (TLAR)-Network. Patients were categorized into three groups based on disease duration: early stage (< 5 years), middle stage (& GE; 5, < 10 years), and late stage (& GE; 10 years). All patients underwent clinical and laboratory assessment using standardized protocol and case report forms. The associations between psychological variables and clinical parameters were assessed by a multivariate analysis. Of the 1113 patients with PsA (63.9% female), 564 (%50.7) had high risk for depression and 263 (%23.6) for anxiety. The risk of psychological burden was similar across all PsA groups, and patients with a higher risk of depression and anxiety also experienced greater disease activity, poorer quality of life, and physical disability. Multivariate logistic regression revealed that female gender (OR = 1.52), PsAQoL (OR = 1.13), HAQ (OR = 1.99), FiRST score (OR = 1.14), unemployment/retired (OR = 1.48) and PASI head score (OR = 1.41) were factors that influenced the risk of depression, whereas the current or past enthesitis (OR = 1.45), PsAQoL (OR = 1.19), and FiRST score (OR = 1.26) were factors that influenced the risk of anxiety. PsA patients can experience a comparable level of psychological burden throughout the course of their disease. Several socio-demographic and disease-related factors may contribute to mental disorders in PsA. In the present era of personalized treatment for PsA, evaluating psychiatric distress can guide tailored interventions that improve overall well-being and reduce disease burden.Öğe Characteristics of Patients With Rheumatoid Arthritis in Turkey: Results From the Turkish League Against Rheumatism Rheumatoid Arthritis Registry(TURKISH LEAGUE AGAINST RHEUMATISM, 2015) Bal, Ajda; Ataman, Sebnem; Bodur, Hatice; Rezvani, Aylin; Paker, Nurdan; Tastekin, Nurettin; Karatepe, Altinay Goksel; Borman, Pinar; Yener, Mahmut; Nas, Kemal; Sezgin, Melek; Yazgan, Pelin; Tekeoglu, Ibrahim; Dogu, Beril; Altay, Zuhal; Kirnap, Mehmet; Gurgan, Alev; Gur, Ali; Hizmetli, Sami; Gunendi, Zafer; Erdem, Rana; Ugurlu, Hatice; Inal, Elem; Olmez, Nese; Kozanoglu, Erkan; Oken, Oznur; Ozel, Sumru; Dundar, Umit; Akinci, Aysen; Ozturk, Cihat; Sivrioglu, Koncuy; Duruoz, Mehmet Tuncay; Aydog, Ece; Capkin, Erhan; Altan, Lale; Evcik, Deniz; Durmus, Oguz; Yagci, Ilker; Sendur, Omer Faruk; Sertpoyraz, Filiz Meryem; Ozgul, Ahmet; Senel, Kazim; Capaci, KazimObjectives: This study investigates the demographic and clinical characteristics of patients with rheumatoid arthritis (RA) in Turkey, and attempts to identify strategies for the prevention, treatment, and support of RA. Patients and methods: A total of 2,359 patients (1,966 females, 393 males; mean age 51.6 +/- 12.5 years; range 18 to 75 years) with RA from 36 centers across Turkey, who were recorded in the Turkish League Against Rheumatism (TLAR) RA Registry between September 2007 and March 2011, were evaluated. Patients' demographic and clinical data were recorded. Disease activity, functional status, and radiographic damage were measured using the Disease Activity Score 28, the Health Assessment Questionnaire, and van der Heijde modified Sharp scoring method. Results: The mean duration of academic education received was 5.2 +/- 3.8 years, and 74.6% of the patients were homemakers. Non-biological disease-modifying anti-rheumatic drugs were used by 91.0% of the patients, while 10.2% used biological disease-modifying anti-rheumatic drugs. The mean Disease Activity Score 28, Health Assessment Questionnaire, and Sharp scores were 4.0 +/- 1.4, 0.38 +/- 0.37, and 31.2 +/- 57.1, respectively. Of the patients, 17.8% were in remission and 14.1% had low disease activity rates, while 42.7% and 25.5% had moderate and high disease activity rates. Conclusion: The majority of patients with RA in Turkey are middle-aged homemakers. Despite the high rates of disease-modifying anti-rheumatic drugs use, the majority of patients had moderate and high disease activity. These findings indicate that treatment needs of RA patients are not met sufficiently.Öğe Diagnostic delay in psoriatic arthritis: insights from a nationwide multicenter study(Springer Heidelberg, 2024) Kilic, Gamze; Kilic, Erkan; Tekeoglu, Ibrahim; Sargin, Betul; Cengiz, Gizem; Balta, Nihan Cuzdan; Alkan, HakanThis study aimed to investigate the duration of diagnostic delay in patients with psoriatic arthritis (PsA) and identify potential contributing factors using a comprehensive, population-based approach. Data were obtained from the Turkish League Against Rheumatism (TLAR)-Network, involving patients who met the CASPAR criteria. Diagnostic delay was defined as time interval from symptom onset to PsA diagnosis, categorized as <= 2 years and > 2 years. Temporal trends were assessed by grouping patients based on the year of diagnosis. Various factors including demographics, clinical characteristics, disease activity, quality of life, physical function, disability, fatigue, and well-being were examined. Logistic regression models were used to identify factors associated with diagnostic delay. Among 1,134 PsA patients, mean diagnostic delay was 35.1 months (median: 12). Approximately 39.15% were diagnosed within 3 months, and 67.02% were diagnosed within 24 months. Patients experiencing longer delays had higher scores in Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), patient's global assessment (PtGA) and physician's global assessment (PhGA). Diagnostic delay has decreased over time, with median delay falling from 60 to 24 months throughout pre-2010 and 2015-2019 terms. Several factors were identified as significant contributors to delayed diagnosis, including lower levels of education (OR = 2.63), arthritis symptoms preceding skin manifestations (OR = 1.72), low back pain at first visit (OR = 1.60), symptom onset age (OR = 0.96), and psoriasis subtype (OR = 0.25). Timely diagnosis of PsA is crucial for effective management and improved outcomes. Despite recent improvements, about one-third of PsA patients still experience delays exceeding 2 years. By identifying influential factors such as education level, arthritis symptoms preceding skin manifestations, initial visit symptoms, age of symptom onset, and psoriasis subtype, healthcare practitioners may create specific techniques to help in early detection and intervention.Öğe THE EFFECT OF GENDER ON DISEASE ACTIVITY, FUNCTIONAL INDEX AND QUALITY OF LIFE IN PATIENTS WITH AXIAL SPA. THE DATA OF TLAR-NETWORK PSA STUDY(BMJ PUBLISHING GROUP, 2019) Nas, Kemal; Kilic, Erkan; Tekeoglu, Ibrahim; Cevik, Remzi; Sargin, Betul; Kasman, Sevtap Acer; Alkan, Hakan; Sahin, Nilay; Cengiz, Gizem; Cuzdan, Nihan; Gezer, Ilknur Albayrak; Keskin, Dilek; Mulkoglu, Cevriye; Resorlu, Hatice; Ataman, Sebnem; Bal, Ajda; Duruoz, Mehmet Tuncay; Kucukakkas, Okan; Yurdakul, Ozan Volkan; Melikoglu, Meltem Alkan; Aydin, Yildiray; Ayhan, Figen; Bodur, Hatice; Calis, Mustafa; Capkin, Erhan; Devrimsel, Gul; Gok, Kevser; Hizmetli, Sami; Kamanli, Ayhan; Keskin, Yasar; Kocabas, Hilal; Kutluk, Oznur; Sen, Nesrin; Sendur, Omer Faruk; Toprak, Murat; Tolu, Sena; Tuncer, Tiraje…Öğe Impact of obesity on quality of life, psychological status, and disease activity in psoriatic arthritis: a multi-center study(Springer Heidelberg, 2022) Gok, Kevser; Nas, Kemal; Tekeoglu, Ibrahim; Sunar, Ismihan; Keskin, Yasar; Kilic, Erkan; Sargin, BetulThis article aims to evaluate the possible effect of obesity on quality of life, psychological status, and other clinical variables in Psoriatic arthritis (PsA). PsA patients have been recruited by the Turkish League Against Rheumatism-Network from various centers in Turkey in this cross-sectional study. Patients with a body mass index (BMI) >= of 30 kg/m(2) were considered obese. Differences among patients with regard to obesity status were assessed with health-related quality of life measures (PsA Quality of Life Questionnaire [PsAQoL]), psychological status (Hospital Anxiety and Depression Scale [HADS]), and disease activity parameters (the Disease Activity index for PSoriatic Arthritis [DAPSA], Disease Activity Score 28-C-reactive protein [DAS28-CRP], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Psoriasis Area and Severity Index [PASI]), physical functions (Ankylosing Spondylitis Functional Index [BASFI], Health Assessment Questionnaire [HAQ], and Health Assessment Questionnaire for the spondyloarthropathies [HAQ-S]). Pain was assessed using visual analog scale of pain (VAS-P), and fatigue was evaluated using visual analog scale of fatigue (VAS-F) and Functional Assessment of Chronic Illness Therapy (FACIT). A total of 1033 patients with PsA, 650 (62.9%) non-obese and 383 (37.1%) obese were included in the study. The PsAQoL, HADS-Anxiety, HADS-Depression, DAPSA, DAS28-CRP, BASDAI, BASFI, HAQ and HAQ-S scores of the obese group were higher than the non-obese group (p < 0.05). VAS-P and PASI scores were similar between group of patients with and without obesity. Obese patients had higher median scores of VAS-F and FACIT than non-obese patients (p < 0.05). Linear regression analysis showed that BMI affects the quality of life, depression, and disease activity. Consequently, obesity has significant associations with higher disease activity, lower QoL, risk of anxiety, depression, and fatigue. Therefore, obesity should also be taken into account in the management of PsA patients.Öğe POSSIBLE POTENTIAL INTERACTIONS BETWEEN OBESITY, QUALITY OF LIFE, PSYCHOLOGICAL STATUS AND CLINICAL PARAMETERS IN PSORIATIC ARTHRITIS(BMJ PUBLISHING GROUP, 2019) Gok, Kevser; Nas, Kemal; Kilic, Erkan; Sargin, Betul; Kasman, Sevtap Acer; Alkan, Hakan; Sahin, Nilay; Cengiz, Gizem; Cuzdan, Nihan; Gezer, Ilknur Albayrak; Keskin, Dilek; Mulkoglu, Cevriye; Resorku, Hatice; Sunar, Ismihan; Hasturk, Ajda Bal; Duruoz, Mehmet Tuncay; Kucukakkas, Okan; Yurdakul, Ozan Volkan; Melikoglu, Meltem Alkan; Aydin, Yildiray; Ayhan, Figen; Bodur, Hatice; Calis, Mustafa; Capkin, Erhan; Devrimsel, Gul; Hizmetli, Sami; Kamanli, Ayhan; Keskin, Yasar; Kocabas, Hilal; Kutluk, Oznur; Sen, Nesrin; Sendur, Omer Faruk; Tekeoglu, Ibrahim; Toprak, Murat; Tolu, Sena; Tuncer, Tiraje…Öğe Regional variations in psoriatic arthritis: Insights from a nationwide multicenter analysis in Türkiye(Turkish League Against Rheumatism, 2024) Kilic, Erkan; Kilic, Gamze; Tekeoglu, Ibrahim; Sargin, Betul; Kasman, Sevtap Acer; Alkan, Hakan; Sahin, NilayObjectives: 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 T & uuml;rkiye. 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 T & uuml;rkiye 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 T & uuml;rkiye. 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.Öğe The effect of gender on disease activity and clinical characteristics in patients with axial psoriatic arthritis(Taylor & Francis Ltd, 2021) Nas, Kemal; Kilic, Erkan; Tekeoglu, Ibrahim; Keskin, Yasar; cevik, Remzi; Sargin, Betul; Acer Kasman, SevtapObjectives In this study, we aimed to evaluate the effect of gender on clinical findings, disease activity, functional status and quality of life in patients with axial involvement in Turkey. Methods Patients with PsA who met the CASPAR classification criteria were enrolled consequently in this cohort. Turkish League Against Rheumatism (TLAR)-Network was formed with the participation of 25 centres. The demographic variables, fatigue, diagnostic delay, the beginning of peripheral arthritis, enthesitis, dactylitis and spine involvement, inflammatory low back pain, BASFI, HAQ, HAQ-s, visual analogue scale-pain (VAS-pain), anxiety, depression and disease activity parameters (ESR, DAS28, BASDAI) were recorded. Axial involvement was assessed according to clinical and radiological data according to modified New York (MNYC) or Assessment of SpondyloArthritis international Society (ASAS) criteria. Results A total of 1018 patients with PsA were included in this study. Of the 373 patients with axial involvement, 150 were male (40.2%) and 223 (59.8%) were female. Spondylitis was detected in 14,7% of men and 21,9% of women in all patients. Pain score (VAS) (p < .002), fatigue (p < .001), ESR (p < .001), DAS28 (p < .001), BASDAI score (p < .001), PsAQoL (p < .001), HAQ score (p < ,01), HAQ-S score (p < .001), anxiety (p < .001), depression (p < .024), FACIT (p < .001) and FiRST (p < .001) scores were statistically significantly worse in women than males with axial PsA. However, quality of life was better (p < .001) and PASI score (p < .005) were statistically worse in male patients than in female patients with axial involvement. Conclusion This study has shown that the burden of disease in axial PsA has significant difference between genders. Disease activity, physical disability, functional limitation, depression and anxiety scores were higher in female patients, while quality of life were better and PASI score were higher in male patients. Therefore, we suggest that new strategies should be developed for more effective treatment of axial PsA in female patients.
