E010 Psoriatic arthritis annual review clinic: a one year review

Background/Aims A comprehensive annual review including comorbidity assessment in patients with rheumatoid arthritis (RA) has been advocated by the National Institute for Clinical Excellence (NICE). Psoriatic arthritis (PsA) carries a similar, if not greater, burden; on meta-analysis, patients with PsA were 1.66 times more likely to have metabolic syndrome than those with RA, driving increased cardiovascular risk and mortality. Furthermore, depression in PsA (prevalence 9 to 22%) is common and linked to nociplastic pain. We describe the first year of a dedicated PsA annual review clinic (ARC), evaluating comorbidity prevalence and the utility of systematic screening. Methods A retrospective review was conducted of all patients attending a PsA ARC between May 2024 and April 2025 at University Hospital Lewisham in London, UK. Clinical and demographic data were collected, including metabolic risk factors, and results from structured assessments, including Fibrosis-4 Index (FIB-4), Fracture Risk Assessment Tool (FRAX), Patient Health Questionnaire-9 (PHQ-9), and Health Assessment Questionnaire-Disability Index (HAQ-DI). Results The cohort (n = 78) had a mean (SD) age of 50.8 (13.1) years, 51.3% were male, and 53.8% were from the two most deprived socioeconomic quintiles. Most patients had established disease, with 59% on conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and 50% on biologic (b) or targeted synthetic (ts)DMARDs. A high comorbidity burden was observed: 39.7% had at least one metabolic risk factor (hypertension 23.1%, diabetes 7.7%, ischaemic heart disease 2.6%). Over half the cohort were overweight (30.8%) or obese (33.3%). We identified that 65.4% had a low risk FIB-4 (<1.3) for liver fibrosis, and 20.5% had intermediate risk (FIB-4 1.3 to 3.25). Of 28 patients with a fibroscan completed, 82.1% had no significant fibrosis (<6.0 kPa) and 17.9% had mild-moderate fibrosis (6.0 to 12.0 kPa). FRAX assessment deemed 12.8% required Bone Mineral Density (BMD) measurement and 2.6% required treatment; subsequent bone density scans in 17 patients revealed osteoporosis in 23.5%. Mood screening found 17.9% had mild, 15.4% moderate and 2.6% severe depression. Functional assessment (HAQ-DI) showed 6.4% had moderate and 6.4% severe difficulty. Conclusion Our dedicated PsA ARC identified a profound comorbidity burden, with over one-third of patients having at least one metabolic risk factor and one-third living with obesity; this is likely a conservative estimate as we did not adjust for ethnicity. Overall, there was a low incidence of significant liver fibrosis within this cohort. It is important to note that patients attending this ARC may have represented a more stable group, and the overall PsA population likely carries an even greater disease burden. These findings support our PsA ARC model as an essential tool for proactive management in PsA, capable of identifying and addressing modifiable risks that can directly impact disease outcomes and long-term health. Disclosure N. Arumalla: Honoraria; Abbvie. Other; Conference fees from AbbVie, Accord Healthcare and Lilly. E. Sayson: None. D. Srikantharajah: None. L.C. Pollard: None. Y.L. Man: None.