Burden of Arthritic Manifestations on Psoriatic Patients - Sub-Analysis of Pessoa, A Patient Reported Outcomes Study In Portugal

Abstract

Psoriasis (PsO) and psoriatic arthritis (PsA) is a chronic inflammatory disorder, presenting several types of manifestations with significant impact on quality of life (QoL). This analysis aimed to characterize PsO patients with and without concomitant PsA, and evaluate the disease impact on QoL and resource use. PeSsoA was a cross-sectional study in 564 adult Portuguese patients with PsO. Data was collected through an electronic questionnaire entered directly by patients (Jun-Jul2016). Comparisons were executed between PsA patients (patients with PsO and PsA) and patients with PsO only. 126 patients (22.4%) reported PsA. 63.5% (n=80) were females, mean(SD) age 47.2±12.9 years. Most common type of psoriasis was plaque psoriasis (67.5%). Based on patient reported Body Surface Area, 67.8% had moderate to severe psoriasis. Comparing to other patients, PsA patients presented higher prevalence of depression/ anxiety (37.7% vs 21.9%; p=0.002) and hypertension (30.2% vs 16.6%; p<0.001). The majority of patients were seen by dermatologist in both groups (54.4% in PsA group vs 64.0%) although more patients in PsA group were followed by rheumatologist (23.0% vs 0.8%). Patients with PsA reported higher monthly medication/ heath product cost (56€ vs 36€) and more frequent physician appointments (66% vs 40% with visiting interval < 6 months). EQ-5D-3L results showed that PsA patients had worse scores in anxiety/depression dimension (62.6% were moderately anxious or depressed; 9,3% extremely anxious or depressed) and in pain/discomfort dimension (60,7% had moderate pain or discomfort; 14,9% had extreme pain or discomfort). PsA patients also had a significant worse overall EQ-5D-3L VAS score (59.4 vs 70.6; p<0.001). This sub-analysis reinforces the humanistic burden of PsA in patients with PsO diagnosis. PsA patients had higher prevalence of comorbidities and health resource use. Patients’ perspective should increasingly be integrated in clinical practice to improve disease awareness and obtain more real-life outcomes evaluation.