TY - JOUR
T1 - Disparities in healthcare in psoriatic arthritis
T2 - An analysis of 439 patients from 13 countries
AU - Lucasson, Florian
AU - Kiltz, Uta
AU - Kalyoncu, Umut
AU - Leung, Ying Ying
AU - Palominos, Penélope
AU - Canete, Juan
AU - Scrivo, Rossana
AU - Balanescu, Andra
AU - Dernis, Emanuelle
AU - Meisalu, Sandra
AU - Ryussen-Witrand, Adeline
AU - Soubrier, Martin
AU - Aydin, Sibel Zehra
AU - Eder, Lihi
AU - Gaydukova, Inna
AU - Lubrano, Ennio
AU - Richette, Pascal
AU - Husni, Elaine
AU - Coates, Laura C.
AU - De Wit, Maarten
AU - Smolen, Josef S.
AU - Orbai, Ana Maria
AU - Gossec, Laure
N1 - Publisher Copyright:
©
PY - 2022/5/6
Y1 - 2022/5/6
N2 - Objectives Patient care can vary substantially by country. The objective was to explore differences in psoriatic arthritis (PsA) across countries for disease activity, impact and treatments. Methods A cross-sectional analysis of 13 countries from the Remission/Flare in PsA study (NCT03119805) of consecutive adult patients with definite PsA was performed. Countries were classified into tertiles by gross domestic product (GDP)/capita. Disease activity (Disease Activity in PsA, DAPSA and Minimal Disease Activity, MDA) and their components, disease impact (patient-reported outcomes) and biological disease-modifying antirheumatic drugs (bDMARDs) were analysed per country and compared between the three tertiles of GDP/capita by parametric and non-parametric tests. We also explored the percentage of patients with significant disease activity (DAPSA >14) and no ongoing bDMARD prescription. Results In 439 patients (50.6% male, mean age 52.3 years, mean disease duration 10.1 years), disease activity and disease impact were higher in the lowest GDP/capita countries. DAPSA remission and MDA were attained in the lowest tertile in 7.0% and 18.4% patients, vs 29.1% and 49.5% in the middle tertile and 16.8% and 41.3% in the high tertile, respectively (all p<0.001). bDMARDs use was similar in the tertiles (overall mean 61%). The overall rate of patients with DAPSA >14 and no bDMARDs was 18.5%, and was higher in lower GDP/capita countries (p=0.004). Conclusion PsA patients from countries with the lowest GDP/capita, despite similar use of bDMARDs, were more likely to have high disease activity and worse disease impact. There is a need for more equity in healthcare.
AB - Objectives Patient care can vary substantially by country. The objective was to explore differences in psoriatic arthritis (PsA) across countries for disease activity, impact and treatments. Methods A cross-sectional analysis of 13 countries from the Remission/Flare in PsA study (NCT03119805) of consecutive adult patients with definite PsA was performed. Countries were classified into tertiles by gross domestic product (GDP)/capita. Disease activity (Disease Activity in PsA, DAPSA and Minimal Disease Activity, MDA) and their components, disease impact (patient-reported outcomes) and biological disease-modifying antirheumatic drugs (bDMARDs) were analysed per country and compared between the three tertiles of GDP/capita by parametric and non-parametric tests. We also explored the percentage of patients with significant disease activity (DAPSA >14) and no ongoing bDMARD prescription. Results In 439 patients (50.6% male, mean age 52.3 years, mean disease duration 10.1 years), disease activity and disease impact were higher in the lowest GDP/capita countries. DAPSA remission and MDA were attained in the lowest tertile in 7.0% and 18.4% patients, vs 29.1% and 49.5% in the middle tertile and 16.8% and 41.3% in the high tertile, respectively (all p<0.001). bDMARDs use was similar in the tertiles (overall mean 61%). The overall rate of patients with DAPSA >14 and no bDMARDs was 18.5%, and was higher in lower GDP/capita countries (p=0.004). Conclusion PsA patients from countries with the lowest GDP/capita, despite similar use of bDMARDs, were more likely to have high disease activity and worse disease impact. There is a need for more equity in healthcare.
KW - Arthritis, Psoriatic
KW - Epidemiology
KW - Outcome Assessment, Health Care
UR - http://www.scopus.com/inward/record.url?scp=85130000515&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85130000515&partnerID=8YFLogxK
U2 - 10.1136/rmdopen-2021-002031
DO - 10.1136/rmdopen-2021-002031
M3 - Article
C2 - 35523519
AN - SCOPUS:85130000515
SN - 2056-5933
VL - 8
JO - RMD Open
JF - RMD Open
IS - 1
M1 - e002031
ER -