Background Inflammatory diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) are associated with significant burden on patients’ (pts) function and health-related quality of life (HRQoL). However, little is known about the relative burden of these conditions across indications (age/gender adjusted for each population).
Objectives To compare HRQoL across RA, PsA and axSpA populations.
Methods Baseline (BL) data were used from the following trials: pooled RA trials RAPID 1 (NCT00152386) and RAPID 2 (NCT00160602), RAPID-PsA (NCT01087788) and RAPID-axSpA (NCT01087762). Differences between SF-36 HRQoL scores and age/gender-matched population norms derived from US general population were calculated (difference = SF-36 from trial – age/gender-matched norm); differences were descriptively compared between the overall RA, PsA and axSpA populations, the PsA subpopulations with skin involvement (≥3% body surface area) and without, and the axSpA subpopulations of ankylosing spondylitis (AS) and axSpA with no definitive sacroiliitis on X-ray (non-radiographic axSpA, nr-axSpA). Physical function was assessed using HAQ-DI scores in the RA and PsA trials. HAQ-DI and SF-36 scores (adjusted for tender and swollen joint counts using ANCOVA analysis) were also compared between PsA subpopulations with/without skin involvement.
Results Comparison of BL SF-36 scores revealed axSpA pts experienced a higher burden on overall physical HRQoL compared to RA and PsA pts, while RA pts reported a higher psychological burden compared to axSpA and PsA pts (Table). Comparison of BL HAQ-DI scores revealed RA pts experienced greater difficulties in all physical function aspects assessed compared to PsA pts; specifically in the “Eating” domain. However, for the “Hygiene” and “Arising” domains disability of PsA pts was similar to that of RA pts. For axSpA pts, the HRQoL burden of disease (SF-36 scores) was similar between AS and nr-axSpA subgroups. For PsA pts, comparison of BL HRQoL scores confirmed that skin involvement does not significantly add to the physical health burden of disease but adds to some of the psycho-social aspects (eg. “Social Function” domain) even after adjusting for arthritis severity.
Conclusions At BL in the clinical trial populations examined, trends suggested axSpA had the highest burden on overall physical HRQoL followed by RA and PsA, while the burden on overall mental HRQoL was highest in RA followed by axSpA and PsA. While the HRQoL burden in axSpA did not appear different between subpopulations, the presence of skin involvement in PsA was associated with a higher burden on psycho-social function.
Acknowledgements The authors acknowledge Costello Medical Consulting for writing and editorial assistance which was funded by UCB Pharma.
Disclosure of Interest P. Mease Grant/research support from: Abbott, Amgen, BiogenIdec, BMS, Celgene, Janssen, Lilly, Novartis, Pfizer, UCB Pharma, Consultant for: Abbott, Amgen, BiogenIdec, BMS, Celgene, Janssen, Lilly, Novartis, Pfizer, UCB Pharma, Speakers bureau: Abbott, Amgen, BiogenIdec, BMS, Celgene, Janssen, Lilly, Novartis, Pfizer, UCB Pharma, A. van Tubergen Grant/research support from: Abbott, MSD, Pfizer, Roche, Consultant for: Abbott, Pfizer, UCB Pharma, Speakers bureau: Abbott, MSD, UCB Pharma, A. Deodhar Grant/research support from: Abbott, Amgen, Janssen, Novartis, UCB Pharma, Consultant for: UCB Pharma, Abbott, Speakers bureau: Abbott, Novartis, G. Coteur Employee of: UCB Pharma, T. Nurminen Employee of: UCB Pharma, D. van der Heijde Grant/research support from: AbbVie, Amgen, AstraZeneca, BMS, Centocor, Chugai, Daiichi, Eli Lilly, GSK, Janssen, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, UCB Pharma, Vertex, Consultant for: AbbVie, Amgen, AstraZeneca, BMS, Centocor, Chugai, Daiichi, Eli Lilly, GSK, Janssen, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, UCB Pharma, Vertex, Employee of: Imaging Rheumatology bv.