Background Alignment of patient and clinician goals and perceptions of psoriatic arthritis (PsA) burden and treatment are important to improving disease management.
Objectives To describe patient and rheumatologist perceptions on factors contributing to PsA severity, treatment goals, and attributes of ideal therapy.
Methods Understanding Psoriatic Disease Leveraging Insights for Treatment (UPLIFT) was a multinational Web-based survey that included adults who reported a healthcare provider (HCP) diagnosis of PsA and/or psoriasis, as well as rheumatologists and dermatologists. This analysis focused on survey responses from patients with PsA and rheumatologists. Respondents ranked their top 3 contributing factors for PsA severity, treatment goals, and ideal attributes for therapy. Results were analyzed using the sum of scores.
Results In all, 1256 patients with PsA and 450 rheumatologists completed the respective surveys between March and June 2020. An oligoarticular (≤4 joints involved) pattern of involvement was prevalent in 43.8% of patients (Table 1). Involvement of large joints (78.8%) was most common, followed by intermediate (69.3%) and small (51.8%) joints. Only half of patients reported seeing an HCP for PsA in the last year (Table 1). Patients and rheumatologists agreed that joint pain is a top factor contributing to disease severity; patients also ranked the impact on quality of life and type of symptoms as top factors whereas rheumatologists placed greater importance on the number of joints involved and joint erosion or deformity (Figure 1). Top treatment goals for patients were reducing joint pain and stiffness and stopping the progression of joint damage or erosion (Figure 1). Rheumatologists agreed that inhibiting progression of joint damage or erosion and reducing joint pain were among the top treatment goals, and they rated disease remission or low disease activity (LDA) as the most important goal (Figure 1). Rheumatologists identified consistent treatment goals for patients regardless of degree of joint involvement (oligoarthritis vs polyarthritis). Patients and rheumatologists agreed that long-term safety and efficacy are key attributes of an ideal PsA therapy. The top attribute for patients was joint pain reduction, whereas achievement of remission or LDA was the top attribute identified by rheumatologists (Figure 1). Despite general alignment between patient and rheumatologist responses across metrics, 87.1% of patients reported they did not feel that their treatment goals matched those of their current HCP.
Conclusion In the UPLIFT survey, patients with PsA and their rheumatologists generally agreed on the top factors contributing to disease severity, treatment goals, and attributes of ideal PsA therapy. However, the majority of patients with PsA did not feel aligned with their current HCP regarding treatment goals. Development of methods for treatment goal discussion and alignment are important to improving patient outcomes.
Acknowledgements The authors gratefully acknowledge Hsiuan Lin Wu for data analysis.
This study was funded by Amgen Inc. Writing support was funded by Amgen Inc. and provided by Kristin Carlin, BSPharm, MBA, of Peloton Advantage, LLC, an OPEN Health company, and Cathryn M. Carter, MS, employee of and stockholder in Amgen Inc.
Disclosure of Interests Pascal Richette Speakers bureau: AbbVie, Amgen Inc., Bristol Myers Squibb, Janssen, Lilly, Novartis, Pfizer, and UCB – speaker bureau fees., William Tillett Speakers bureau: AbbVie, Amgen Inc., Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB – speaker bureau fees., Consultant of: AbbVie, Amgen Inc., Celgene, Eli Lilly, Merck Sharp & Dohme, Novartis, Pfizer, and UCB – consultant, Grant/research support from: AbbVie, Celgene, Eli Lilly, and Janssen – grant/research support, Alexis Ogdie Consultant of: AbbVie, Amgen Inc., Bristol Myers Squibb, Celgene, CorEvitas’ Psoriatic Arthritis/Spondyloarthritis Registry (formerly Corrona), Eli Lilly, Gilead, Janssen, Novartis, Pfizer, and UCB – consultant, Grant/research support from: AbbVie, Amgen Inc., Novartis, and Pfizer – grant/research support, Alice B Gottlieb Consultant of: AnaptysBio, Avotres, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, LEO Pharma, Eli Lilly, Novartis, Sun, UCB, and Xbiotech – advisory board member and consultant, Grant/research support from: Boehringer Ingelheim, Janssen, Novartis, Sun, UCB, and Xbiotech – grant/research support, Shauna Jardon Shareholder of: Stock ownership in Amgen Inc., Employee of: Employment by Amgen Inc., Sven Richter Shareholder of: Stock ownership in Amgen Inc., Employee of: Employment by Amgen Inc., Andrea Flower Employee of: Employment by ProUnlimited, under contract for Amgen Inc., Joseph Merola Consultant of: AbbVie, Arena, Avotres, Biogen, Bristol Myers Squibb, Dermavant, Eli Lilly, EMD, Janssen, LEO Pharma, Merck, Novartis, Pfizer, Regeneron, Sanofi, Serono, Sun, and UCB – consultant and/or investigator.
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