Background/Purpose:  Patients (pts) with psoriatic arthritis (PsA) may experience temporary worsening of symptoms or disease flare, which can be painful enough to interfere with day-to-day activities. The impact of pt perception of severity of disease flare on work productivity, treatment satisfaction, and other pt-reported outcomes (PROs) has not been quantified in detail. The purpose of this analysis is to evaluate the perception of disease flares in pts with PsA and its impact on work productivity and treatment satisfaction in real world setting.

Methods:  Adelphi¹ 2014 Rheumatology Disease Specific Programme is a large multi-center, multi-country, cross-sectional survey of pts with a physician confirmed diagnosis of PsA. Pts filled out a self-completion survey providing an assessment of their symptoms (severity of disease and flaring), quality of life (QoL), and satisfaction with disease control. The self-assessment questionnaire also included pt-reported alternative Health Assessment Questionnaire-Disability Index (HAQ-DI, without aids and devices), Work Productivity and Activity Impairment–Specific Health Problem (WPAI-SHP), and treatment satisfaction. Statistical differences between the groups were evaluated using chi-square test (categorical variables) or analysis of variance (ANOVA, continuous variables).

Results:  Of the 341 PsA pts analyzed from the Adelphi database, 236 (69.2%) pts experienced temporary worsening of symptoms or disease flare. Among pts who reported experiencing a flare, mean age was 51 years and 54% were female. At survey, 126 (55.3%) pts reported experiencing moderate flare, while 53 (23.2%) and 49 (21.5%) experienced mild and severe flare, respectively. Pt-reported severity of last flare increased significantly with increasing perception of PsA severity at survey (P<0.001), at its worst (P<0.001), or before current treatment (P=0.003, Table). The severity of disease flare, as reported by pts, was negatively associated with the ability of pts to go to work and perform well at work (P<0.001) and perform daily tasks (P<0.001). The mean HAQ-DI (P<0.001) and WPAI (P<0.001) scores significantly worsened with increasing severity of disease flare perception. Of the pts reporting mild, moderate, and severe flares, 32 (64.0%), 72 (60.0%), and 26 (53.1%), respectively, were receiving biologic medicine. Pts’ satisfaction with the current treatment (P=0.002) was significantly lower with increasing severity of disease flare.

Conclusion:  Pt perception of PsA severity increased with the severity of pt-reported disease flare. Increasing severity of disease flare perception was associated with decreased work productivity, reduced ability to perform day-to-day activities, and less treatment satisfaction. Pts reporting moderate to severe disease flare experience significantly higher disease burden. References: 

1. Anderson et al., Curr Med Res Opin., 2008; 24 (11):3063-72.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-disease-flare-perception-on-work-productivity-and-treatment-satisfaction-in-patients-with-psoriatic-arthritis-in-real-world-setting/