Impact of Enthesitis on Patient Reported Outcomes and Physician Satisfaction with Treatment: Data from a Multinational Patient and Physician Survey

Ana-Maria Orbai¹, Birt Julie ², Elizabeth Holdsworth ³, Nicola Booth ⁴, Matthew M. Hufford ², Malatestinic William ², Aubrey Trevelin Sprabery ² and Anthony Reginato ⁵, ¹Johns Hopkins University School of Medicine, Baltimore, MD, ²Eli Lilly and Company, Indianapolis, IN, ³Adelphi Real World, Manchester, England, United Kingdom, ⁴Adelphi Real World, Bollington, United Kingdom, ⁵Division of Rheumatology, Providence VAMC, Associate Professor in Medicine, The Warren Alpert School of Medicine, Providence

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Enthesitis, Psoriatic arthritis, quality of life and treatment satisfaction

Session Information

Date: Tuesday, November 12, 2019

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster III: Psoriatic Arthritis, Clinical Features

Session Type: Poster Session (Tuesday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Enthesitis, a characteristic clinical feature of psoriatic arthritis (PsA) [1], is a core outcome for PsA clinical trials. While enthesitis is considered important when treating patients with PsA [2], there is limited evidence to show the impact of enthesitis on patient reported outcomes (PROs) and physician satisfaction with treatment in the real-world. The objective of this analysis is to describe the impact of enthesitis on PROs and physician satisfaction with treatment in a real-world setting.

Methods: Cross-sectional survey of rheumatologists, dermatologists, and their consulting PsA patients in Australia, Canada, EU5, and US, conducted by Adelphi from 2018-2019. Physicians assessed current presence and severity (mild, moderate, or severe) of enthesitis, overall PsA disease severity, symptoms experienced, and their satisfaction with disease control the current treatment provides (5-point Likert scale: very satisfied to very dissatisfied). Patient self-reported data included current level of pain (1-10 scale), EQ-5D, Psoriatic Arthritis Impact of Disease (PsAID12), Health Assessment Questionnaire Disability Index (HAQ-DI) and Work Productivity and Activity Impairment Index (WPAI-SHP). Bivariate descriptive analyses were conducted to describe features and outcomes in patients with and without enthesitis.

Results: Rheumatologists (454) and dermatologists (238) provided information related to enthesitis for 3157 PsA patients with 653 patient self-completed questionnaires. Mean (SD) age was 49.2 (13.3) years, mean (SD) body mass index 26.9 (6.5), 45.9% were female and 57.4% were in full-time employment. Enthesitis was present in 6.5% (205) of PsA patients surveyed. Patients with current enthesitis had worse overall disease severity compared to patients without enthesitis (12.2% vs. 2.2% severe) [Table 1]. Patients with enthesitis had more extraarticular manifestations, including nail deformities, dactylitis, sacroiliitis and inflammatory back pain than patients without enthesitis [Table 1]. Enthesitis was associated with more pain, worse quality of life (QoL), more disability, and a greater impact on work [Table 2]. Patients with enthesitis had increase NSAID and opioid pain medication use, but similar biologic use (with enthesitis 58.5% vs. without enthesitis 58.5%, p=1.0000). Physicians were significantly less satisfied with the control the current treatment provided in patients with enthesitis vs without enthesitis (57.6% vs 84.3% satisfied, p< 0.0001).

Conclusion: PsA patients with enthesitis had more severe disease and experienced worse QoL than patients without enthesitis but were not more likely to receive advanced therapies. Physicians were significantly more dissatisfied with treatment for patients with enthesitis than those without.

Table 1

Table 1: Physician reported clinical characteristics

Table 2

Table 2: Patient reported outcomes

Disclosure: A. Orbai, Abbvie, 2, Celgene, 2, Eli Lilly and Company, 2, 5, Novartis, 2, 5, Pfizer, 2, 5, UCB, 5; B. Julie, Eli Lilly and Company, 1, 3; E. Holdsworth, None; N. Booth, Adelphi Real World, 3; M. Hufford, Eli Lilly and Company, 1, 3; M. William, Eli Lilly and Company, 1, 3; A. Trevelin Sprabery, Eli Lilly and Company, 1, 3; A. Reginato, Eli Lilly and Company, 5, Novartis, 5, Horizon, 5.

To cite this abstract in AMA style:

Orbai A, Julie B, Holdsworth E, Booth N, Hufford M, William M, Trevelin Sprabery A, Reginato A. Impact of Enthesitis on Patient Reported Outcomes and Physician Satisfaction with Treatment: Data from a Multinational Patient and Physician Survey [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/impact-of-enthesitis-on-patient-reported-outcomes-and-physician-satisfaction-with-treatment-data-from-a-multinational-patient-and-physician-survey/. Accessed .

« Back to 2019 ACR/ARP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-enthesitis-on-patient-reported-outcomes-and-physician-satisfaction-with-treatment-data-from-a-multinational-patient-and-physician-survey/