ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 0307

Longitudinal Analysis of the Patient Pathways to Diagnosis of Psoriatic Arthritis

Alexis Ogdie1, Martin Rozycki2, Theresa Arndt2, Cheng Shi3, Nina Kim4 and Peter Hur3, 1Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 2HVH Precision Analytics, LLC, Wayne, PA, 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, 4The University of Texas at Austin; Baylor Scott and White Health, Austin, TX

Meeting: ACR Convergence 2020

Keywords: Administrative Data, Cohort Study, education, medical, longitudinal studies, Psoriatic arthritis

  • Tweet
  • Email
  • Print
Session Information

Date: Friday, November 6, 2020

Session Title: Spondyloarthritis Including Psoriatic Arthritis – Diagnosis, Manifestations, & Outcomes Poster I: Psoriatic Arthritis

Session Type: Poster Session A

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

Background/Purpose: In developing algorithms within claims databases that may inform how to find patients with psoriatic arthritis (PsA) prior to diagnosis, it is important to identify meaningful potential predictors that appear prior to diagnosis. This study aims to better understand PsA patient pathways by examining the sequences of health events over the 6 years prior to PsA diagnosis, as well as differences in patients with and without PsA.

Methods: This retrospective cohort study used administrative claims data from patients in the Truven Health MarketScan® Commercial and Medicare Supplemental Databases from January 2006 to April 2019. The PsA population included all patients aged ≥ 18 years with ≥ 2 diagnoses of PsA (ICD-9-CM/ICD-10-CM) ≥ 30 days apart who had ≥ 6 years of continuous enrollment prior to first PsA diagnosis. Control (non-PsA) patients were matched 2:1 to patients with PsA by age, sex, geographic location, insurance, and enrollment duration. Sequences of health events as described by diagnosis codes, procedures performed, drugs prescribed, and physician types were examined over the 6 years prior to PsA diagnosis and for controls; results were also stratified by psoriasis vs no psoriasis prior to PsA diagnosis.

Results: Among 13,661 patients who met the inclusion criteria for diagnosis of PsA, the mean age was 55.8 years and 60.2% were women. Compared with controls, patients with PsA had an increased history of coding for arthritis and skin issues including osteoarthritis (OA; 48% vs 22%), rheumatoid arthritis (RA; 18% vs 2%), inflammatory polyarthropathy (IA; 18% vs 1%), and psoriasis (60% vs 2%) (Figure 1A). PsA patients without a prior diagnosis of psoriasis had higher levels of coding for other forms of arthritis compared to PsA patients with psoriasis including OA (53% vs 45%), RA (27% vs 13%), and IA (26% vs 12%) (Figure 1B). For many patients, diagnoses of different types of arthritis, axial symptoms, and tendonitis/enthesitis steadily increased over time prior to their PsA diagnosis (Figure 2A). In particular, there was a sharp rise in psoriasis diagnoses preceding the diagnosis of PsA and smaller increases in diagnoses of OA and IA prior to PsA diagnosis. Rheumatology visits were much more common just before the diagnosis of PsA (Figure 2B). Diagnoses made prior to diagnosis of PsA differed by the type of provider patients seen. Dermatologists were less likely than other providers to enter codes for arthritis and musculoskeletal issues, while rheumatologists were unlikely to code for psoriasis but had a fairly even distribution across different types of arthritis. General practitioners focused more on axial symptoms and general musculoskeletal codes than arthritis diagnoses (Figure 3A). PsA was most commonly diagnosed by rheumatologists (40%) but was diagnosed in 22% and 7% of cases by general practitioners and dermatologists, respectively (Figure 3B).

Conclusion: Rheumatologists, general practitioners, and dermatologists were responsible for diagnosing two-thirds of patients with PsA. Musculoskeletal symptoms and potential misdiagnoses are common in the years preceding diagnosis of PsA and the diagnoses and codes entered prior to PsA diagnosis varied by provider type.


Disclosure: A. Ogdie, AbbVie, 5, Amgen, 2, 5, BMS, 1, Celgene, 1, Corrona, 1, Janssen, 1, Eli Lilly, 1, Novartis, 2, 5, Pfizer, 2, 5, National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2, Rheumatology Research Foundation, 2, National Psoriasis Foundation, 2; M. Rozycki, HVH Precision Analytics, 3; T. Arndt, HVH Precision Analytics, 3; C. Shi, Novartis Pharmaceuticals Corporation, 3; N. Kim, Novartis Pharmaceuticals Corporation, 9; P. Hur, Novartis Pharmaceuticals Corporation, 3.

To cite this abstract in AMA style:

Ogdie A, Rozycki M, Arndt T, Shi C, Kim N, Hur P. Longitudinal Analysis of the Patient Pathways to Diagnosis of Psoriatic Arthritis [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/longitudinal-analysis-of-the-patient-pathways-to-diagnosis-of-psoriatic-arthritis/. Accessed January 27, 2023.
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/longitudinal-analysis-of-the-patient-pathways-to-diagnosis-of-psoriatic-arthritis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences