Impact of Enthesitis on Psoriatic Arthritis Patient-Reported Outcomes and Physician Satisfaction with Treatment: Data fr
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ORIGINAL RESEARCH
Impact of Enthesitis on Psoriatic Arthritis PatientReported Outcomes and Physician Satisfaction with Treatment: Data from a Multinational Patient and Physician Survey Ana-Maria Orbai . Julie A. Birt
. Elizabeth A. Holdsworth .
Nicola Booth . William N. Malatestinic . Aubrey T. Sprabery . Anthony M. Reginato Received: July 22, 2020 / Accepted: September 30, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Enthesitis is a core outcome domain assessed in psoriatic arthritis (PsA) clinical trials. Limited evidence describes the impact of enthesitis on patient-reported outcomes (PROs) and physician satisfaction with current treatment options. The objective of this analysis is to characterize the impact of enthesitis on PROs and physician satisfaction with currently available treatment in clinical practice settings. Methods: Cross-sectional survey of rheumatologists, dermatologists, and their consulting patients with PsA in Australia, Canada, Electronic Supplementary Material The online version of this article (https://doi.org/10.1007/s40744020-00242-3) contains supplementary material, which is available to authorized users. A.-M. Orbai Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA J. A. Birt (&) W. N. Malatestinic A. T. Sprabery Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA e-mail: [email protected] E. A. Holdsworth N. Booth Adelphi Real World, Bollington, UK A. M. Reginato Division of Rheumatology and Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
European Union (EU5), and the USA conducted in 2018. Physicians assessed current presence and severity of enthesitis, overall disease severity, other symptoms experienced, and their satisfaction with the current treatment. PsA participant self-reported data included current pain level, EQ5D, 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 participants with and without enthesitis. Results: Rheumatologists (454) and dermatologists (238) provided information for 3157 participants with PsA. Mean participant age was 49.2 years, and 45.9% were female. Enthesitis was present currently in 6.5% (205) of participants with PsA. Those with enthesitis had worse overall disease severity compared to those without enthesitis (12.2% vs 2.2% severe) and had more extraarticular manifestations, including nail psoriasis, dactylitis, and sacroiliitis. Enthesitis was associated with more pain, worse quality of life (QoL), increased disability, and a negative impact on work. Participants with enthesitis had higher NSAIDs and opioid pain medication use but similar biologic use. Physicians were significantly less satisfied with current PsA treatment in participants with enthesitis versus without enthesitis. Conclusions: Participants with psoriatic arthrit
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