Lin Iris, Krupsky Kathryn, Way Nate, Patel Aarti A, Tieng Arlene
Janssen Scientific Affairs, LLC, 800 Ridgeview Dr, Horsham, PA, 19044, USA.
Oracle Life Sciences, Austin, TX, USA.
Rheumatol Ther. 2024 Dec;11(6):1569-1590. doi: 10.1007/s40744-024-00717-7. Epub 2024 Sep 29.
Psoriatic arthritis (PsA) is a chronic, autoimmune form of arthritis that is associated with a substantial humanistic and economic burden. Potential differences in patient-reported outcomes (PROs) and economic outcomes among groups of varying PsA severity and different races/ethnicities have not been well studied.
This cross-sectional study assessed sociodemographic data, PROs, and economic outcomes for participants with PsA from the National Health and Wellness Survey (2018-2020). Multivariable analyses were used to assess the association of self-reported PsA severity and race/ethnicity with health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), healthcare resource utilization (HCRU), and medical costs.
This study included 1544 participants with PsA (1073 non-Hispanic white, 114 non-Hispanic Black, 223 Hispanic, and 134 Other). Self-reported moderate/severe PsA was associated with significantly worse HRQoL and WPAI, greater HCRU, and higher costs than self-reported mild PsA. Black participants reported more absenteeism (31.11% vs. 16.69%; P = 0.007) and activity impairment (54.27% vs. 47.96%; P = 0.047) than white participants, and fewer healthcare provider (5.93 vs. 7.42; P = 0.039) and rheumatologist visits (0.29 vs. 0.53; P = 0.028) over the past 6 months. No differences in outcomes were observed between Hispanic and white participants. Race/ethnicity moderated the association of perceived PsA severity and PROs and HCRU, such that white participants with self-reported moderate/severe PsA had a higher likelihood of depression (P < 0.001), lower HRQoL (P < 0.001), and more emergency room visits (P = 0.001) than those with self-reported mild PsA. Race/ethnicity did not moderate the relationship of PROs, HCRU, and economic outcomes among Black or Hispanic participants.
Participants with self-reported moderate/severe PsA reported a greater burden than those with self-reported mild PsA. Black participants had a greater humanistic burden than white participants but reported lower HCRU. Moderation results were driven by white participants, suggesting important differences in PROs, HCRU, and perception of PsA severity across race/ethnicity groups. Small sample sizes in Hispanic and non-Hispanic racial/ethnic groups limited ability to discern differences related to disease severity in these groups. Further research is needed to better understand the differential burden of PsA among individuals with varying perceptions of PsA severity across different racial/ethnic groups.
银屑病关节炎（PsA）是一种慢性自身免疫性关节炎，会带来巨大的人文和经济负担。银屑病关节炎严重程度不同和种族/族裔不同的群体之间，患者报告结局（PROs）和经济结局的潜在差异尚未得到充分研究。
这项横断面研究评估了来自国家健康与 Wellness 调查（2018 - 2020 年）中银屑病关节炎患者的社会人口统计学数据、PROs 和经济结局。多变量分析用于评估自我报告的银屑病关节炎严重程度和种族/族裔与健康相关生活质量（HRQoL）、工作生产力和活动障碍（WPAI）、医疗资源利用（HCRU）以及医疗费用之间的关联。
本研究纳入了 1544 名银屑病关节炎患者（1073 名非西班牙裔白人、114 名非西班牙裔黑人、223 名西班牙裔和 134 名其他种族）。与自我报告为轻度银屑病关节炎相比，自我报告为中度/重度银屑病关节炎与显著更差的 HRQoL 和 WPAI、更高的 HCRU 以及更高的费用相关。黑人参与者报告的旷工率（31.11%对 16.69%；P = 0.007）和活动障碍率（54.27%对 47.96%；P = 0.047）高于白人参与者，且在过去 6 个月中看普通医疗服务提供者（5.93 次对 7.42 次；P = 0.039）和风湿病专家（0.29 次对 0.53 次；P = 0.028）的次数更少。西班牙裔和白人参与者之间未观察到结局差异。种族/族裔调节了感知到的银屑病关节炎严重程度与 PROs 和 HCRU 之间的关联，使得自我报告为中度/重度银屑病关节炎的白人参与者比自我报告为轻度银屑病关节炎的白人参与者患抑郁症的可能性更高（P < 0.001）、HRQoL 更低（P < 0.001）以及急诊就诊次数更多（P = 0.001）。种族/族裔并未调节黑人或西班牙裔参与者中 PROs、HCRU 和经济结局之间的关系。
自我报告为中度/重度银屑病关节炎的参与者报告的负担比自我报告为轻度银屑病关节炎的参与者更大。黑人参与者的人文负担比白人参与者更大，但报告的 HCRU 更低。调节结果由白人参与者驱动，表明不同种族/族裔群体在 PROs、HCRU 和银屑病关节炎严重程度认知方面存在重要差异。西班牙裔和非西班牙裔种族/族裔群体的样本量较小，限制了辨别这些群体中与疾病严重程度相关差异的能力。需要进一步研究以更好地理解不同种族/族裔群体中对银屑病关节炎严重程度认知不同的个体之间银屑病关节炎的差异负担。
