Patients: PsA Treatment Should Prioritize Musculoskeletal Pain, Functional Improvement

The most bothersome symptoms of psoriatic arthritis (PsA) for patients tend to revolve around musculoskeletal pain, according to results from a survey-based study published in Rheumatology and Therapy.

“Despite recent advances in treatment for PsA, many patients experience inadequate response or intolerance to therapy, indicating that unmet treatment-related needs remain,” wrote first author Alexis Ogdie, MD, of the University of Pennsylvania Perelman School of Medicine, and coauthors. “To further characterize these unmet needs, we evaluated patients’ experiences regarding the burden of PsA symptoms and disease impacts, and patients’ preferences for treatment.”

The study included 332 patients with PsA from the ArthritisPower rheumatology registry. Participants were mostly White and female, researchers reported, and their average age was 54. Participants completed a web-based survey, using best-to-worst scaling, to rank the burden of PSA-related symptoms and the importance of improvement among various disease impacts.

According to the study, participants ranked joint pain as the most bothersome symptom, followed by lower back or spine pain, tender or painful tendons and ligaments, and fatigue. When it came to disease impacts, improving the ability to perform physical activities was most important to participants. Improving the ability to function independently, sleep quality, and the ability to perform daily activities followed.

“The most burdensome symptoms and desired disease impact improvements were similar in patients regardless of their experience with biologic disease-modifying antirheumatic drugs,” reported researchers.

Regarding the preferred mode and frequency of treatment administration, oral, once-daily medication was the top preference, and nearly three-quarters of respondents prioritized therapies that significantly improved joint-related symptoms rather than psoriasis-related symptoms. Meanwhile, 2 out of 3 respondents preferred treatment regimens that did not include methotrexate.

“However, around one-third (35%) of respondents who reported having experience with methotrexate reported satisfaction with methotrexate because it worked well for their symptoms…” researchers wrote. “These findings indicate that, despite the beneficial affordability and accessibility of methotrexate, there is an unmet need for many patients for whom methotrexate does not work well, and that clinicians need early access to tools to properly tailor treatment plans to respondents if their current therapy is not sufficiently managing their disease.”

Reference:
Ogdie A, Myers K, Mansfield C, et al. Experiences and treatment preferences in patients with psoriatic arthritis: a cross-sectional study in the ArthritisPower Registry. Rheumatol Ther. 2022;9(2):735-751. doi:10.1007/s40744-022-00436-x