Among patients with psoriatic arthritis, those who also report fatigue incurred significantly greater health care costs and resource utilization than patients without fatigue, according to an abstract presented at ACR Convergence 2021.

The abstract was presented by Joseph F. Merola, MD, from Brigham and Women's Hospital in Boston, Massachusetts.

“Fatigue is a complex symptom affecting physiological, psychological, and social factors and is commonly seen in psoriatic arthritis (PsA),” the authors stated. The study was designed to determine if differences existed among patients with PsA with and without a fatigue component.

The researchers used identified adult patients with PsA between 2009 and 2019, including those with ≥ 2 diagnoses for PsA ≥ 30 days apart. Patients with fatigue were defined as those with ≥ 1 fatigue diagnosis after their initial PsA diagnosis, while patients with PsA who had no fatigue diagnoses during the study period served as controls. Patients had continuous enrollment from ≥ 6 months before their initial PsA diagnosis (baseline period) to ≥ 12 months after the index date (follow-up period).

“Controls were matched 1:1 to patients with PsA and fatigue based on propensity scores that balanced age, gender, year of initial PsA diagnosis, PsA treatment, related conditions, the Charlson Comorbidity Index, variables associated with PsA disease severity, vitamin D deficiency, and respiratory infection. Healthcare resource utilization and costs were evaluated during follow-up,” the authors wrote.

The investigators found that 30% of the included patients with PsA also experienced fatigue. A total of 7,350 patients with fatigue were matched to the control group. “Average annual all-cause healthcare costs per patient were $26,102 and $34,344 for the control group and patients with fatigue, respectively (p< 0.0001),” the researchers reported. “The costs were greater among patients with fatigue due to greater inpatient costs (controls: $2,046, fatigue: $3,959), outpatient medical costs (controls: $7,058, fatigue: $11,182), and outpatient pharmacy costs (controls: $16,998, fatigue: $19,203). Across all categories of healthcare resources, utilization was greater among patients with PsA and fatigue than the control group. Patients with PsA and fatigue had significantly more physician office visits than controls during follow-up (average of 11.4 and 8.0, respectively, p< 0.0001).”

The authors concluded, “Effective treatments that help reduce fatigue among patients with PsA may improve patient outcomes including decreased healthcare costs. Further research is warranted to better understand what is driving these greater costs.”

--Rebecca Mashaw

Reference:

Merola J, Yang F, Dennis N. Economic burden of fatigue among patients with psoriatic arthritis – a retrospective study using claims data, 2009-2019. Presented at: American College of Rheumatology Convergence 2021; November 5-9, 2021; virtual. Abstract 0240.