Healthcare and Burden of Disease in Psoriatic Arthritis. A Comparison with Rheumatoid Arthritis and Ankylosing Spondylitis

ANGELA ZINK, KATJA THIELE, DOERTE HUSCHER, JOACHIM LISTING, JOACHIM SIEPER, ANDREAS KRAUSE, ERIKA GROMNICA-IHLE, ULRICH von HINUEBER, SIEGFRIED WASSENBERG, EKKEHARD GENTH, and MATTHIAS SCHNEIDER for the German Collaborative Arthritis Centres

ABSTRACT.

Objective. To compare quality of life and treatment among patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) treated by German rheumatologists.

Methods. Data for outpatients with PsA (n = 1863), RA (n = 9627), or AS (n = 1378) enrolled in the national database of the German collaborative arthritis centers in the year 2002 were analyzed. Among those with PsA, 2 subgroups with predominantly peripheral arthritis (n = 1612) and predominantly axial disease (n = 251) were distinguished.

Results. We found a high burden of illness in patients with PsA treated by rheumatologists. Among the 2 subgroups, those with axial PsA had worse outcomes (pain, function) than those with peripheral PsA. However, compared with RA and AS, physician ratings of disease activity and severity were lower in PsA. Concerning access to rheumatology care, there were similarities between AS and axial PsA, with very long disease duration at first visit (mean of about 6 yrs), versus RA and peripheral PsA, with shorter duration (1.6 and 2.5 yrs, respectively). A majority (84%) of patients with PsA were treated with disease modifying antirheumatic drugs. Thirty percent of the patients with PsA currently were under therapy with glucocorticoids, mainly (89%) with a dose < 7.5 mg.

Conclusion. Patients with PsA seen in rheumatologic care have a burden of illness comparable to that of patients with RA or AS. (J Rheumatol 2006;33:86-90)

Key Indexing Terms:

HEALTH SERVICES RESEARCH
BURDEN OF DISEASE
PSORIATIC ARTHRITIS
ARTHRITIS CENTERS
NATIONAL DATABASE

---

From the German Rheumatism Research Centre, Berlin, Germany.

Supported by grants from the German Federal Minister of Health from 1993 to 1999 (FB2-433346-8/13) and the Federal Minister of Education and Research within the Competence Network Rheumatology since 1999 (91GI9344/3).

A. Zink, PhD; K. Thiele, Medical Data Manager; D. Huscher, Statistician; J. Listing, PhD, Statistician, Epidemiology Unit, German Rheumatism Research Centre; J. Sieper, MD, Charité, University Medicine Berlin; A. Krause, MD, Immanuel Hospital, Berlin; E. Gromnica-Ihle, MD, Rheumaklinik Berlin-Buch, Berlin; U. von Hinueber, MD, Hildesheim; S. Wassenberg, MD, Evangelisches Fachkrankenhaus, Ratingen; E. Genth, MD, Rheumaklinik Aachen, Aachen; M. Schneider, MD, Rheumatology, Heinrich Heine University, Duesseldorf.

Participating German Collaborative Arthritis Centres: Aachen/Koeln/Bonn (E. Genth), Berlin (J. Sieper), Dresden (H.E. Schroeder), Duesseldorf (M. Schneider), Erlangen (B. Swoboda), Essen (C. Specker), Giessen/Bad Nauheim (K.L. Schmidt), Greifswald (H. Merk), Hannover (H. Zeidler), Heidelberg (U. Schneider), Jena (G. Hein), Leipzig (H. Haentzschel), Luebeck/Bad Bramstedt (W.L. Gross), Magdeburg/Vogelsang (J. Kekow), Mainz/Bad Kreuznach (R. Dreher), Muenchen (M. Schattenkirchner), Muenster (M. Gaubitz), Ostwestfalen/Lippe (H. Mielke), Regensburg/Bad Abbach (U. Mueller-Ladner), Rhein-Main (J.P. Kaltwasser), Rostock (M. Keysser), Saarland (M. Pfreundschuh), Suedbaden (H.H. Peter), Suedwuerttemberg (R. Maleitzke).

Address reprint requests to Prof. A. Zink, Deutsches Rheuma-Forschungszentrum Berlin, Schumannstrasse 21/22, D10117 Berlin, Germany. E-mail: Zink@DRFZ.de

Accepted for publication August 29, 2005.

---