PT - JOURNAL ARTICLE AU - Florian Lucasson AU - Uta Kiltz AU - Umut Kalyoncu AU - Ying Ying Leung AU - Penélope Palominos AU - Juan D Cañete AU - Rossana Scrivo AU - Andra Balanescu AU - Emanuelle Dernis AU - Sandra Meisalu AU - Adeline Ryussen-Witrand AU - Martin Soubrier AU - Sibel Zehra Aydin AU - Lihi Eder AU - Inna Gaydukova AU - Ennio Lubrano AU - Pascal Richette AU - Elaine Husni AU - Laura C Coates AU - Maarten de Wit AU - Josef S Smolen AU - Ana-Maria Orbai AU - Laure Gossec TI - Disparities in healthcare in psoriatic arthritis: an analysis of 439 patients from 13 countries AID - 10.1136/rmdopen-2021-002031 DP - 2022 May 01 TA - RMD Open PG - e002031 VI - 8 IP - 1 4099 - http://rmdopen.bmj.com/content/8/1/e002031.short 4100 - http://rmdopen.bmj.com/content/8/1/e002031.full SO - RMD Open2022 May 01; 8 AB - Objectives Patient care can vary substantially by country. The objective was to explore differences in psoriatic arthritis (PsA) across countries for disease activity, impact and treatments.Methods A cross-sectional analysis of 13 countries from the Remission/Flare in PsA study (NCT03119805) of consecutive adult patients with definite PsA was performed. Countries were classified into tertiles by gross domestic product (GDP)/capita. Disease activity (Disease Activity in PsA, DAPSA and Minimal Disease Activity, MDA) and their components, disease impact (patient-reported outcomes) and biological disease-modifying antirheumatic drugs (bDMARDs) were analysed per country and compared between the three tertiles of GDP/capita by parametric and non-parametric tests. We also explored the percentage of patients with significant disease activity (DAPSA >14) and no ongoing bDMARD prescription.Results In 439 patients (50.6% male, mean age 52.3 years, mean disease duration 10.1 years), disease activity and disease impact were higher in the lowest GDP/capita countries. DAPSA remission and MDA were attained in the lowest tertile in 7.0% and 18.4% patients, vs 29.1% and 49.5% in the middle tertile and 16.8% and 41.3% in the high tertile, respectively (all p<0.001). bDMARDs use was similar in the tertiles (overall mean 61%). The overall rate of patients with DAPSA >14 and no bDMARDs was 18.5%, and was higher in lower GDP/capita countries (p=0.004).Conclusion PsA patients from countries with the lowest GDP/capita, despite similar use of bDMARDs, were more likely to have high disease activity and worse disease impact. There is a need for more equity in healthcare.Data are available on reasonable request. The ReFlaP data are available from the last author on reasonable request.