Patient Survey Shows Impact of Psoriatic Arthritis Varies Globally

The impact of psoriatic arthritis on quality of life can vary depending on geographic location and culture, according to a global patient survey.

A global survey revealed the variance amonf different nations in terms of how much and in which ways psoriatic arthritis (PsA) impacts a patient’s health-related quality of life (HRQOL).

PsA is a chronic immune-mediated inflammatory musculoskeletal disease that can lead to negative physical and mental health as well as a reduced HRQOL. Patients are often diagnosed with psoriasis about 10 years prior to musculoskeletal symptoms developing. It is estimated that around 6% to 42% of patients with psoriasis will develop PsA. PsA incidence ranges by geographic area from 0.01% to 1% of the population.

“Results from the survey can provide physicians with key geographical and cultural insights about how PsA impacts patients’ daily lives and could lead to a better understanding of individual patient goals,” wrote investigators.

Survey results from the PsA Impact of Disease (PsAID) questionnaire could also be used by physicians to evaluate the efficacy of PsA therapies. The questionnaire analyzes multiple areas of life where patients are affected by PsA, including physical impact, skin impact, and psychological and social impact.

The survey, conducted by The Harris Poll, included 1286 patients with PsA from 8 countries; nearly 65% reported their current overall health as poor or fair. The other 35% described their overall health as excellent or good.

The majority of patients reported that PsA has impacted their physical function and their ability to perform certain activities; many reported a substantial impact of social, emotional and work-related aspects of life.

Investigators said that “the country-specific differences observed in this study may reflect phenotypical variations in disease severity between different populations, as well as different expectations or cultural norms.”

In total, nearly 88% of patients were using disease-modifying anti-rheumatic drugs (DMARDs). Globally, 38% of patients used biologic DMARDs only, 33% used oral DMARDs only and 18% used a combination of both. Patients who used DMARDs as monotherapy mostly came from Canada (38%), France (46%), and the United States (52%) versus other countries (range 19%—24%; P <.05).

Skin patches and plaques were most commonly reported in the United States (68%) compared with other countries (range 42%—58%; P <.05). However, social shame or disapproval was more commonly reported in Spain (50%) than other countries (range 17%—35%; P <.05). Unusual fatigue was most reported in France (67%).

Survey results from Canada had some of the highest reported experiences with musculoskeletal symptoms, unusual fatigue (56%), and skin and nail symptoms (47%) among the included nations. Canada also had lower reports emotional distress (46%) compared with Brazil, Taiwan, the United Kingdom, and the United States (range 17%—35%; P <.05).

The proportion of patients who reported their PsA as having a moderate or major impact on ability to perform certain activities and work productivity were higher in Brazil, France and the United States (range 78%—79% and 60%-73%, respectively) compared with Canada, Spain and Taiwan (range 57%-79% and 47%-50%, respectively).

Moderate or major impact on romantic relationships and familial or platonic relationships was lower in Canada (41% and 32%, respectively) and Taiwan (40% and 24%, respectively) than other countries (romantic relationships, range 47%—62%; relationships with family and friends, range 39%–50%).

Patients from Canada (35%), Taiwan (40%), and Australia (28%) were among the highest to report mild cases of the disease.

“The findings of this survey confirm the heterogeneous nature of PsA and highlight the importance of taking into account a range of symptoms, and the related physical, psychological, and social impact when considering treatment options,” said investigators.


Coates LC, Orbai AM, Azevedo VF, et al. Results of a global, patient-based survey assessing the impact of psoriatic arthritis discussed in the context of the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire. Health Qual Life Out. 2020; 18(173):1-10. doi: 10.1186/s12955-020-01422-z.