title: Healthcare and burden of disease in psoriatic arthritis. A comparison with rheumatoid arthritis and ankylosing spondylitis.
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.
  
  
  CONCLUSIONS
  Patients with PsA seen in rheumatologic care have a burden of illness comparable to that of patients with RA or AS.
authors.affiliation: German Rheumatism Research Centre, Berlin, Germany. Zink@DRFZ.de
authors.forename: Angela
authors.initials: A
authors.lastname: Zink
authors.forename: Katja
authors.initials: K
authors.lastname: Thiele
authors.forename: Doerte
authors.initials: D
authors.lastname: Huscher
authors.forename: Joachim
authors.initials: J
authors.lastname: Listing
authors.forename: Joachim
authors.initials: J
authors.lastname: Sieper
authors.forename: Andreas
authors.initials: A
authors.lastname: Krause
authors.forename: Erika
authors.initials: E
authors.lastname: Gromnica-Ihle
authors.forename: Ulrich
authors.initials: U
authors.lastname: von Hinueber
authors.forename: Siegfried
authors.initials: S
authors.lastname: Wassenberg
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Genth
authors.forename: Matthias
authors.initials: M
authors.lastname: Schneider
mesh_terms: D015535:Arthritis, Psoriatic / Q000191:economics*; D001172:Arthritis, Rheumatoid / Q000191:economics*; D017281:Cost of Illness; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013167:Spondylitis, Ankylosing / Q000191:economics*