Real-world comparative evaluation of quality of life and economic burden in patients with psoriatic arthritis and axial spondyloarthritis under different treatment strategies: a multicenter cross-sectional study.

BACKGROUND: Psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) are chronic inflammatory disorders that significantly impair patients’ quality of life and impose substantial economic burdens. The advent of Janus kinase (JAK) inhibitors and biologic therapies has diversified treatment options, prompting increased attention to the balance between clinical efficacy and economic impact. METHODS: This study analyzed 451 valid responses from a total of 508 collected questionnaires (validity rate: 88.78%), comprising 203 PsA and 248 axSpA patients. Participants were categorized based on treatment modality into three groups: conventional therapy, biologic agents, and JAK inhibitors. Economic burden was assessed using analysis of variance (ANOVA). Generic quality of life was evaluated via the Short Form-36 (SF-36) survey, while disease-specific quality of life was measured using the Dermatology Life Quality Index (DLQI) for PsA and the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire for axSpA. Multiple linear regression models were constructed to identify factors influencing quality of life outcomes. RESULTS: Patients receiving JAK inhibitors or biologic therapies demonstrated significantly better DLQI and ASQoL scores compared to those undergoing conventional treatment, indicating superior efficacy of targeted therapies in enhancing disease-specific quality of life. While SF-36 scores also varied among treatment groups, the differences were less pronounced, suggesting limited sensitivity of this generic measure to disease-specific changes. Economically, the conventional therapy group incurred the lowest costs but also reported the poorest quality of life, reflecting a “low cost–low benefit” scenario. Conversely, JAK inhibitors and biologics, despite higher costs, substantially improved symptoms and quality of life, underscoring their greater clinical value. CONCLUSION: Treatment modality significantly influences both quality of life and economic burden in PsA and axSpA patients. Targeted therapies, including JAK inhibitors and biologics, offer marked improvements in disease-specific quality of life, as evidenced by DLQI and ASQoL scores, compared to conventional treatments. Although associated with higher direct costs, these therapies’ long-term benefits and potential to improve patient outcomes justify their broader clinical adoption, particularly in contexts with supportive health policies and expanding insurance coverage.