Sociodemographic factors and biologic therapy exposure impacting health-related quality of life in psoriatic arthritis - findings from a nationwide registry Reuma.pt.

Psoriatic arthritis (PsA) is a very heterogeneous disease with significant impact on health-related quality-of-life (HRQoL). Our objective was to assess and identify predictors of HRQoL in a 3-year follow-up period among PsA patients. Patients with PsA included in the Rheumatic Diseases Portuguese Register (Reuma.pt), with HRQoL data measured by the EuroQoL five Dimensions (EQ-5D) with at least two evaluations throughout a 3-year period, were analysed. Statistics included t-tests, logit and linear mixed models and univariable and multivariable linear regression. PsA patients' (n = 342) mean age 51.0 (12.2) years, 48.5% being female, mean disease duration 11.8 (9.3) years with a follow-up period of 3-years had a mean EQ-5D of 0.53 (0.28), 0.59 (0.29), and 0.58 (0.28) at baseline, 1-year and 3-year evaluations, respectively. During the follow-up period, EQ-5D score and EQ VAS, significantly improved at both time-point assessments, compared to baseline. Poorer HRQoL was significantly associated with older age (β=-0.004; p-value = 0.008), female sex (β=-0.092; p-value = 0.01), non-employment (β=-0.112; p-value = 0.018), higher disease activity (β=-0.005; p-value < 0.001), prior exposure of three or more biologics at baseline and switching of biologic therapy during the study follow-up [(β=-0.182; p-value = 0.04); (β=-0.150; p-value = 0.002), respectively]. Our study provides important insights into the long-term predictors of HRQoL in PsA patients, highlighting the influence of sociodemographic factors, disease activity and therapeutic approach (prior use and switch/cycle of biologic therapies) on HRQoL.