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region) in each country. Overall rates of OT/PT visits were reported. Patients who reported an OT/PT visit in the past six months were compared with those who did not with respect to demographics, health history, and comorbidity variables. Logistic regression models were then conducted to predict OT/PT visits from these variables. Results: Rates of OT/PT visits did not change from 2010 to 2013 but significant differences among countries was observed (p< .05). In 2013, France (0.54%) and the US (4.51%) had the most infrequent visits while Spain (11.13%) and Germany (11.92%) had the most frequent. Being in Germany (OR= 3.46), being in Spain (OR= 3.24), and having an above the median income (OR= 1.14) were the strongest demographic predictors of an OT/PT visit (all p< .05). Although most comorbidities were associated with an increased probability of an OT/PT visit, pain (OR= 2.30), arthritis conditions (OR= 1.73), and psychiatric conditions (OR= 1.73) were most strongly associated (all p< .05). ConClusions: PT and OT utilization varies significantly across countries, being highest in Germany and Spain where over 10% of adults reported a visit in the past six months. Pain-related (pain, arthritis) and psychiatric comorbidities were among the strongest predictors of PT/OT use.

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BackgroundSex medicine studies have shown that there are sex differences with regard to disease characteristics in immune-mediated inflammatory diseases, including psoriasis, in immune response and susceptibility to viral infections. We performed a post hoc analysis of the Observational Study of infectious events in psoriasis complicated by active psoriatic arthritis (SYNERGY) study in patients with psoriatic arthritis (PsA) treated with immunosuppressive regimens including cyclosporine, in order to evaluate potential between-sex differences in severity of disease and prevalence of viral infections.MethodsSYNERGY was an observational study conducted in 24 Italian dermatology clinics, which included 238 consecutively enrolled patients with PsA, under treatment with immunosuppressant regimens including cyclosporin A. In this post hoc analysis, patients’ demographical data and clinical characteristics of psoriasis, severity and activity of PsA, prevalence of seropositivity for at least one viral infection, and treatments administered for PsA and infections were compared between sexes.ResultsA total of 225 patients were evaluated in this post hoc analysis, and 121 (54%) were males. Demographic characteristics and concomitant diseases were comparable between sexes. Statistically significant sex differences were observed at baseline in Psoriasis Area and Severity Index score (higher in males), mean number of painful joints, Bath Ankylosing Spondylitis Disease Activity Index, and the global activity of disease assessed by patients (all higher in females). The percentage of patients with at least one seropositivity detected at baseline, indicative of concomitant or former viral infection, was significantly higher among women than among men. No between-sex differences were detected in other measures, at other time points, and in treatments. Patients developed no hepatitis B virus or hepatitis C virus reactivation during cyclosporine treatment.ConclusionOur post hoc sex analysis suggests that women with PsA have a greater articular involvement and a higher activity of disease compared to males. Immunosuppressive treatment with cyclosporine seems not to increase susceptibility to new infections or infectious reactivations, with no sex differences.

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