Biologic use in psoriatic arthritis and ankylosing spondylitis patients: a descriptive epidemiological study using linked, routine data in Wales, UK

Abstract

Objectives Psoriatic arthritis (PsA) and ankylosing spondylitis (AS) are chronic diseases associated with significant morbidities. National and international management guidelines include treatment with biologic therapies to improve outcomes and quality-of-life. There are limited real-world data on patient journey from symptom onset to diagnosis and treatment in the UK. We use real-life, linked health data to explore patient pathways and impact of biologics on patient outcomes. Methods Data from the Secure Anonymised Information Linkage databank in Wales were used to assess diagnosis and treatment of patients, aged 18 years or over with at least one ICD-10 code present for PsA/AS in rheumatology clinic data and at least one READ code present in primary care records. We investigated the use of biologics while exploring demographics, comorbidities and surgical procedures of 641 AS patients and 1,312 PsA patients. Results AS patients were significantly younger at diagnosis and were predominantly male. The average time from presenting symptoms to diagnosis of AS and PsA was 7.9 ± 5.5 and 9.3 ± 5.5 years, respectively. The proportion of patients receiving biologic treatment was significantly higher in AS (46%) compared with PsA patients (28.8%); of these, 23.1% of AS and 22.2% of PsA patients stopped/switched a biologic. There was a significant reduction in primary care involvement, sick notes and disability living allowance for both AS and PsA patients following biologic initiation. Conclusion This real-world descriptive study confirms that patients treated with biologics have reduced disability and time off work despite being initiated approximately 13 years post-first symptoms and 6 years post-diagnosis.

Prevalence and characteristics of musculoskeletal complaints in primary care: an analysis from the population level and analysis reporting (POLAR) database

“…General practice databases have been used to determine the prevalence of some musculoskeletal complaints including arthritis, chronic back pain, gout, osteoporosis, spondyloarthropathies and rheumatoid arthritis in various countries [ 13 – 17 ]. Trends and trajectories of opioid prescription for people with general musculoskeletal conditions, [ 18 , 19 ] use of osteoporosis medicines in people with osteoporosis [ 16 ] and use of biologic drugs in people with psoriatic arthritis and ankylosing spondylitis [ 20 ] have also been examined. However, to date the characteristics of patients presenting to general practice with musculoskeletal complaints and the healthcare utilisation at the primary care level has not been comprehensively examined using primary care databases.…”