Utility and Its Relationship With Disease Activity and Physical Disability of Patients With Psoriatic Arthritis in Thailand

Abstract

Physical disability and severity of skin disease are important factors for evaluating healthy utility in psoriatic arthritis (PsA) patient. This study aims to estimate health utility and its related factors incorporating both rheumatologic and dermatologic factors in PsA. This cross-sectional study performed in PsA patients in Thailand. EQ-5D-5L, Health Assessment Questionnaire Disability Index (HAQ-DI), and Psoriasis Area and Severity Index (PASI) tools were used to collect health utility, physical disability, and severity of psoriatic skin lesions by face-to-face interviewed. Linear regression analysis was performed to relate health utility and its related factors. Of 84 patients enrolled, 49 (58.3%) were female, 67 (79.8%) had remission or low disease activity. Eighty-three patients (98.8%) received conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or biologic DMARDs (bDMARDs). The mean±SD overall utility was 0.87±0.15. The utility score of patients with low disease activity was significantly greater than those with moderate to severe disease activity (0.89±0.12 vs 0.72±0.19, p<0.001). The HAQ-DI (unstandardized β = -0.167, 95%CI; -0.218 to -0.116, p<0.001) and PASI (unstandardized β = -0.006, 95%CI; -0.009 to -0.003, p<0.001) were found to be significant related factors for utility. These results indicated that Thai patients with PsA had relatively high health utility. However, most included patients were in remission or had low disease activity. The HAQ-DI and PASI showed a strong predictors of patients’ health utility.