Sámi psoriatic arthritis patients in northern Norway receive less conventional synthetic disease-modifying anti-rheumatic drug treatment and have more arthritis, axial symptoms, and joint damage.

Abstract

Objectives: To compare Sámi and non-Sámi patients with psoriatic arthritis (PsA) and evaluate potential differences in treatment and joint damage.

Method: A total of 424 adult PsA patients meeting the ClASsification for Psoriatic ARthritis (CASPAR) criteria were recruited from the Norwegian Arthritis Registry and hospitals in northern Norway. A questionnaire from the SAMINOR (a study in regions with Sámi and Norwegian populations) was used to identify Sámi and non-Sámi patients. Demographic and clinical characteristics, joint damage, and disease-modifying anti-rheumatic drug treatment data were compared between the groups. Binary logistic regression was used to adjust for age and gender differences.

Results: Sixty Sámi and 364 non-Sámi patients were identified, and the groups were comparable in demographic characteristics and disease activity measurements. Sámi patients experienced more joint damage than non-Sámi patients (42% vs 26%, p = 0.010), and the highest rate was observed among Sámi men (p = 0.005). Sámi patients also had a higher prevalence of arthritis and axial involvement (92% vs 76%, p = 0.007 vs 32% vs 20%, p = 0.033). In addition, Sámi men showed significant underutilization of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) (83% vs 92%, p = 0.031), particularly methotrexate (68% vs 90%, p = 0.002).

Conclusion: Sámi PsA patients show higher rates of axial involvement, arthritis, and joint damage than their non-Sámi peers. Furthermore, Sámi patients demonstrate underutilization of csDMARDs. These findings underscore the importance of implementing culturally adapted healthcare strategies to improve treatment outcomes for Sámi patients with PsA.