OBJECTIVES: Evaluate how physicians’ first- or second-line prescribing preferences for Tumor Necrosis Factor inhibitor (TNFi) versus non-TNFi (i.e. interleukin-23 or interleukin-17 inhibitor) biologics affect the patient-reported outcome measures (PROMs) of their psoriatic arthritis (PsA) patients.

METHODS: Data were drawn from the Adelphi PsA Disease Specific Programme™, a real-world point in time survey of rheumatologists and dermatologists, and their consulting patients with PsA in France, Germany, Italy, Spain, the United Kingdom and United States in 2021. Physicians provided data on their first- and second-line PsA treatment preferences. Patients independently completed PROMs. Linear regression analyses were used for the EuroQoL 5-Dimension 5-Level Quality of Life Survey (EQ-5D-5L), Work Productivity and Activity Impairment Questionnaire (WPAI) and Psoriatic Arthritis Impact of Disease (PsAID12). Logistic regressions were used for individual EQ-5D-5L domains. Advanced therapies were categorised into TNFi and non-TNFi therapies.

RESULTS: Patients of physicians who preferred to prescribe TNFi at first line observed a significant 0.052-point decrease in EQ-5D-5L (p=0.044), a 7.6 percentage point increase in activity impairment due to PsA (p=0.020) and a 0.570-point increase in PsAID12 (p=0.049). There was a 1.95-fold increase in the odds that patients would experience problems with mobility (p=0.033), a 2.07-fold increase in the odds that they would have issues with self-care (p=0.036) and a 2.27-fold increase in the odds that patients would have pain/discomfort (p=0.05). Physician preference for second-line TNFi versus non-TNFi biologics had no significant impact on patients’ health related quality of life (HRQoL).

CONCLUSIONS: Physician preferences for first-line TNFi in PsA patients were associated with a significant negative impact on PROMs, including decreased HRQoL, and increased activity impairment, likelihood of pain and issues with mobility and self-care. These findings suggest that PsA patients may observe improvements in PROMs from the use non-TNFi (i.e. interleukin-23 or interleukin-17 inhibitor) biologics versus TNFi biologics as first-line biologic therapy.