OBJECTIVES: To analyze the therapeutic strategies and to estimate the health care resources consumption in in patients with PsA. METHODS: An observational retrospective cohort analysis of administrative databases of 4 Italian Local Health Units was performed. Patients ≥ 18 years with a hospitalization discharge diagnosis of PsA (ICD-9-CM 696.0) or exemption code (045.696.0) for PsA from 01/01/2010 to 31/12/2015 (inclusion period), with at least one prescription of any therapy used for PsA were included. The index-date (ID) was the matching with at least one of the inclusion criteria during the inclusion period. All patients were followed up after the ID until the end of data availability. RESULTS: A total of 1,884 patients with PsA, 40.7% male, mean age of 52.1 years, were enrolled in the study. About 74.4% of patients were treated with only 1 systemic drug, and of these 52.5% received MTX, 11.5% bDMARD. Patients treated with 2 systemic drugs were 20.9% of which in combination were 50.8% and after switching were 49.2%. Of the patients treated with csDMARD, 41.6% had levels of C-reactive protein (CRP) higher than >1 mg/dL, 33.7% between 0.5-1, and 24.8% below 0.5 mg/dL. These percentages in patients treated with bDMARD were 43.3%, 26.7% and 30%, respectively. The mean overall healthcare costs were € 1,653 and € 13,500 per year for patients treated with csDMARD and bDMARD, respectively. CONCLUSIONS: Our findings confirm that, in an Italian real-world setting, costs are usually higher for patients treated with biologics; the concentration of CRP, we found that inflammation levels due to pathology were above the normal limits in a high proportion of patients receiving both csDMARD and bDMARD. Futher research needs to assess disease progression and disease remission.