OBJECTIVES:

The aim of this study was to assess patients’ preferences for treatment-related benefits of psoriatic arthritis (PsA) without psoriasis and with psoriasis (PsA+Ps).

METHODS:

COEPSO study was an observational cross-sectional study performed in 14 Spanish centres. Study included PsA patients, with or without Ps, naïve to biological therapies. To assess treatment preferences of patients, it was designed a discrete choice experiment (DCE) questionnaire with an orthogonal design including 7 factors: reduction of psoriatic body surface area (BSA), reduction of itching and pain, route of administration, tolerability (gastrointestinal disorders during the first two weeks of treatment) and safety profile (risk of tumours and severe infection). A multinomial logit model was fitted to analyse the responses considering as relevant the criteria with p-values<0.05. To assess the impact of each factor in patients’ preference, the relative weight index was estimated.

RESULTS:

Twenty-five patients with PsA and 47 with PsA+Ps fulfilled the DCE. For PsA patients, the most important factors were: (1) avoidance of the risk of severe infections (p<0.001;weight:35.6%); (2) risk of tumours appearance (p<0.001;weight:19.8%); (3) pain reduction (p<0.001;weight:18.1%); (4) route of administration (p<0.001;weight:18.1%); (5) tolerability (p<0.001;weight:13.1%). Reduction of psoriatic BSA and reduction of intensity of itching were not relevant (p>0.05) for patients with PsA.

In PsA+Ps patients, the main factors detected were: (1) risk of severe infections (p<0.001;weight:31.2%): (2) pain reduction (p<0.001;weight:21.1%) and (3) increased risk of tumours (p<0.001;weight:16.3%). The route of administration (p<0.001;weight:8.3%), tolerability (p<0.001;weight:8.2%), reduction of the intensity of itching (p<0.001;weight:7.1%) and reduction of BSA (p<0.001;weight:7.0%) were less important preference factors for the patients.

CONCLUSIONS:

For both types of patients (PsA and PsA+Ps), safety profile and pain reduction were the key driver of the treatment. However, for patients with Ps the most important factors were the reduction of itching intensity and reduction of psoriatic BSA.