Pain, fatigue may persist in PsA despite biologic therapy

Some psoriatic arthritis (PsA) patients still experience substantial pain and fatigue despite treatment, a study has shown. These persisting conditions negatively affect health-related quality of life (HRQoL), physical function, and work productivity.

A total of 3,782 patients with PsA participated in the study, among whom 1,475 (39 percent) had been receiving TNF inhibitor for at least 3 months. Of these, 640 (43.4 percent) patients completed both the vitality and bodily pain domains of the 36-Item Short-Form version 2 (SF-36v2) and were included in the analysis.

There were 33.1 percent of patients who reported no pain, 29.2 percent moderate pain, and 37.7 percent severe pain. Moreover, 31.9 percent, 22.5 percent, and 45.6 percent of patients reported low, moderate, and severe fatigue, respectively.

Scores across HRQoL variables and Work Productivity and Activity Impairment (WPAI) were significantly different across pain and fatigue cohorts (p<0.0001), with both measures substantially worse in patients with moderate to severe pain or fatigue than those with low pain or fatigue levels.

The present data indicate that patients with severe vs low pain and/or fatigue have poorer HRQoL, impaired ability to work, and high rates of unemployment and retirement. This is in line with previous reports that PsA patients often experience pain despite being treated with TNF inhibitors. [BMJ Open 2017;7:e016619]

Researchers called for improved disease management with modern advanced therapies to address the significant burden of pain and/or fatigue associated with reduced HRQoL in the PsA population.