AB0769 PATIENT IDENTIFIED TREATMENT GOALS IN PSORIATIC ARTHRITIS: DECREASING PAIN AND INCREASING ACTIVITY LEVEL ARE HIGH PRIORITIES
Authors: Alexis Ogdie, M Elaine Husni, Kathleen Bush, Christina Burgese, Soumya Reddy, Jose Scher, Jessica a. Walsh
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Treatment goals for physicians are primarily focused on improving musculoskeletal and cutaneous signs and symptoms of psoriatic disease. Studies have reported that perceptions of psoriatic arthritis (PsA) disease control are often divergent between patients and physicians. Moreover, specific patient goals are uncommonly discussed or elicited in routine clinical practice. <h3>Objectives</h3> To examine patient reported treatment goals through direct questioning on what they most want to improve about their disease and how an effective treatment would improve their lives. <h3>Methods</h3> Patients in the Psoriatic arthritis Research Consortium (PARC) completed standardized assessments between 2017-2018. PARC is a longitudinal observational cohort study conducted at four institutions in the United States: University of Pennsylvania, Cleveland Clinic, New York University, and University of Utah that includes a range of patient and physician disease measures. Answers to two open-ended questions (questions included on figures) were qualitatively categorized into response categories and descriptively reported in this cross-sectional study. While patients were encouraged to provide the one best answer, many listed multiple themes. We also examined differences in responses by gender, self-identified race (Caucasian vs not Caucasian), and whether a change in disease modifying anti-rheumatic drug was recommended (yes/no) on the date the questionnaire was completed. <h3>Results</h3> Among 82 patients with PsA enrolled, mean age was 48.3 (SD 13.2), 38 (46%) were female, and 57 (70%) of patients were changing therapy. The mean swollen (0-66) and tender (0-68) joint counts were 4.3 (SD 6.0) and 8.5 (12.2) respectively, mean psoriasis body surface area was 3.2% (SD 10.0), and mean physician and patient global assessments were 4.6 (SD 2.0) and 4.7 (2.6) respectively. Patient answers to the two questions are shown in the Figures. Decreasing pain was the most commonly cited goal for improvement (56%) with skin improvement the second most commonly reported goal for improvement (12%). Goals for successful therapy were more diverse. Decreasing pain was still most common (24%) but general improvement in life (18%), the ability to be more active (15%), participate in recreational activities (9%), function at work (11%) and exercise (5%) were common responses. There were no significant differences in responses according to race, or therapy change. However, all patients reporting fatigue or enjoyment as important outcomes for improvement were women. <h3>Conclusion</h3> In order to inform goals of care for patients with PsA, both physician and patient treatment goals should be defined to achieve optimal treatment success. In this study, while the majority of patients reported pain and activity as the most important outcomes for improvement, patient goals were heterogeneous. This underscores the importance of eliciting patient treatment goals on a regular basis to best individualize management in PsA. <h3>Acknowledgement</h3> This work was funded by NIH/NIAMS R01- aR072363. <h3>Disclosure of interests</h3> Alexis Ogdie Grant/research support from: (To my university) Novartis, Pfizer, Grant/research support from: Novartis, Pfizer, Grant/research support from: Novartis, Pfizer, Grant/research support from: Novartis, Pfizer, Consultant for: abbVie, Bristol-Myers Squibb, Celgene, Corrona, Eli Lilly and Company, Novartis, Pfizer, and Takeda, Consultant for: abbVie, amgen, Bristol-Myers Squibb, Celgene, Corrona, Eli Lilly, Novartis, Pfizer inc, Takeda, Consultant for: abbvie, amgen, BMS, Celgene, Corrona, Lilly, Novartis, Pfizer, Takeda, Consultant for: abbvie, amgen, BMS, Celgene, Corrona, Lilly, Novartis, Pfizer, Takeda, M Elaine Husni Grant/research support from: Janssen, Kathleen Bush: None declared, Christina Burgese: None declared, Soumya Reddy Consultant for: amgen, UCB, Novartis, Pfizer, abbvie, Jose Scher Grant/research support from: Pfizer, Novartis, Consultant for: Janssen, UCB, Novartis, amgen, Jessica a. Walsh Grant/research support from: abbvie, Pfizer , Consultant for: abbvie, Celgene, Lilly, Novartis