{"doi":"10.1136/rmdopen-2021-002031","title":"Disparities in healthcare in psoriatic arthritis: an analysis of 439 patients from 13 countries","abstract":"OBJECTIVES: Patient care can vary substantially by country. The objective was to explore differences in psoriatic arthritis (PsA) across countries for disease activity, impact and treatments. METHODS: A cross-sectional analysis of 13 countries from the Remission/Flare in PsA study (NCT03119805) of consecutive adult patients with definite PsA was performed. Countries were classified into tertiles by gross domestic product (GDP)/capita. Disease activity (Disease Activity in PsA, DAPSA and Minimal Disease Activity, MDA) and their components, disease impact (patient-reported outcomes) and biological disease-modifying antirheumatic drugs (bDMARDs) were analysed per country and compared between the three tertiles of GDP/capita by parametric and non-parametric tests. We also explored the percentage of patients with significant disease activity (DAPSA >14) and no ongoing bDMARD prescription. RESULTS: In 439 patients (50.6% male, mean age 52.3 years, mean disease duration 10.1 years), disease activity and disease impact were higher in the lowest GDP/capita countries. DAPSA remission and MDA were attained in the lowest tertile in 7.0% and 18.4% patients, vs 29.1% and 49.5% in the middle tertile and 16.8% and 41.3% in the high tertile, respectively (all p<0.001). bDMARDs use was similar in the tertiles (overall mean 61%). The overall rate of patients with DAPSA >14 and no bDMARDs was 18.5%, and was higher in lower GDP/capita countries (p=0.004). CONCLUSION: PsA patients from countries with the lowest GDP/capita, despite similar use of bDMARDs, were more likely to have high disease activity and worse disease impact. There is a need for more equity in healthcare.","journal":"RMD Open","year":2022,"id":265036,"datarank":0.6594534304044466,"base_score":2.4849066497880004,"endowment":2.4849066497880004,"self_citation_contribution":0.37273599746820013,"citation_network_contribution":0.2867174329362464,"self_endowment_contribution":0.37273599746820013,"citer_contribution":0.2867174329362464,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":11,"citers_with_citation_signal":7,"citers_with_endowment":7,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6963,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03119805"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":923615,"name":"Uta Kiltz","orcid":"0000-0001-5668-4497","position":1,"is_corresponding":false},{"id":923616,"name":"Umut Kalyoncu","orcid":"0000-0001-7129-2109","position":2,"is_corresponding":false},{"id":408493,"name":"Ying Ying Leung","orcid":"0000-0001-8492-6342","position":3,"is_corresponding":false},{"id":923617,"name":"Penélope Esther Palominos","orcid":"0000-0003-0132-4325","position":4,"is_corresponding":false},{"id":923618,"name":"Juan D. Cañete","orcid":"0000-0003-2606-0573","position":5,"is_corresponding":false},{"id":923619,"name":"Rossana Scrivo","orcid":"0000-0002-2889-8962","position":6,"is_corresponding":false},{"id":408495,"name":"Andra Bălănescu","orcid":"0000-0003-0688-9173","position":7,"is_corresponding":false},{"id":924203,"name":"E. Dernis","orcid":null,"position":8,"is_corresponding":false},{"id":924204,"name":"Sandra Meisalu","orcid":null,"position":9,"is_corresponding":false},{"id":924205,"name":"Adeline Ryussen-Witrand","orcid":null,"position":10,"is_corresponding":false},{"id":408497,"name":"Martin Soubrier","orcid":"0000-0001-9349-0720","position":11,"is_corresponding":false},{"id":923620,"name":"Sibel Zehra Aydın","orcid":"0000-0001-8792-4449","position":12,"is_corresponding":false},{"id":408498,"name":"Lihi Eder","orcid":"0000-0002-1473-1715","position":13,"is_corresponding":false},{"id":923621,"name":"I. Z. Gaydukova","orcid":"0000-0003-3500-7256","position":14,"is_corresponding":false},{"id":923622,"name":"Ennio Lubrano","orcid":"0000-0001-6189-5328","position":15,"is_corresponding":false},{"id":91466,"name":"Pascal Richette","orcid":"0000-0003-2132-4074","position":16,"is_corresponding":false},{"id":317329,"name":"M. Elaine Husni","orcid":"0000-0002-3181-4205","position":17,"is_corresponding":false},{"id":408500,"name":"Laura C. Coates","orcid":"0000-0002-4756-663X","position":18,"is_corresponding":false},{"id":408494,"name":"Maarten de Wit","orcid":"0000-0002-8428-6354","position":19,"is_corresponding":false},{"id":408499,"name":"Josef S Smolen","orcid":"0000-0002-8899-9087","position":20,"is_corresponding":false},{"id":376863,"name":"Ana‐Maria Orbai","orcid":"0000-0001-8644-8567","position":21,"is_corresponding":false},{"id":243073,"name":"Laure Gossec","orcid":"0000-0002-4528-310X","position":22,"is_corresponding":false},{"id":923614,"name":"Florian Lucasson","orcid":"0000-0001-7479-1392","position":0,"is_corresponding":true}],"reference_count":47,"raw_metadata":null,"created_at":"2026-07-19T00:26:45.905331Z","pmid":"35523519","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}