{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:14:18Z","timestamp":1791476058531,"version":"4.3.4"},"reference-count":50,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:00:00Z","timestamp":1651795200000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2022,4,14]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A cross-sectional analysis of 13 countries from the Remission\/Flare in PsA study (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03119805\">NCT03119805<\/jats:ext-link>) 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 &gt;14) and no ongoing bDMARD prescription.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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&lt;0.001). bDMARDs use was similar in the tertiles (overall mean 61%). The overall rate of patients with DAPSA &gt;14\u2009and no bDMARDs was 18.5%, and was higher in lower GDP\/capita countries (p=0.004).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2021-002031","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T12:28:09Z","timestamp":1651840089000},"page":"e002031","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Disparities in healthcare in psoriatic arthritis: an analysis of 439 patients from 13 countries"],"prefix":"10.1136","volume":"8","clinical-trial-number":[{"clinical-trial-number":"nct03119805","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03119805","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7479-1392","authenticated-orcid":false,"given":"Florian","family":"Lucasson","sequence":"first","affiliation":[{"name":"INSERM, Institut Pierre Louis d'Epid\u00e9miologie et de Sant\u00e9 Publique, Sorbonne Universit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5668-4497","authenticated-orcid":false,"given":"Uta","family":"Kiltz","sequence":"additional","affiliation":[{"name":"Herne and Ruhr-Universit\u00e4t, Rheumazentrum Ruhrgebiet, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umut","family":"Kalyoncu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying Ying","family":"Leung","sequence":"additional","affiliation":[{"name":"Duke-NUS Medical School, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0132-4325","authenticated-orcid":false,"given":"Pen\u00e9lope","family":"Palominos","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2606-0573","authenticated-orcid":false,"given":"Juan D","family":"Ca\u00f1ete","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, Hospital Cl\u00ednic and IDIBAPS, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"Scrivo","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza Universit\u00e0 di Roma, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andra","family":"Balanescu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u201cSf. 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