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Alexis Ogdie-Beatty, MD, discusses the UPLIFT survey and UPLIFT Innovation Challenge, the unmet needs of patients with psoriatic arthritis, and the clinical significance of the survey’s results.
Rheumatology Network sat down with Alexis Ogdie-Beatty, MD, Associate Professor of Medicine and Epidemiology and rheumatologist at the University of Pennsylvania. We discuss the UPLIFT survey and UPLIFT Innovation Challenge, the unmet needs of patients with psoriatic arthritis, and the clinical significance of the survey’s results.
Rheumatology Network: To begin, what are some of the unmet needs and most common challenges patients with psoriatic arthritis (PsA) face on a daily basis?
Alexis Ogdie-Beatty, MD: One of the challenges is that patients with psoriatic arthritis continue to have active disease despite treatment, and there's a number of patients that aren't even being adequately treated. So, I think one of our goals as rheumatologists is to get better control of psoriatic arthritis disease activity and also get patients into clinics so we can start treatment earlier when possible.
RN: Can you tell me a little bit about the design of the UPLIFT survey?
AO: Yes. The UPLIFT survey was a survey designed by a group of academic rheumatologists and dermatologists and it was sent to patients with psoriasis and psoriatic arthritis as well as providers. It was actually kind of designed similarly to the MAPP survey, or the Multinational Assessment of Psoriasis and Psoriatic Arthritis, which was performed in 2012. So, it's nice because we had 2012 data to compare to this 2020 data with to kind of see where we've been and how far we've come since 2012.
RN: How can the data from this survey help patients who continue to be undertreated?
AO: Well, one thing is it identifies the gap. So first, it did identify that we have closed a little bit of the gap since 2012. So, we know that it is possible to do better. But it also shows how much there's still left to do and kind of just the overall global burden of psoriatic arthritis not only in the US and Europe, but in other countries such as some of the Asian countries as well.
RN: How will the UPLIFT Innovation Challenge impact the psoriatic disease community?
AO: The UPLIFT Innovation Challenge’s goal is really kind of get people thinking about how we can get patients and physicians working together to improve health care and health outcomes in patients with psoriatic arthritis or psoriatic disease broadly.
RN: What were the major takeaway points of the 2 abstracts regarding the UPLIFT data involving patients with PsA and/or PsA with psoriasis?
AO: Well, I think one of the things was that patients with psoriatic arthritis, about half in Europe actually, hadn't seen a healthcare provider in the last year for their disease, which was a little surprising. We always think of our patients with psoriatic arthritis coming to see us every 3 to 6 months. So, if half haven't seen a doctor in the last year about this disease, it's a little concerning. Additionally, we also found that there was a large number of patients that weren't really receiving treatment or weren't receiving the treatment needed to kind of address their disease to get them to acceptable disease state.
RN: What is the clinical significance of these results?
AO: I think one is that we have a ways to go in terms of improving our patients care. So that means the way we interact with them and getting them into clinics. Interestingly, I think I wonder if telemedicine has actually helped with that since we've kind of started that process because it's really easy. And part of the problem, at least in the US, is actually getting into the clinic. So maybe we're already starting to address that. And the second is that we really do need to do a little bit better, too, in terms of getting patients on appropriate therapy. And appropriate therapy may differ depending on the stage of the disease or the type of disease, for example, articular versus axial versus fibromyalgia. So, understanding kind of what the patient's disease is and treating them appropriately is really important. We have ways to go there.
RN: You mentioned that a large number of European participants surveyed had not seen a health care provider in the past year. Why do you think that is?
AO: I don't really know exactly. So, this was performed somewhere in the June time point in 2020. So obviously, it was during COVID when the was the survey was sent. However, we were surveying over the past year or so, and most of that time was not during COVID. So that's why it doesn't make sense. And maybe that's just real, maybe patients aren't seeing their doctors enough. But we're not really sure exactly why.
RN: What are the next steps for uplift?
AO: There’s a lot of information within the survey there. So, I think we're going to be working with other committees to kind of share the data and try to get additional questions and kind of see what else we can turn out from that data. So, there's a lot of work still to do within that data set.
RN: Is there anything else that you'd like our audience to know before we wrap up?
AO: I think one thing is that despite having a lot of different treatments available for psoriatic arthritis, we still don’t know exactly how to use them best. We need more research on how to better utilize our therapies and how to get patients to lower disease activity, which might not always be specifically about the therapies, it might be about the care paradigm. The other thing is we saw a dissociation between physician and patient assessment of disease. And we've seen that in rheumatoid arthritis, we see that in other diseases too. It's really important to take note of that, for some reason, we're not addressing what the patient needs. So, we need to do better with getting physicians and patients communicating in a better way. And I think our healthcare system kind of works against us in that way, because we have such short time and to see the patient. But certainly, there's something that needs to be done to improve how we're working with patients to get their disease to a better state.