This analysis included data from 1286 patients who participated in the survey and met eligibility criteria. Of these, 674 (52%) were female and 612 (48%) were male. Patient demographics and disease characteristics were generally similar for females and males, with some exceptions (Table 1). Females had a longer time between symptoms and diagnosis, compared with males (mean [standard deviation]: 5.2 [9.8] vs. 3.4 [7.2], respectively, p < 0.05; Table 1). A greater proportion of females than males were from the United States (47 vs. 33%, respectively, p < 0.05). More females than males reported having ever taken a steroid (57 vs. 43%, p < 0.05) and another prescription medication for PsA (12 vs. 8%, p < 0.05), other than a biologic, DMARD, non-steroidal anti-inflammatory drug (NSAID), or steroid (Table 1). More females than males were currently taking a biologic DMARD and oral conventional synthetic or targeted synthetic DMARD (20 vs. 15%, respectively, p < 0.05; Table 1). In addition, a greater proportion of females vs. males had ever been diagnosed with other conditions, including anxiety (32 vs. 24%, respectively), depression (27 vs. 19%), and osteoarthritis (17 vs. 9%; all p < 0.05).

For both females and males, starting to experience pain (62 and 61%, respectively) was the most commonly reported reason for visiting an HCP that led to a diagnosis of PsA. More females than males reported experiencing musculoskeletal symptoms (59 vs. 42%, p < 0.05) or stiffness (48 vs. 39%, p < 0.05) and having to cover up their skin when around others (31 vs. 23%, p < 0.05), as reasons for visiting an HCP that led to a diagnosis of PsA. In contrast, more males than females stated difficulty participating in sports or recreational activities (33 vs. 26%, p < 0.05) as a reason for visiting an HCP that led to a diagnosis of PsA (Fig. 1).

Patient-reported reasons for visiting an HCP that led to a PsA diagnosis, with ORs and relative differences for males vs. females. Percentages are based on weighted data (adjusted for size of each country’s adult population); data reported are in response to the question: ‘What caused you to visit a healthcare profession that ultimately led to your PsA diagnosis? Please select all that apply’. ORs (adjusted for confounders) and relative differences (defined as OR minus 1) are based on unweighted data and are only reported for responses determined to be statistically significant by multivariate logistic regression models. *p < 0.05 for males vs. females without adjustment for confounders; ††p < 0.01, †††p < 0.001 for males vs. females with adjustment for confounders (ORs). CI confidence interval, HCP healthcare professional, N number of patients who answered the question (weighted), OR odds ratio, PsA psoriatic arthritis

Compared with females, males were 45.9% (OR 0.54 [95% CI 0.43–0.68]) and 29.2% (OR 0.71 [95% CI 0.55–0.91]) less likely to report experiencing musculoskeletal symptoms and having to cover up skin when around others, respectively, as reasons for visiting an HCP that led to a diagnosis of PsA. In contrast, males were 43.0% more likely than females (OR 1.43 [95% CI 1.12–1.83]) to report difficulty participating in sports or recreational activities as a reason for visiting an HCP that led to a diagnosis of PsA (Fig. 1).

Both females and males stated that they experienced a range of PsA-related symptoms in the 12 months prior to their participation in the survey (Fig. 2a). The most commonly reported musculoskeletal symptom in both females and males was joint pain (80 and 77%, respectively). Generally, more females than males reported that they experienced musculoskeletal symptoms, such as joint swelling, joint tenderness, stiffness, inflammatory back pain/stiffness, tenderness or swelling of the ligaments/tendons that connect to bones (commonly the heel or elbow) and swollen or inflamed (“sausage”) fingers or toes (all p < 0.05). The most frequent skin/nail symptoms for both genders were skin patches/plaques, which were experienced by a greater proportion of females than males (63 vs. 53%, respectively), as were skin discomfort and nail changes (all p < 0.05). In addition, unusual fatigue was reported by 56% of females vs. 48% of males (p < 0.05; Fig. 2a).

Patient-reported symptoms related to PsA a experienced in the 12 months prior to participation in the survey and b experienced despite PsA treatment, with ORs and relative differences for males vs. females. Percentages are based on weighted data (adjusted for size of each country’s adult population); a Data reported are in response to the question: ‘Which of the following symptoms, if any, have you experienced in the past 12 months related to psoriatic arthritis? Please select all that apply’; b Data reported are in response to the question: ‘Which of the following symptoms do you still experience despite psoriatic arthritis treatment? Please select all that apply. I still experience…’. ORs (adjusted for confounders) and relative differences (defined as OR minus 1) are based on unweighted data and are only reported for responses determined to be statistically significant by multivariate logistic regression models. *p < 0.05 for males vs. females without adjustment for confounders; †p < 0.05 for males vs. females with adjustment for confounders (ORs). CI confidence interval, N for a number of patients who answered the question (weighted) and for b, number of patients who were taking Rx medications for their psoriatic arthritis, who answered the question (weighted), Net the net percentages of the individual responses for the musculoskeletal and skin/nail symptoms categories, OR odds ratio, PsA psoriatic arthritis, Rx doctor’s prescription

Overall, most (91% of females and males) patients taking medication at the time of the survey responded that, despite treatment for PsA, they still experienced symptoms; most symptoms were experienced by a similar proportion of females and males (Fig. 2b). Despite treatment, the most common musculoskeletal symptom in both females and males was joint pain (54 and 51%, respectively). The most common skin/nail symptoms in both genders were skin patches or plaques and they were also experienced by more females vs. males (43 vs. 36%, respectively, p < 0.05). More females than males experienced joint tenderness (43 vs. 36%, respectively, p < 0.05) and similarly, despite treatment, enthesitis was still experienced by 30% of females, compared with 24% of males (p < 0.05; Fig. 2b). Compared with females, males were 35.0% more likely (OR 1.35 [95% CI 1.01–1.81]) to report experiencing joint damage despite PsA treatment (Fig. 2b).

For patients of both genders, the most commonly reported aspect of their lives that PsA had a major or moderate negative impact on was the level of physical activity, which was reported by a greater proportion of females vs. males (81 vs. 75%, respectively, p < 0.05). In addition, a major or moderate negative impact on their emotional/mental well-being was reported by more females than males (73 vs. 65%, respectively, p < 0.05; Fig. 3a).

Patient-reported perceptions on a major/moderate negative impact of PsA on aspects of life, b social impact and work impact of PsA, and c patient-reported concerns about the impact of PsA, with ORs and relative differences for males vs. females. Percentages are based on weighted data (adjusted for size of each country’s adult population); a Data reported are a summary of major/moderate life impact of PsA in response to the question: ‘How much of a negative impact if any, has psoriatic arthritis had on each of the following aspects of your life?’ (data not shown for no/slight impact). b Data reported are in response to the question: ‘Have you done any of the following as a result of psoriatic arthritis? Please select all that apply’; c Data reported are in response to the question: ‘What do you worry about the most because of psoriatic arthritis? Please select all that apply’. ORs (adjusted for confounders) and relative differences (defined as OR minus 1) are based on unweighted data and are only reported for responses determined to be statistically significant by multivariate logistic regression models. *p < 0.05 for males vs. females without adjustment for confounders; †††p < 0.001 for males vs. females with adjustment for confounders (ORs). ‡Not shown in United Kingdom; §Only shown in United Kingdom. CI confidence interval, N number of patients who answered the question (weighted), OR odds ratio, PsA psoriatic arthritis

Compared with females, males were 37.9% less likely (OR 0.62 [95% CI 0.49–0.78]) to report an impact to their emotional/mental well-being as an aspect of their lives that PsA had a major or moderate negative impact on (Fig. 3a). The impact of PsA on other aspects of patients’ lives, including education, ability to perform and progress at work, and relationships with family, friends, and romantic partners, was similar between genders (Fig. 3a).

To further explore the impact of PsA, patients were asked about their perceptions of the impact of PsA on their social and work lives. A similar proportion of females and males reported that they stopped participating in sports or recreational activities (56 vs. 55%, respectively) and experienced social shame (34 vs. 31%; Fig. 3b). However, more females than males experienced emotional distress (65 vs. 50%, respectively, p < 0.05) and stopped participating in social activities (49 vs. 41%, p < 0.05; Fig. 3b). Relating to impact of PsA on work life, more females than males went on permanent disability (14 vs. 9%, respectively, p < 0.05), whereas fewer females vs. males reported lower work productivity due to PsA (38 vs. 47%, p < 0.05; Fig. 3b). A similar proportion of females and males took a sick day (47 vs. 51%, respectively), medical leave (32 vs. 36%), quit or were let go from their jobs (14 vs. 11%), or switched jobs because of PsA (11 vs. 13%; Fig. 3b). When asked what they worry about most because of their PsA, more females than males expressed concern that their life expectancy may be shortened by PsA and/or other health conditions that typically accompany PsA (36 vs. 27%, respectively, p < 0.05), whereas more males than females were concerned that PsA would affect their ability to work (42 vs. 31%, respectively, p < 0.05; Fig. 3c).

Patients who responded that they had goals for managing PsA were asked which of their goals were most important to them. More females than males answered that putting PsA into remission was most important (21 vs. 16%, respectively, p < 0.05), whereas for more males than females, increasing their levels of physical activity (7 vs. 4%, respectively, p < 0.05), reducing stiffness (5 vs. 2%, p < 0.05), and switching from injections or infusions to oral medications (3 vs. 1%, p < 0.05) were most important (Fig. 4a).

a Most important goal for managing PsA, b reasons for switching PsA medication, and c most desired changes to PsA medication, with ORs and relative differences for males vs. females. Percentages are based on weighted data (adjusted for size of each country’s adult population); a Data reported are in response to the question: ‘You mentioned that you have goals related to managing psoriatic arthritis. Which of these goals is most important to you right now?’; b Data reported are in response to the question: ‘Thinking of the most recent time you switched your psoriatic arthritis medication(s), which of the following, if any, are reasons why you switched? Please select all that apply’; c) Data reported are in response to the question: ‘Ideally, what would you most like to change, if anything, about your current prescription medication(s)? Please select all that apply’. ORs (adjusted for confounders) and relative differences (defined as OR minus 1) are based on unweighted data and are only reported for responses determined to be statistically significant by multivariate logistic regression models. *p < 0.05 for males vs. females without adjustment for confounders; †p < 0.05, ††p < 0.01, †††p < 0.001 for males vs. females with adjustment for confounders (ORs); ‡Not shown in the United Kingdom; §Only shown in the United Kingdom. CI confidence interval, N number of patients who a had goals for managing PsA, b switched medications in the past 2 years, c were currently taking prescription medications for PsA, who answered the question (weighted), Net the net percentages of the individual responses for patients’ most desired changes to their PsA medication categories, OR odds ratio, PsA psoriatic arthritis

For goals related to managing PsA, males were 37.8% (OR 0.62 [95% CI 0.49–0.79]) and 28.3% (OR 0.72 [95% CI 0.57–0.90]) less likely to report putting PsA into remission and improving their emotional well-being, respectively, compared with females. Similarly, males were 27.5% (OR 0.73 [95% CI 0.57–0.92]) and 21.8% (OR 0.78 [95% CI 0.61–1.00]) less likely than females to report preventing disability and reduction of general swelling or dactylitis, respectively, as goals related to managing PsA (Fig. 4a).

Overall, 37% of patients reported that they switched their PsA medication in the 2 years prior to participating in the survey, with females less likely to switch (34%) vs. males (41%). Of these patients, more females than males reported that switching PsA treatment was due to joint symptoms not improving or getting worse (41 vs. 28%, respectively, p < 0.05) and side effects being difficult to manage (35 vs. 22%, p < 0.05; Fig. 4b). By contrast, more males than females reported switching medication due to potential serious side effect concerns (29 vs. 16%, respectively), symptoms being under control (18 vs. 9%), because the medication interrupted their daily routine (16 vs. 8%), or because they did not like taking pills (15 vs. 5%) (all p < 0.05; Fig. 4b).

Males were 86.5% (OR 1.87 [95% CI 1.18–2.95]), 81.1% (OR 1.81 [95% CI 1.13–2.91]) and 104.5% (OR 2.05 [95% CI 1.16–3.60]) more likely than females to report concerns about potential serious effects, dactylitis not improving or getting worse, and not liking needles or injections, respectively, as reasons for switching PsA medication. Additionally, compared with females, males were 104.8% (OR 2.05 [95% CI 1.18–3.56]), 273.9% (OR 3.74 [95% CI 1.75–7.98]) and 435.6% (OR 5.36 [95% CI 1.86–15.43]) more likely to report their symptoms being under control, not liking taking pills and needing surgery as reasons for switching PsA medication (Fig. 4b).

Of patients taking medication for PsA at the time of the survey, more females than males reported that the change they most wanted from their PsA prescription medication was better relief of musculoskeletal symptoms (43 vs. 35%, respectively, p < 0.05), and more males than females most wanted to change how often they had to take their medication (37 vs. 28%, respectively, p < 0.05; Fig. 4c).

When asked about their satisfaction with the communication they had with their HCPs (rheumatologist or dermatologist) that they had seen during the 12 months prior to the survey, most patients (88% for dermatologist and 89% for rheumatologist) were ‘very’ or ‘somewhat’ satisfied. More females than males (60 vs. 51%, respectively, p < 0.05) were ‘very satisfied’ with the communication with their rheumatologist, whereas fewer females than males were ‘somewhat satisfied’ (28 vs. 39%, p < 0.05; Fig. 5a). For patients who had seen a dermatologist in the previous 12 months, there were no differences between males and females in terms of their satisfaction in their communication with their dermatologist (Fig. 5b).

Patients’ satisfaction with their communication with their a rheumatologist and b dermatologist. Percentages are based on weighted data (adjusted for size of each country’s adult population); a Data reported are in response to the question: ‘How satisfied are you with the communication you currently have with your healthcare professionals regarding psoriatic arthritis? 1. Rheumatologist’; b Data reported are in response to the question: ‘How satisfied are you with the communication you currently have with your healthcare professionals regarding psoriatic arthritis? 2. Dermatologist’; *p < 0.05 for females vs. males. N number of patients who had seen a a rheumatologist or b a dermatologist in the past 12 months, who answered the question (weighted)

The most common topic that females discussed with their rheumatologist and dermatologist, was treatment goals (83 and 80%, respectively), whereas males most frequently discussed their overall health (80 and 75%; Fig. 6a, b). More females than males discussed treatment goals (83 vs. 78%, respectively, p < 0.05), the impact of PsA on their ability to conduct daily activities (82 vs. 73%, p < 0.05), and response to and/or satisfaction with their treatment regimen (81 vs. 72%, p < 0.05) with their rheumatologist (Fig. 6a). Treatment goals was the only topic that more females than males (80 vs. 72%, respectively, p < 0.05) discussed with their dermatologist (Fig. 6b).

Patients’ topics of discussion with their a rheumatologist and b dermatologist, with ORs and relative differences for males vs. females. Percentages are based on weighted data (adjusted for size of each country’s adult population); a Data reported are ‘yes’ responses to the question: ‘In the last 12 months, have you discussed/conducted each of the following with your rheumatologist regarding psoriatic arthritis?’; b Data reported are ‘yes’ responses to the question: ‘In the last 12 months, have you discussed/conducted each of the following with your dermatologist regarding psoriatic arthritis?’. ORs (adjusted for confounders) and relative differences (defined as OR minus 1) are based on unweighted data and are only reported for responses determined to be statistically significant by multivariate logistic regression models. *p < 0.05 for males vs. females without adjustment for confounders; †p < 0.05, ††p < 0.01 for males vs. females with adjustment for confounders (ORs); ‡Including how my current medication may help reach my treatment goals; §Including diet, exercise, and/or natural remedies. CI confidence interval, N number of patients who had seen a a rheumatologist or b a dermatologist in the past 12 months, who answered the question (weighted), OR odds ratio

Compared with females, males were less likely to discuss treatment goals, impact on ability to conduct daily activities and response to and/or satisfaction with treatment regimen with their rheumatologist; for instance, 39.7% (OR 1.40 [95% CI 1.04–1.87]), 40.5% (OR 1.41 [95% CI 1.06–1.86]) and 62.0% (OR 1.62 [95% CI 1.22–2.15]) of males, respectively, were more likely to say they did not discuss these topics with their rheumatologist (Fig. 6a).