{
  "abstract": "Introduction Systemic sclerosis (SSc), an autoimmune condition, varies in symptoms, progression, and treatment. While early clustering efforts support the value of phenotype-based approaches, less is known about how clinical subgroups differ in disease burden, treatment, and physician–patient interactions. This analysis examined physician-reported disease management and patient-reported treatment experiences across SSc clinical clusters.Material and Methods Data were obtained from rheumatologists and their SSc patients across USA, France, Germany, Italy, Spain, UK and Japan between Q1–Q3 2022. Physicians completed patient record forms and patients completed self-completion forms. Clinical trial participants were excluded. Cluster analysis used five physician-assessed variables at data collection: body areas affected, symptoms, severity, frequency of flares in the past year, and remission status. A cluster solution was selected based on clinical interpretability and statistical model fit, using the Akaike and Bayesian Information Criterion. Physician- and patient-reported treatment and experiences were assessed across clusters.Results Among 1,906 patients, four distinct clusters were identified, reflecting different clinical profiles. Clusters 1 and 2 had younger patients with less physician-reported comorbidities compared with clusters 3 and 4. Musculoskeletal involvement (joint and muscle symptoms) was more prominent in clusters 2 and 4, based on patient-reported first symptoms; and physician-reported symptoms at data collection. Physicians reported more patients with moderate or severe disease in clusters 3 and 4 versus clusters 1 and 2, with cluster 4 having the highest proportion rated as severe.Pharmacologic treatment generally increased with disease severity, with clusters 3 and 4 receiving a higher mean number of treatment classes (2.5–3.4) versus clusters 1 and 2 (1.8–2.1). Treatment goals were discussed more often in clusters 3 and 4 (62–71%) versus clusters 1 and 2 (53–57%), and a higher proportion were managed by an SSc specialist in clusters 3 and 4 (58% in both) versus clusters 1 and 2 (36–54%) (physician-reported). Across all clusters, patients most frequently identified ‘gets rid of the disease’ or ‘slows disease progression’ as the most important treatment benefit. Most patients felt informed about treatment options (71–92%) and would recommend their treatment to others (82–96%).Conclusions Patients with more severe disease received more treatment and specialist SSc management. This study also highlights musculoskeletal manifestations as a core contributor to SSc disease burden and an important aspect for rheumatologists to consider. In this sense, active musculoskeletal involvement may integrate cutaneous subsets for an improved and clinically meaningful stratification.",
  "authors": [
    {
      "affiliations": [
        "University of Leeds, Leeds, UK"
      ],
      "name": "Francesco Del Galdo"
    },
    {
      "affiliations": [
        "Therapeutic Area Inflammation, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA"
      ],
      "name": "Mario Ehlers"
    },
    {
      "affiliations": [
        "Therapeutic Area Inflammation, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany"
      ],
      "name": "Lizette Moros"
    },
    {
      "affiliations": [
        "Therapeutic Area Mental and Eye Health, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany"
      ],
      "name": "Arpit Misra"
    },
    {
      "affiliations": [
        "Cross Therapeutic Area Marketing and Operations, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany"
      ],
      "name": "Hyemin Song"
    },
    {
      "affiliations": [
        "Adelphi Real World, Bollington, UK"
      ],
      "name": "Isabel Truman"
    },
    {
      "affiliations": [
        "Adelphi Real World, Bollington, UK"
      ],
      "name": "Liane Gillespie-Akar"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, University of Michigan Scleroderma Clinic, Ann Arbor, MI, USA"
      ],
      "name": "Dinesh Khanna"
    }
  ],
  "title": "P.402 Understanding care experiences in systemic sclerosis: physician and patient perspectives stratified by clinical clusters",
  "uid": "ab9835b6-398d-5b3d-b71a-2930569b572c"
}