Journal ArticleDOI
High prevalence of psoriatic arthritis in patients with severe psoriasis with suboptimal performance of screening questionnaires
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Psoriasis severity was associated with a new diagnosis of PsA, and poor sensitivities for the screening questionnaires were noted due to inadequate detection of patterns of arthritis other than polyarticular disease.Abstract:
Objectives The objectives of this study were to: (1) assess the prevalence of psoriatic arthritis (PsA) among Psoriasis (Ps) patients attending dermatology clinics; (2) identify clinical predictors of the development of PsA; and (3) compare the performance of three PsA screening questionnaires: Psoriatic Arthritis Screening and Evaluation (PASE), Psoriasis Epidemiology Screening Tool (PEST) and Toronto Psoriatic Arthritis Screening (ToPAS). Methods Patients were divided into two groups: Group-1, consecutive psoriasis patients attending dermatology clinics with no known diagnosis of inflammatory arthritis and Group-2, consecutive patients attending rheumatology clinics with a confirmed diagnosis of PsA. In Group-1, patients completed the screening questionnaires, followed by a full rheumatological evaluation whether or not they reported musculoskeletal symptoms. Results 200 patients were recruited with 100 in each group. In all, 84% of patients in dermatology group were using systemic therapy for their skin disease, and 99% of patients in rheumatology group were on systemic immunosuppressives. In Group-1, 29% of patients were diagnosed with PsA after rheumatological evaluation. On univariate and multivariate analyses, there was a significant positive association between Psoriasis Area and Severity Index and a new diagnosis of PsA (p=0.046). Different patterns of joint involvement were noted in patients with newly diagnosed PsA versus patients with established PsA with fewer polyarticular disease presentations (p=0.0001). In Group-1, the PEST, PASE and ToPAS assessments had sensitivities of 27.5%, 24% and 41%, and specificities of 98%, 94% and 90%, respectively. In Group-2, the sensitivities were 86%, 62% and 83%, respectively. Conclusions 29% of Ps patients attending dermatology clinics had undiagnosed PsA. Psoriasis severity was associated with a new diagnosis of PsA. Poor sensitivities for the screening questionnaires were noted due to inadequate detection of patterns of arthritis other than polyarticular disease.read more
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Journal ArticleDOI
Psoriasis Pathogenesis and Treatment.
Adriana Rendon,Knut Schäkel +1 more
TL;DR: The role of genetics, associated epigenetic mechanisms, and the interaction of the skin flora in the pathophysiology of psoriasis is described, which includes a comprehensive review of well-established widely available therapies and novel targeted drugs.
Journal ArticleDOI
Psoriasis and comorbid diseases: Epidemiology.
Junko Takeshita,Sungat K. Grewal,Sinead Langan,Nehal N. Mehta,Alexis Ogdie,Abby S. Van Voorhees,Joel M. Gelfand +6 more
TL;DR: A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic diseases, gastrointestinal diseases, kidney disease, malignancy, infection, and mood disorders.
Journal ArticleDOI
Effect of certolizumab pegol on signs and symptoms in patients with psoriatic arthritis: 24-week results of a Phase 3 double-blind randomised placebo-controlled study (RAPID-PsA).
Philip J. Mease,Roy Fleischmann,A. Deodhar,Jürgen Wollenhaupt,Majed Khraishi,D. Kielar,F. Woltering,C. Stach,Bengt Hoepken,T. Arledge,D. van der Heijde +10 more
TL;DR: Rapid improvements in the signs and symptoms of PsA, including joints, skin, enthesitis, dactylitis and nail disease were observed across both CZP dosing regimens, independent of prior TNF inhibitor exposure.
Journal ArticleDOI
Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis
TL;DR: Even a 6-month delay from symptom onset to the first visit with a rheumatologist contributes to the development of peripheral joint erosions and worse long-term physical function.
Journal ArticleDOI
Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics
Philip J. Mease,Dafna D. Gladman,Kim A. Papp,Majed Khraishi,Diamant Thaçi,F. Behrens,Robert Northington,Joanne Fuiman,Eustratios Bananis,R. Boggs,Daniel F. Alvarez +10 more
TL;DR: Almost a third of patients with psoriasis seen in dermatology centers had PsA as determined by rheumatologists, and more than a third had not been previously given the diagnosis.
References
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Journal ArticleDOI
Classification criteria for psoriatic arthritis: Development of new criteria from a large international study
William J. Taylor,Dafna D. Gladman,Philip S. Helliwell,Antonio Marchesoni,Philip J. Mease,Herman Mielants +5 more
TL;DR: The CASPAR criteria are simple and highly specific but less sensitive than the Vasey and Espinoza criteria and are confirmed as the validity of clinical diagnosis as the gold standard definition of "case"-ness.
Journal ArticleDOI
Psoriatic Arthritis (PSA) - An Analysis of 220 Patients
TL;DR: Overall, there was a 40 per cent incidence of deforming, erosive arthropathy, with 17 per cent of patients having five or more deformed joints, and polyarthritis was the most common joint pattern, present in 61% with symmetric and asymmetric patterns occurring equally.
Journal ArticleDOI
A prospective, clinical and radiological study of early psoriatic arthritis: an early synovitis clinic experience
TL;DR: This study confirms that PsA is a chronic, progressive disease in the majority of patients despite clinical improvement with current DMARD treatment, PsA results in radiological damage in up to 47% of patients at a median interval of 2 yr.
Journal ArticleDOI
Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: A population‐based study
Floranne C. Wilson,Murat Icen,Cynthia S. Crowson,Marian T. McEvoy,Sherine E. Gabriel,Hilal Maradit Kremers +5 more
TL;DR: In this population-based study, <10% of patients with psoriasis developed clinically recognized PsA during a 30-year period, indicating that the likelihood of PsA in PsA subjects did not change over time.
Journal ArticleDOI
Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis
TL;DR: This poster discusses how best to select a dermatologist for the initial diagnosis of psoriatic arthritis based on the individual patient's history, symptoms, and once-and-a-half-year-old to six-month-old twins.