[No abstract available

Background: Consensus among dermatologists and rheumatologists in the diagnosis and assessment of musculoskeletal diseases in psoriasis (PsO) patients is needed. This study assesses characteristics of musculoskeletal pain in patients with PsO for the presence of psoriatic arthritis (PsA) and evaluation of a novel 16-item visual instrument (PsA-Disk). Methods: Data were collected from eight dermatological/rheumatological centres across Italy. Patients with PsO completed PEST (Psoriasis Epidemiology Screening Tool) and PsA-Disk questionnaires during the first visit. A rheumatological visit was performed to confirm the presence of PsA. Both validity and reliability of PsA-Disk were assessed. Results: A total of 573 patients with PsO were examined at the first visit, and 120 (21%) were diagnosed with PsA. Patients with PsA compared with patients with PsO ( n = 119) presented statistically significant differences for: nail involvement, PEST score ⩾3, higher erythrocyte sedimentation rate (ESR), Nail Psoriasis Severity Index (NAPSI)-feet, NAPSI-(hands + feet) and PsA-Disk scores (73.9 ± 32.1 versus 58.1 ± 39.8, p < 0.001). Patients with PsA with knee arthritis had higher PsA-Disk scores (98.4 ± 26 versus 71.5 ± 31.9, p = 0.006) that were also correlated with number of swollen ( r = 0.2, p < 0.05) and tender joints ( r = 0.24, p = 0.021), patient ( r = 0.4, p < 0.001) and physician-pain-visual analogue scale (VAS; r = 0.33, p < 0.001), patient global assessment (PGA)-VAS ( r = 0.23, p = 0.025), physician-health assessment questionnaire (HAQ; r = 0.38, p = 0.011), Disease Activity Score (DAS)-44 ( r = 0.25, p = 0.023) and Disease Activity in Psoriatic Arthritis (DAPSA; r = 0.31, p = 0.005). The instrument had excellent reliability in terms of internal consistency (Cronbach’s alpha = 0.90) and stability (intraclass correlation = 0.98). Moderate agreement between PsA-Disk and PEST (Cohen’s kappa = 0.46) was observed, while construct validity appeared appropriate [PsA + patients: PsA-Disk score (interquartile range; IQR) =71 (50–96); PsA-patients: PsA-Disk score (IQR)=50 (20–90); p < 0.001]. Conclusion: PsA-Disk may be considered a valid novel instrument aiding both dermatologists and rheumatologists in the rapid detection and assessment of musculoskeletal disease characteristics.

BackgroundThe assessment of joint disease in psoriasis (PsO) patients is paramount, particularly where consensus among dermatology and rheumatology specialists is necessary.ObjectivesTo evaluate the prevalence of psoriatic arthritis (PsA) in PsO patients and assess how a novel 16-item visual instrument (PsA-Disk) correlates with the disease and its clinical manifestations.MethodsData were prospectively collected from 8 dermatological/rheumatological centres across Italy. During their first dermatological visit, patients completed both PEST (Psoriasis Epidemiology Screening Tool) and PsA-disk questionnaires. Rheumatological visit was performed in order to confirm presence/absence of PsA. Clinimetric and disease activity variables were recorded.ResultsFrom a total of 239 PsO patients, 120 (50.2%) patients were diagnosed with PsA. More PsA-positive patients had nail PsO (54.2% vs. 42%, p=0.05) and a PEST score ≥3 vs. PsA-negative patients (77.5% vs. 37.8%, p<0.001). PsA-positive patients presented with significantly higher ESR (21.9±17.1 vs. 15.9±10.2 mm/h, p=0.041), NAPSI-feet (10.2±9.7 vs. 3.9±7.8, p=0.002), NAPSI-(hands+feet; 9.3±6.8 vs. 4.6±7.9, p=0.007), and PsA-Disk scores (73.9±32.1 vs. 58.1±39.8, p<0.001) vs. PsA-negative patients. PsA-patients with axial involvement had higher PsA-Disk scores (86.7 vs. 72.5, p=0.088) as well as patients with knee arthritis (98.4 vs. 71.5, p=0.006). PsA-Disk scores were also positively correlated with number of swollen (r=0.2, p<0.05) and tender joints (r=0.24, p=0.021), patient- (r=0.4, p<0.001) and physician-pain-VAS (r=0.33, p<0.001), PGA-VAS (r=0.23, p=0.025), physician-HAQ (r=0.38, p=0.011), DAS-44 (r=0.25, p=0.023) and DAPSA scores (r=0.31, p=0.005) (figure 1A). Examples of the powerful visual use of this instrument can be seen in figure 1B.Abstract – Figure 1[A] Correlation between clinical variables and PsA-Disk score in PsA+ patients.ConclusionsPsA-Disk is a novel instrument helping both dermatologist and rheumatologist in the rapid assessment PsA, facilitating in the timely therapeutic management of these patients.Disclosure of InterestNone declared

L'avvento dei farmaci biologici (biological disease-modifying antirheumatic drug, bDMARD) ha sensibilmente modificato la gestione dell'artrite reumatoide (AR), permettendo a molti pazienti di raggiungere miglioramenti della propria condizione clinica difficilmente ottenibili con i farmaci tradizionali (conventional disease-modifying antirheumatic drug, cDMARD) (1-5).

L'avvento dei farmaci biologici (biological disease-modifying antirheumatic drug, bDMARD) ha sensibilmente modificato la gestione dell'artrite reumatoide (AR), permettendo a molti pazienti di raggiungere miglioramenti della propria condizione clinica difficilmente ottenibili con i farmaci tradizionali (conventional disease-modifying antirheumatic drug, cDMARD) (1-5).