High prevalence of psoriatic arthritis in patients with severe psoriasis with suboptimal performance of screening questionnaires

Haroon, Muhammad; Kirby, Brian; FitzGerald, Oliver

doi:10.1136/annrheumdis-2012-201706

Cited by 271 publications

(227 citation statements)

References 17 publications

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“…Though no absolute indicators have been identified to predict that a person with psoriasis may develop PsA, the presence of soluble biomarkers, for example, highly sensitive C‐reactive protein (hsCRP), osteoprotegerin (OPG), matrix metalloproteinase‐3 (MMP‐3) and the C‐propeptide of type II collagen to collagen fragment neoepitopes Col2‐3/4 long mono ratio or certain susceptibility genes (e.g. certain human leucocyte antigen alleles [HLA‐B and HLA‐C]) may confer susceptibility to PsA among patients with psoriasis 9, 10, 11, 12. Moreover, the predictive nature of clinical observations such as the severity of psoriasis (as measured by the Psoriasis Area Severity Index [PASI]), the severity of joint involvement and the presence of certain psoriasis features (e.g.…”

Section: Overcoming Barriers To the Early And Accurate Diagnosis Of Psamentioning

confidence: 99%

“…Moreover, the predictive nature of clinical observations such as the severity of psoriasis (as measured by the Psoriasis Area Severity Index [PASI]), the severity of joint involvement and the presence of certain psoriasis features (e.g. scalp lesions, nail disease and intergluteal/perianal psoriasis) with respect to the risk of developing PsA remains unclear 10, 13, 14, 15. Determining such absolute indicators for PsA remains complicated because of varying study designs (e.g.…”

Section: Overcoming Barriers To the Early And Accurate Diagnosis Of Psamentioning

confidence: 99%

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Promoting patient‐centred care in psoriatic arthritis: a multidisciplinary European perspective on improving the patient experience

Betteridge

Boehncke

Bundy

et al. 2015

Acad Dermatol Venereol

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Patients with psoriatic arthritis (PsA) may not be optimally treated. The impact of the disease extends beyond skin and joint symptoms, impairing quality of life. This indicates that the adoption of a patient‐focused approach to PsA management is necessary. An expert multidisciplinary working group was convened, with the objective of developing an informed perspective on current best practice and needs for the future management of PsA. Topics of discussion included the barriers to current best practice and calls to action for the improvement of three areas in PsA management: early and accurate diagnosis of PsA, management of disease progression and management of the impact of the condition on the patient. The working group agreed that, to make best use of the available of diagnostic tools, clinical care recommendations and effective treatments, there is a clear need for healthcare professionals from different disciplines to collaborate in the management of PsA. By facilitating appropriate and rapid referral, providing high quality information about PsA and its treatment to patients, and actively involving patients when choosing management plans and setting treatment goals, management of PsA can be improved. The perspective of the working group is presented here, with recommendations for the adoption of a multidisciplinary, patient‐focused approach to the management of PsA.

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Section: Overcoming Barriers To the Early And Accurate Diagnosis Of Psamentioning

confidence: 99%

Section: Overcoming Barriers To the Early And Accurate Diagnosis Of Psamentioning

confidence: 99%

Promoting patient‐centred care in psoriatic arthritis: a multidisciplinary European perspective on improving the patient experience

Betteridge

Boehncke

Bundy

et al. 2015

Acad Dermatol Venereol

View full text Add to dashboard Cite

show abstract

“…Most have undergone validation, but until recently there has been little research directly comparing questionnaires with the aim of identifying one questionnaire that can be recommended for routine clinical use in the future. There have been 3 head-to-head comparisons that have shown conflicting results, but all have recognized problems in identifying PsA (2,7,8). In the CONTEST study, the questionnaires identified many cases who had musculoskeletal symptoms due to an alternative diagnosis, particularly osteoarthritis or degenerative disease, leading to poor specificity (7).…”

Section: Discussionmentioning

confidence: 99%

“…Data from 2 comparative independent head-to-head studies based in Dublin, Ireland and Utah were used to test the new proposed questionnaires (2,8). Both of these studies evaluated some patients with known PsA and some with psoriasis and no known diagnosis of inflammatory arthritis.…”

Section: Development Cohort (Contest)mentioning

confidence: 99%

Development and Testing of New Candidate Psoriatic Arthritis Screening Questionnaires Combining Optimal Questions From Existing Tools

Coates

Walsh

Haroon

et al. 2014

Arthritis Care & Research

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Objective. Several questionnaires have been developed to screen for psoriatic arthritis (PsA), but head-to-head studies have found limitations. This study aimed to develop new questionnaires encompassing the most discriminative questions from existing instruments. Methods. Data from the CONTEST study, a head-to-head comparison of 3 existing questionnaires, were used to identify items with a Youden index score of >0.1. These were combined using 4 approaches: CONTEST (simple additions of questions), CONTESTw (weighting using logistic regression), CONTESTjt (addition of a joint manikin), and CONTESTtree (additional questions identified by classification and regression tree [CART] analysis). These candidate questionnaires were tested in independent data sets. Results. Twelve individual questions with a Youden index score of >0.1 were identified, but 4 of these were excluded due to duplication and redundancy. Weighting for 2 of these questions was included in CONTESTw. Receiver operating characteristic (ROC) curve analysis showed that involvement in 6 joint areas on the manikin was predictive of PsA for inclusion in CONTESTjt. CART analysis identified a further 5 questions for inclusion in CONTESTtree. CONTESTtree was not significant on ROC curve analysis and discarded. The other 3 questionnaires were significant in all data sets, although CONTESTw was slightly inferior to the others in the validation data sets. Potential cut points for referral were also discussed. Conclusion. Of 4 candidate questionnaires combining existing discriminatory items to identify PsA in people with psoriasis, 3 were found to be significant on ROC curve analysis. Testing in independent data sets identified 2 questionnaires (CONTEST and CONTESTjt) that should be pursued for further prospective testing.

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“…По данным американских и евро-пейских исследователей [20,21], на долю больных ПсА приходится около 30% всех больных ПС. В бра-зильской популяции [22] ПсА отмечен у 33% паци-ентов с ПС.…”

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Clinical and anamnestic criteria of the progression of psoriasis

Смирнова¹,

Смольникова²,

Барило³

2016

Klin. dermatol. venerol.

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High prevalence of psoriatic arthritis in patients with severe psoriasis with suboptimal performance of screening questionnaires

Abstract: 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.

Cited by 271 publications

References 17 publications

Promoting patient‐centred care in psoriatic arthritis: a multidisciplinary European perspective on improving the patient experience

Promoting patient‐centred care in psoriatic arthritis: a multidisciplinary European perspective on improving the patient experience

Development and Testing of New Candidate Psoriatic Arthritis Screening Questionnaires Combining Optimal Questions From Existing Tools

Clinical and anamnestic criteria of the progression of psoriasis

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