The early psoriatic arthritis screening questionnaire: a simple and fast method for the identification of arthritis in patients with psoriasis

Tinazzi, Ilaria; Adami, Silvano; Zanolin, Elisabetta; Caimmi, Cristian; Confente, Silvia; Girolomoni, Giampiero; Gisondi, Paolo; Biasi, Domenico; McGonagle, Dennis

doi:10.1093/rheumatology/kes187

Cited by 123 publications

(130 citation statements)

References 7 publications

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“…Скрининговые опросни-ки для использования как в дерматологической, так и в ревматологической клинической практике активно разрабатываются в последнее время за рубежом [8][9][10], од-нако в российской популяции у больных псориазом они пока не применялись.…”

Section: Osteoarticular Injury In Psoriatic Patients According To Theunclassified

Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis

2014

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Objectives(1) To investigate the demographic and clinical characteristics contributing to the delay from symptom onset to the first visit to a rheumatologist; (2) to compare clinical, radiographic and patient-reported outcome measures of those who saw a rheumatologist early in their disease course with those who were diagnosed later.MethodsAll psoriatic arthritis (PsA) patients, fulfilling CASPAR criteria, with an average disease duration of >10 years were invited for detailed clinical evaluation. The total lag time from symptom onset to their first rheumatological encounter was studied. The data were extracted from the referral letters and medical records. Patients were classified as early consulters or late consulters depending on whether they were seen by a rheumatologist within or beyond 6 months of symptom onset.Results283 PsA patients were studied. Median lag time from the disease onset to the first rheumatological assessment of the cohort was 1.00 years (IQR 0.5–2). 30% (n=86), 53% (n=149) and 71% (n=202) of the cohort were seen by a rheumatologist within 6 months, 1 and 2 years of symptom onset, respectively. PsA patients with low education status (OR 2.09, p=0.02) and Body Mass Index (OR 0.92, p=0.01) were significantly more likely to have a diagnostic delay of >2 years. On multiple stepwise regression analysis, the model predicted significant association of late consulters with the development of peripheral joint erosions (OR 4.25, p=0.001) and worse Health Assessment Questionnaire scores (OR 2.2, p=0.004).ConclusionsEven 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.

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Section: Osteoarticular Injury In Psoriatic Patients According To Theunclassified

Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis

2014

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“…Simple and validated screening tests, such as the Psoriatic Arthritis Screening and Evaluation (PASE) tool, the Psoriasis Epidemiology Screening Tool (PEST), the Toronto Psoriatic Arthritis Screen (ToPAS) and the Early ARthritis for Psoriatic patients (EARP) questionnaire, have been assessed to determine whether people with suspected PsA should be referred to confirm the diagnosis (Table 1). 16, 17, 18, 19 Despite such tools, the paucity of data from secondary care regarding their feasibility, sensitivity and specificity, along with the lack of consensus on which tool is best, hampers their widespread clinical use. In some cases the sensitivities and specificities of the tools have been found to be lower than originally reported; when the PASE, PEST and ToPAS questionnaires were compared in the CONTEST study, it was found that they would identify cases of musculoskeletal disease other than PsA, and there was little difference between the performance of the tools 20…”

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

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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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“…The ToPAS questionnaire has a broad setting including dermatologic evaluation which is unnecessary for an already dermatologically examined psoriatic patient. In this questionnaire, one third of the questions is about skin and nail symptoms of psoriasis 8 . This questionnaire has claimed its power in indicating PsA; in a prospective cross-sectional study by Reich et al…”

Section: Discussionmentioning

confidence: 99%

Evaluation of psoriasis patients with a rheumatologic questionnaire efficiently aids in early detection of psoriatic arthritis

Doğan¹,

Atakan²,

Yıldırım³

et al. 2017

TURKDERM

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ÖzAmaç: Psoriatik artrit (PsA), entezit ve/veya yumuşak doku şişliği tüm psoriazisli hastaların yaklaşık %6-30'unda birlikte görülmektedir. Geri dönüşü olmayan komplikasyonlar ile giden sakatlayıcı ciddi bir komorbidite olması nedeniyle PsA'nın erken tanısı önemlidir. Gereç ve Yöntem: Mart 2014-Mart 2015 tarihleri arasında Hacettepe Üniversitesi Tıp Fakültesi, Dermatoloji Anabilim Dalı'na başvuran öncesinde PsA tanısı olmayan plak psoriazisli hastalar çalışmaya dahil edildi. Demografik bilgiler, daha önce alınan tedaviler, laboratuvar parametreler ve muayene bulguları toplandı. Tüm hastalara aynı hekim tarafından eşlik edebilecek romatolojik şikayetler ile ilgili hazırlanmış beş sorudan oluşan romatolojik anket uygulandı. En az bir soruya pozitif yanıt veren hastalar aynı merkezin romatoloji bölümüne konsülte edilerek değerlendirildi. Bulgular: İki yüz yirmi üç hasta çalışmaya dahil edildi, %58'i (n=129) erkek ve %42'si (n=94) kadındı. Hastaların ortalama yaşı 43,46±14,31 yıldı. Ortalama Psoriazis Alan ve Şiddet İndeks skoru 12,66±9,89 idi. Ankette en sık saptanan şikayet istirahatte miyalji/artralji varlığı olarak hastaların %28'inde (n=62) saptandı. Hastalardan ankette en az bir pozitif yanıtı olan %30'u (n=69) romatoloji bölümüne konsülte edildi, bu hastaların %24'ü (n=53) romatoloji tarafından değerlendirildi. Bu hastaların %40'ında (n=21) PsA, %6'sında (n=3) sakroiliit, %4'ünde (n=2) ankilozan spondilit ve bir hastada tanımlanamayan bağ doku hastalığı olmak üzere hastaların %51'i (n=27) hasta romatolojik hastalık tanısı aldı Sonuç: Dermatoloji hekimlerinin PsA semptomlarından şüphelenme, bu belirtileri sorgulama ve muayene yetilerinin geliştirilmesi erken tanının sağlanabilmesi için önemlidir. Bu çalışmada psoriazisli hastalarda standart bir romatolojik anket uygulaması ile verimli biçimde PsA tanısının tahmin edilebileceği sonucuna varılmıştır. Anahtar Kelimeler: Psoriazis, psoriatik artrit, anket Background and Design: Psoriatic arthritis (PsA), enthesitis and/or soft tissue swelling accompany psoriasis in 6-30% of all psoriatic patients. Early recognition of PsA is crucial since it is a serious disabling comorbidity with irreversible complications. Materials and Methods: Patients, who were admitted to the outpatient clinic of Hacettepe University Faculty of Medicine Department of Dermatology between March 2014 and 2015 with plaque psoriasis lacking any prior PsA diagnosis, were enrolled for this study. Demographic data, previous treatment history, laboratory parameters and physical examination of the patients were collected. All patients were examined by the same physician with a rheumatologic questionnaire that consists of five questions about any accompanying rheumatologic complaints. All patients who had at least one positive answer were consulted with the department of rheumatology at the same center. Results: Two hundred and twenty-three patients were included, 58% (n=129) were male and 42% (n=94) were female. The mean age of the patients was 43.46±14.31 years. The mean Psoriasis Area and S...

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The early psoriatic arthritis screening questionnaire: a simple and fast method for the identification of arthritis in patients with psoriasis

Abstract: The EARP questionnaire is simple and fast to administer and proved robust for the identification of PsA in the dermatological setting. Dermatologists should consider the EARP for patients attending clinics, as it correlates well with early PsA diagnosis.

Cited by 123 publications

References 7 publications

Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis

Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis

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

Evaluation of psoriasis patients with a rheumatologic questionnaire efficiently aids in early detection of psoriatic arthritis

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