A modified sharp score demonstrates disease progression in established psoriatic arthritis

Stopping or preventing structural progression is a goal common to all inflammatory rheumatic diseases. Imaging may capture structural progression across diseases, but is susceptible to measurement error. Progression can be analysed as a continuous change score over time (eg, mean change of the van der Heijde-modified Sharp score) or as a binary change score (eg, percentage of progressors according to the modified New York criteria). Here, we argue that the former takes measurement error into account while the latter ignores it, which may lead to spurious conclusions. We will argue that assumptions underlying commonly used binary definitions of progression are false and we propose a method that incorporates (inevitable) measurement error.

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The role of hla antigens as indicators of disease progression in psoriatic arthritis

Arthritis & Rheumatism ◽

10.1002/art.1780380619 ◽

1995 ◽

Vol 38 (6) ◽

pp. 845-850 ◽

Cited By ~ 75

Author(s):

Dafna D. Gladman ◽

Vernon T. Farewell

Keyword(s):

Psoriatic Arthritis ◽

Disease Progression ◽

Hla Antigens

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The Relationship between HLA-B27, HLA-Cw06, HLA-DR7 and Psoriatic Arthritis in Vietnamese Patients: Disease Progression and Therapeutic Burden

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.064 ◽

2019 ◽

Vol 7 (2) ◽

pp. 300-301

Author(s):

Vinh Ngo Minh ◽

Van Bui Thi ◽

Tro Chau Van ◽

Trai Nguyen Ngoc ◽

Anh Tran Ngoc ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Disease Progression ◽

Plaque Psoriasis ◽

Cross Sectional Study ◽

Ho Chi Minh City ◽

City Hospital ◽

Hla B27 ◽

Cross Sectional ◽

Severe Arthritis ◽

The Relationship

We conducted a prospective, cross-sectional study at Ho Chi Minh City Hospital of Dermato Venereology from January 2016 to March 2017 in 40 psoriatic arthritis (PsA) patients to evaluate the disease progression and therapeutic burden about the HLA patterns. Based upon our results, PsA with HLA-B27 (+) had a threat of severe arthritis. PsA with HLA-Cw06 (+) had a higher risk of earlier onset and shorter duration for plaque psoriasis to transform into PsA. HLA-DR7 (+) in PsA delayed the time for conversion from plaque psoriasis into PsA. These findings are quite similar to other studies in the literature.

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THE CASE OF PSORIATIC ERYTHRODERMA AND SEVERE COMORBID PSORIATIC ARTHRITIS

Russian Journal of Skin and Venereal Diseases ◽

10.17816/dv42931 ◽

2019 ◽

Vol 22 (1-2) ◽

pp. 15-23

Author(s):

O. Yu Olisova ◽

N. G Kochergin ◽

T. A Belousova ◽

Victoria O. Nikuradze ◽

V. V Gudova

Keyword(s):

Psoriatic Arthritis ◽

Early Diagnosis ◽

Disease Progression ◽

Systemic Therapy ◽

Biological Agents ◽

Severe Psoriasis ◽

Early Initiation ◽

Main Role ◽

Treatment And Prevention ◽

Timely Treatment

Early diagnosis of psoriatic arthritis (PsA) is necessary for timely treatment and prevention of the disease progression with destruction of the joints. In most patients, comorbid PsA develops many years after the debut of the skin process. Consequently, the main role in timely diagnosis of PsA is played by a dermatologist, who is able to identify its initial signs and refer the patient to a rheumatologist. Early initiation of systemic therapy with the use of modern biological agents for progressive psoriatic arthritis and severe psoriasis can prevent the development of irreversible disability.

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PP36 Early Diagnosis And Treatment Of Psoriatic Arthritis

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462318002027 ◽

2018 ◽

Vol 34 (S1) ◽

pp. 79-80

Author(s):

Nicolas Iragorri ◽

Eldon Spackman

Keyword(s):

Psoriatic Arthritis ◽

Cost Effectiveness ◽

Disease Progression ◽

Biologic Therapy ◽

Cost Effective ◽

Screening Tools ◽

Test Accuracy ◽

Life Years ◽

Cost Effectiveness Threshold ◽

Effectiveness Threshold

Introduction:Screening for psoriatic arthritis (PsA) is expected to identify patients at earlier stages of the disease. Early treatment is expected to slow disease progression and delay the need for biologic therapy. This study estimated the cost-effectiveness of screening tools for PsA in Canada.Methods:A Markov model was built to estimate the associated costs and quality-adjusted life-years (QALYs) of screening tools for PsA in patients using topical treatment for psoriasis. The screening tools included: the Toronto Psoriatic Arthritis Screening (ToPAS) questionnaire; the Psoriasis Epidemiology Screening Tool (PEST); the Psoriatic Arthritis Screening and Evaluation (PASE) questionnaire; and the Early ARthritis for Psoriatic patients (EARP) questionnaire. Health states were defined by disability levels, as measured by the Health Assessment Questionnaire (HAQ), and state transition was modeled according to annual disease progression. Screening was assumed to be effective during a 2-year sojourn period. Incremental cost-effectiveness ratios (ICERs) were estimated based on health-state specific costs and utilities. A probabilistic analysis was undertaken to account for parameter uncertainty. All results were compared with the commonly cited cost-effectiveness threshold of CAD 50,000 (USD 37, 600) per additional QALY.Results:Screening with the ToPAS questionnaire resulted in cost savings compared with no screening or the EARP questionnaire, with a total cost of CAD 30,706 (USD 23,090) and 17.29 QALYs. The PEST dominated the PASE questionnaire and was more costly and more effective than the ToPAS questionnaire, with an ICER of CAD 312,398 (USD 234,909). The results were most sensitive to test sensitivity and specificity, HAQ progression, and average HAQ score at diagnosis and the start of biologic therapy. A scenario analysis tested screening efficacy for a 1-year period before diagnosis, with the ToPAS questionnaire remaining the most cost-effective option.Conclusions:Screening was cost-effective compared with no screening at the commonly used cost-effectiveness threshold of CAD 50,000 (USD 37, 600). Value of information analyses will be useful for determining the need to collect further information around test accuracy parameters.

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AB0134 RELATIONSHIP BETWEEN INFLAMMATORY RATIOS AND RADIOGRAPHIC JOINT DAMAGE IN RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2879 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1095.2-1095

Author(s):

F. Maatoug ◽

M. Slouma ◽

R. Dhahri ◽

O. Beskri ◽

I. Gharsallah ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Structural Damage ◽

Joint Space Narrowing ◽

Joint Damage ◽

Joint Space ◽

Albumin Ratio ◽

Sharp Score ◽

The Mean ◽

Modified Sharp Score ◽

Joint Erosion

Background:The tight control strategy is recommended in rheumatoid arthritis to tailor treatment for patients. This strategy requires regular monitoring of both disease activity and structural damage. However, radiographic assessement cannot be performed frequently and the modified Sharp score is rarely evaluated in current practice. Besides, no biomarker was able to mirror structural damage (1).Objectives:Our study aimed to assess the relationship between the modified Sharp score and the inflammatory ratios (platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), fibrinogen to albumin ratio (FAR) and CRP to albumin ratio (CAR)).Methods:We performed a cross-sectional study including 53 patients with rheumatoid arthritis (RA). A cell blood count, fibrinogen and an albumin blood test were measured for each patient. Inflammatory ratios were also measured (PLR, NLR, LMR, FAR, and CAR). Modified Sharp score and its components (erosion score and joint space narrowing score) were evaluated using the radiograph of hand and foot.Patients with infectious or hematological diseases were excluded from the study.Statistical analysis was performed using SPSS (Statistical Package for Social Sciences).Results:Of the 53 patients, 39 were female (Sex Ratio: 2.8). The mean age was 53.9 ± 12.7 years. The mean disease duration was 10.1 ± 8.2 years.The average age of the onset of the disease was 43.8±13.5 years.The mean DAS 28-ESR score was 4.64 ± 1.23. Forty three patients had a score higher than 3.2 (patients with moderate or high disease activity).The mean values of PLR, NLR, LMR, FAR and CAR were 161.62 ± 86.59, 2.84 ± 2.39, 4.99 ± 3.23, 0.12 ± 0.06 and 1.15 ± 1.38.The mean scores of joint erosion and joint space narrowing were respectively 12.76 ± 15.05 and 33.57 ± 25.80. The mean modified Sharp score was 46.33 ± 37.74.There was a positive correlation between modified Sharp score and following ratios: PLR (r: 0.501; p <10-3), NLR (r: 0.302; p:0.031), FAR (r: 0.300; p:0.030), CAR (r:0.286; p:0.042).Moreover, a positive correlation between joint space narrowing score and these ratios was identified: PLR (r: 0.558; p <10-3), NLR (r: 0.428; p:0.002), FAR (r: 0.371; p:0.007), CAR (r:0.387; p:0.005).Joint erosion score correlated with PLR (r: 0.299; p:0.033).No correlation was found between LMR and radiographic score.Conclusion:Our study showed that the modified Sharp score correlated with PLR, NLR, FAR and CAR in patients with RA. This finding suggests that these ratios could be used as inexpensive and reliable markers to reflect radiographic joint damage.Longitudinal studies are necessary to confirm our results.References:[1]Syversen SW, Landewe R, Van Der Heijde D, Bathon JM, Boers M, Bykerk VP, et al. Testing of the OMERACT 8 draft validation criteria for a soluble biomarker reflecting structural damage in rheumatoid arthritis: a systematic literature search on 5 candidate biomarkers. J Rheumatol. 2009;36(8):1769-84.Disclosure of Interests:None declared

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Repair of Radiographic Joint Damage Following Treatment with Etanercept in Psoriatic Arthritis Is Demonstrable by 3 Radiographic Methods

The Journal of Rheumatology ◽

10.3899/jrheum.100919 ◽

2011 ◽

Vol 38 (6) ◽

pp. 1066-1070 ◽

Cited By ~ 16

Author(s):

LIHI EDER ◽

VINOD CHANDRAN ◽

DAFNA D. GLADMAN

Keyword(s):

Psoriatic Arthritis ◽

Scoring System ◽

Joint Space Narrowing ◽

Joint Damage ◽

Joint Space ◽

Radiographic Assessment ◽

Radiographic Damage ◽

Erosion Score ◽

Sharp Score ◽

Hands And Feet

Objective.Psoriatic arthritis (PsA) is characterized by varied radiographic features. We describe a patient with PsA with severe radiographic damage that improved significantly following treatment with etanercept. The improvement was documented by several methods of radiographic assessment.Methods.Etanercept was introduced in September 2005. Radiographs of the hands and feet were read using 3 methods: the modified Steinbrocker method, the van der Heijde (vdH) modification of the Sharp method, and the Ratingen scoring system.Results.In July 2009, radiographs of the hands and feet showed improvement in erosion score and joint space narrowing, while bony proliferation remained the same [43 by modified Steinbrocker, 26 by the vdH Sharp score (12 for erosions and 14 for joint space narrowing), and 56 by the Ratingen (18 for erosion and 38 for proliferation].Conclusion.The 3 radiographic methods were useful in demonstrating improvement in joint scores. The modified Steinbrocker method, which is the simplest, was able to reveal improvement in our patient.

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