SAT0406 Low Level of Erosive Change is Found in Early Psoriatic Arthritis:

Abstract Objective To systematically review the accuracy and characteristics of different questionnaire-based PsA screening tools. Methods A systematic review of MEDLINE, Excerpta Medical Database, Cochrane Central Register of Controlled Trials and Web of Science was conducted to identify studies that evaluated the accuracy of self-administered PsA screening tools for patients with psoriasis. A bivariate meta-analysis was used to pool screening tool-specific accuracy estimates (sensitivity and specificity). Heterogeneity of the diagnostic odds ratio was evaluated through meta-regression. All full-text records were assessed for risk of bias with the QUADAS 2 tool. Results A total of 2280 references were identified and 130 records were assessed for full-text review, of which 42 were included for synthesis. Of these, 27 were included in quantitative syntheses. Of the records, 37% had an overall low risk of bias. Fourteen different screening tools and 104 separate accuracy estimates were identified. Pooled sensitivity and specificity estimates were calculated for the Psoriatic Arthritis Screening and Evaluation (cut-off = 44), Psoriatic Arthritis Screening and Evaluation (47), Toronto Psoriatic Arthritis Screening (8), Psoriasis Epidemiology Screening Tool (3) and Early Psoriatic Arthritis Screening Questionnaire (3). The Early Psoriatic Arthritis Screening Questionnaire reported the highest sensitivity and specificity (0.85 each). The I2 for the diagnostic odds ratios varied between 76 and 90.1%. Meta-regressions were conducted, in which the age, risk of bias for patient selection and the screening tool accounted for some of the observed heterogeneity. Conclusions Questionnaire-based tools have moderate accuracy to identify PsA among psoriasis patients. The Early Psoriatic Arthritis Screening Questionnaire appears to have slightly better accuracy compared with the Toronto Psoriatic Arthritis Screening, Psoriasis Epidemiology Screening Tool and Psoriatic Arthritis Screening and Evaluation. An economic evaluation could model the uncertainty and estimate the cost-effectiveness of PsA screening programs that use different tools.

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AB1267 Clinical and ultrasound examinatoin of enthesis in early psoriatic arthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2012-eular.1263 ◽

2013 ◽

Vol 71 (Suppl 3) ◽

pp. 710.5-710

Author(s):

I. Troshkina ◽

V. Badokin ◽

R. Osipyants

Keyword(s):

Psoriatic Arthritis ◽

Early Psoriatic Arthritis

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Achieving sustained minimal disease activity with methotrexate in early interleukin 23-driven early psoriatic arthritis

RMD Open ◽

10.1136/rmdopen-2020-001175 ◽

2020 ◽

Vol 6 (2) ◽

pp. e001175

Author(s):

Hannah den Braanker ◽

Kim Wervers ◽

Adriana M C Mus ◽

Priyanka S Bangoer ◽

Nadine Davelaar ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Disease Activity ◽

Usual Care ◽

Treat To Target ◽

Minimal Disease Activity ◽

Cytokine Profiles ◽

First Line Therapy ◽

Minimal Disease ◽

Interleukin 23 ◽

Early Psoriatic Arthritis

ObjectivesMethotrexate (MTX) is currently the recommended first-line therapy for treating psoriatic arthritis (PsA), despite lacking clear evidence. No estimates of efficacy of MTX in usual care and no clear MTX responsive clinical or laboratory variables are currently available. This study describes the response to MTX monotherapy in newly diagnosed patients with PsA in usual care. Second, we compared clinical variables and cytokine profiles in patients responding and not responding to MTX monotherapy.MethodsWe used data collected in the Dutch southwest Early Psoriatic Arthritis cohoRt study to select patients with PsA with oligoarthritis or polyarthritis, and at least 1 year follow-up. We analysed disease activity at 6 months of patients who started MTX monotherapy and still used MTX monotherapy 1 year after diagnosis. Cytokine profiles were determined at baseline and after 3 and 6 months with a bead-based multi-immunoassay.ResultsWe identified 219 patients of which 183 (84%) patients started MTX monotherapy within 6 months after diagnosis. 90 patients used MTX monotherapy throughout the first year of which 44 patients (24%) reached minimal disease activity(MDA) at 6 months, decreasing to 33 patients (18%) after 1 year. Non-responders had significantly higher concentrations of interleukin (IL) 23 and IL-10 before and during MTX therapy.ConclusionsOur results showed that only 18% of patients with PsA are in sustained MDA after 1 year of MTX monotherapy and non-responders more often had IL-23-driven disease. Our results indicate the need for more treat-to-target and personalised therapy strategies in PsA.

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Long-term follow-up of patients in the TIght COntrol of inflammation in early Psoriatic Arthritis (TICOPA) trial

Rheumatology ◽

10.1093/rheumatology/kez369 ◽

2019 ◽

Vol 59 (4) ◽

pp. 807-810 ◽

Cited By ~ 1

Author(s):

Laura C Coates ◽

Farrouq Mahmood ◽

Jane Freeston ◽

Paul Emery ◽

Philip G Conaghan ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Drug Use ◽

Disease Activity ◽

Clinical Outcomes ◽

Therapeutic Drug ◽

Tight Control ◽

Low Disease Activity ◽

Clinical Advantage ◽

Early Psoriatic Arthritis

Abstract Objectives The TIght COntrol of inflammation in early Psoriatic Arthritis (TICOPA) study was the first strategy trial in psoriatic arthritis using an early treat-to-target strategy to improve clinical outcomes. The current study aimed to review a cohort of patients who had completed TICOPA to judge if the clinical advantage gained by participants in the tight control (TC) arm was sustained, and to explore subsequent therapy. Methods A case note review was conducted for a cohort of patients who had participated in TICOPA. Current drug use and clinical status were obtained, with low disease activity judged as no tender or swollen joints, no dactylitis and enthesitis, and no change in treatment required. Results Approximately five years after completion of the TICOPA study, notes were reviewed for 110 patients [TC, n = 54; standard care (StdC), n = 56]. Disease activity was found to be similar in both groups (current low disease activity: TC 69%, StdC 76%). Biologic use at the end of the study was higher in the TC arm (TC 33%, StdC 9%), but at review a similar percentage in both groups were taking biologic drugs (TC 54%, StdC 52%), whereas MTX use diminished. Conclusion After several years, clinical outcomes and therapeutic drug use were similarly good for patients in both arms of the TICOPA study, with no obvious clinical advantage after TC ended. Notably, TC did not result in greater biological use long term, and MTX use decreased in both arms of the study.

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The TICOPA protocol (TIght COntrol of Psoriatic Arthritis): a randomised controlled trial to compare intensive management versus standard care in early psoriatic arthritis

BMC Musculoskeletal Disorders ◽

10.1186/1471-2474-14-101 ◽

2013 ◽

Vol 14 (1) ◽

Cited By ~ 71

Author(s):

Laura C Coates ◽

Nuria Navarro-Coy ◽

Sarah R Brown ◽

Sarah Brown ◽

Lucy McParland ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Randomised Controlled Trial ◽

Standard Care ◽

Controlled Trial ◽

Intensive Management ◽

Tight Control ◽

Randomised Controlled ◽

Early Psoriatic Arthritis

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The Self-Administered Psoriasis and Arthritis Screening Questionnaire (PASQ): A Sensitive and Specific Tool for the Diagnosis of Early and Established Psoriatic Arthritis

Psoriasis Forum ◽

10.1177/247553031016a00202 ◽

2010 ◽

Vol 16a (2) ◽

pp. 9-16 ◽

Cited By ~ 10

Author(s):

Majed Khraishi ◽

Ian Landells ◽

Gerry Mugford

Keyword(s):

Psoriatic Arthritis ◽

Joint Damage ◽

Screening Questionnaire ◽

Optimal Score ◽

Short Disease Duration ◽

Established Disease ◽

History Of ◽

Optimal Cutoff Point ◽

Disease Analysis ◽

Early Psoriatic Arthritis

Background Psoriatic arthritis is a serious chronic inflammatory arthritis that can lead to significant joint damage and often is associated with comorbidities. Early detection and effective management of psoriatic arthritis may prevent the development of such complications. Most patients develop psoriatic arthritis years after onset of psoriasis, and most patients with psoriasis alone are managed by dermatologists or general practitioners. These clinicians are thus in an excellent position to screen for psoriatic arthritis early in the disease course. Objective The objective of this study was to evaluate the sensitivity and specificity of the Psoriasis and Arthritis Screening Questionnaire (PASQ) in detecting patients with psoriatic arthritis. Methods Two groups of patients were screened: patients with established disease and patients referred for evaluation of possible (i.e., early) psoriatic arthritis. Results In patients with established disease, analysis of the PASQ score yielded an optimal cutoff point of 9 with 86.27% sensitivity and 88.89% specificity. In patients with early disease, the PASQ indicated an optimal score of 7 with 92.86% sensitivity and 75% specificity. Conclusion The PASQ is an effective screening tool in psoriatic arthritis patients with a long history of disease as well as in those with short disease duration.

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