Nomenclature Standardized for Psoriasis to PsA Continuum

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International experts in psoriatic disease agreed to 3 standardized terms and definitions to define patient subgroups during the transition from psoriasis to psoriatic arthritis (PsA).

The terminology—which was revealed during the American College of Rheumatology (ACR) annual meeting, Convergence 2020—will aid in the facilitation and harmonization of recruitment for future studies.

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“The concept of prevention of PsA has gained increased interest given the physical limitation and poor quality-of-life experienced by PsA patients coupled with low remission rates observed with the use of currently available therapies,” the researchers wrote. “The transition from psoriasis to PsA offers a unique window of opportunity to identify individuals at increased risk for PsA, to study and implement preventive strategies.”

The Delphi consensus study consisted of 3 rounds, in which experts from the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis and the Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network voted and ranked terms and definitions for patients with preclinical PsA. A total 29 experts participated in the first round, 33 in the second round, and 35 in the third round.

Experts achieved consensus on the following terms and definitions:

• Increased risk for PsA—any individual with psoriasis and 1 or more risk factor(s) for progression to PsA; 

• Psoriasis with asymptomatic synovio-entheseal imaging abnormalities—any individual with psoriasis and imaging evidence of synovio-entheseal abnormalities that is not associated with clinical signs or symptoms; and

• Psoriasis with musculoskeletal symptoms not explained by other diagnosis—any individual with psoriasis and heel pain, stiffness, and/or arthralgias not explained by other diagnoses.

“The adoption of standardized nomenclature and common definitions for research in this area should improve the communication of ideas in the field and help to enroll well-defined, homogenous cohorts of psoriasis patients, for comparison across future studies,” the researchers wrote. “These terms and definitions may evolve as increasing evidence regarding the molecular, clinical, and imaging features of the psoriasis to PsA continuum emerges.”

—Jolynn Tumolo

Reference:

Haberman R, Perez-Chada L, Chandran V, et al. A Delphi consensus study to standardize terminology for the pre-clinical phase of psoriatic arthritis. Study presented at: American College of Rheumatology Convergence 2020; November 5-9, 2020; Virtual. Accessed November 2, 2020. https://acrabstracts.org/abstract/a-delphi-consensus-study-to-standardize-terminology-for-the-pre-clinical-phase-of-psoriatic-arthritis/