Early Detection Tool for Psoriatic Arthritis in Psoriasis Patients

Psoriatic arthritis (PsA), an inflammatory musculoskeletal condition that affects around one-third of individuals with psoriasis, often requires early diagnosis and treatment to mitigate the severity of PsA-related complications. In most cases, PsA emerges after a psoriasis diagnosis, making psoriasis patients a high-risk group for PsA, according to a study published in Arthritis & Rheumatology. However, researchers believe there needs to be an effective prediction tool for identifying high-risk psoriasis patients. Developing a simple, scalable tool for early PsA risk detection is imperative to enable timely interventions to halt the progression from psoriasis to PsA.

A study involving 635 psoriasis patients revealed that 51 developed PsA within one year and 71 within five years. Various risk factors were associated with the development of PsA, including age, gender, family history of psoriasis, specific symptoms like back stiffness, nail pitting, and medication use. The study followed the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) framework in its methodology and reporting.

This longitudinal cohort study aims to understand risk factors for PsA development among psoriasis patients using PRESTO. "PRESTO estimates PsA risk within shorter and longer time horizons using easily collected information including many variables that were previously reported as risk factors for PsA," said researchers. All patients in the cohort have a confirmed psoriasis diagnosis and received an assessment by a rheumatologist to exclude those with prior or concurrent inflammatory arthritis. Annual assessments track patients' health status, lifestyle, musculoskeletal symptoms, and family history.

Seven hundred-two psoriasis patients without clinical evidence of musculoskeletal inflammatory diseases were followed from 2006 to 2019. From the 635 included in the analysis, 51 and 71 developed PsA within 1 and 5 years, respectively. Notably, several risk factors previously associated with PsA were included in the risk prediction model, making it a valuable tool for early detection and intervention among psoriasis patients.

The model demonstrates good performance, which can be adjusted based on its intended use, such as screening or targeting high-risk individuals for intervention. This tool can potentially prevent the progression from psoriasis to PsA by facilitating early diagnosis and interventions.

"PRESTO has good model performance and can provide estimated risk of developing PsA within shorter and longer time periods that are relevant for both clinical and research purposes," said researchers.

Reference

Eder L, Lee KA, Chandran V, et al. Derivation of a multivariable psoriatic arthritis risk estimation tool (PRESTO): a step towards prevention. Arthritis & Rheumatology. Published online August 9, 2023. Accessed October 24, 2023. doi:10.1002/art.42661