Increased Suspicion Needed for Diagnosis of Psoriatic Disease

While rheumatologists, dermatologists, and general practitioners diagnose two-thirds of patients with psoriatic arthritis (PsA), increased awareness of health events and disease patterns is necessary to improve diagnosis.

In a retrospective cohort study, researchers analyzed MarketScan clains data from January 2006 to April 2019 to assess real-world PsA diagnosis. Data were included if patients were adulst with 2 or more PsA diagnoses at least 30 days apart with at least 6 years of continuous enrollment before PsA diagnosis. Various health events, included diagnoses and provider type, were analyzed and stratified by the presence of psoriasis.

Analysis included more than 13,000 patients. Patients with PsA had increased history of coding for osteoarthritis, rheumatoid arthritis, and psoriasis vs patients without PsA. Further, diagnoses of known PsA risk factors such as arthritis, axial symptoms, tendonitis/enthesitis, and psoriasis increased before PsA diagnosis.

Patients were often referred for a rheumatology consult before PsA diagnosis. Rheumatologists, general practitioners, and dermatologists were most likely to make a PsA diagnosis than other specialties.

Based on these results, the authors concluded that “greater awareness of patterns of health events may alert providers to suspect a diagnosis of PsA.”

Reference
Ogdie A, Rozycki M, Arndt T, Shi C, Kim N, Hur P. Longitudinal analysis of the patient pathways to diagnosis of psoriatic arthritis. Arthritis Res Ther. Published online October 1, 2021. doi:10.1186/s13075-021-02628-2