SpA Screening Tools Not Applicable to All Patients With Extramusculoskeletal Symptoms

Instruments used to screen for spondyloarthritis (SpA) in patients with psoriasis, uveitis, and inflammatory bowel disease (IBD) are varied and not generalizable to all patients with extramusculoskeletal manifestations at risk for SpA, according to a study published online ahead of print in Arthritis Care & Research.

“Future studies should explore the utility of a generic patient-oriented SpA screening tool that can be applied to patients with psoriasis, uveitis, or IBD, is easy to use and comprehend, and captures all clinical domains of SpA,” advised corresponding author Joerg Ermann, MD, of Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, and study coauthors.

The study was a scoping review of screening tools for undiagnosed SpA in patients with possible extramusculoskeletal manifestations seen in dermatology, ophthalmology, and gastroenterology settings.

Researchers identified 2 SpA screening tools in uveitis, 3 SpA screening tools in IBD, and 13 screening tools for psoriatic arthritis. Most questionnaires were patient-oriented, according to the study. The single exception was the Dublin Uveitis Evaluation Tool, a physician-applied algorithm.

The review found differences in length, scoring methods, and cut-off scores among the various screening tools. The spectrum of included SpA features, too, differed among the instruments.

On average, screening took less than 5 minutes for each.

“Across the three patient populations, the sensitivities and specificities of these screening tools were comparable in the primary validation cohorts,” researchers reported. “Sensitivities and specificities were generally lower in secondary validation studies, with marked variability between cohorts.”

Reference
Kesarwani V, Sinnappan S, Husni ME, Weisman MH, Ermann J. Screening tools for spondyloarthritis in patients with psoriasis, uveitis, and inflammatory bowel disease - a scoping review. Arthritis Care Res. Published online February 1, 2024. doi:10.1002/acr.25308