Identifying Progression of Psoriasis to Psoriatic Arthritis

The European Alliance of Associations for Rheumatology, formerly the European League Against Rheumatism (EULAR) recently released a new “points to consider” document to help clinicians identify people most likely to develop psoriatic arthritis (PsA).

A multidisciplinary task force of 30 members—which included rheumatologists, dermatologists, methodologists, and patient research partners—from 13 European countries developed the new points to consider to include patients who show “persistent pain and imaging abnormalities in the joints” to be at a heightened risk of progressing from psoriasis (PsO) to early PsA. The final paper was published in the Annals of the Rheumatic Diseases.

The document includes 5 overarching principles and 10 points to consider. They are in addition to traditional risk factors for progression, such as family history, obesity, very extensive psoriatic lesions, and nail involvement.

The key elements—arthralgia and abnormalities seen on ultrasound or magnetic resonance imaging—can be used to predict which patients may go on to develop PsA later in life. Using this information, researchers hope to design better and more effective clinical trials to intercept and possibly, prevent early PsA.

Patients with PsO may progress to PsA at different times, and in some cases, may not at all. These overarching principles “address the nature of PsA at its onset and underline the importance of collaboration of rheumatologists and dermatologists for strategies for prevention and interception of PsA,” the researchers concluded.

Reference:
Zabotti A, De Marco G, Gossec L, et al. EULAR points to consider for the definition of clinical and imaging features suspicious for progression from psoriasis to psoriatic arthritis. Ann Rheum Dis. Published online June 9, 2023. doi:10.1136/ard-2023-224148