Tool Predicts Risk of Developing PsA Among Patients With Psoriasis

Readily available clinical information can predict with reasonable accuracy the 1- and 5-year risk of developing psoriatic arthritis (PsA) in patients with psoriasis, according to study results published online ahead of print in Arthritis & Rheumatology. 

To improve early diagnosis, researchers developed the Psoriatic Arthritis Risk Estimation Tool, or PRESTO, using data for 635 patients with psoriasis but without PsA at baseline. The prospective cohort underwent annual rheumatologist assessments for the development of PsA over 5 years. Researchers used information on patient demographics, psoriasis characteristics, comorbidities, medications, and musculoskeletal symptoms to develop prediction models for the development of PsA at 1 and 5 years.

Among the 635 patients with psoriasis in the cohort, 51 developed PsA at the 1-year follow-up, and 71 developed PsA at the 5-year follow-up.

Developing PsA within 1 year was associated with younger age, male sex, family history of psoriasis, back stiffness, nail pitting, joint stiffness, use of biologic medications, worse global health, and pain severity, according to the study. The 1-year risk prediction model using these elements showed an area under the curve of 72.3.

Patients who developed PsA within 5 years showed more morning stiffness, psoriatic nail lesions, psoriasis severity, fatigue, pain, and use of systemic nonbiologic medication or phototherapy, the study found. The 5-year risk prediction model using these elements showed an area under the curve of 74.9.

The PRESTO tool is available online.

Reference

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