Will It Progress to Arthritis?

TOPLINE: 

Primary care patients with predominantly mild psoriasis seldom develop psoriatic arthritis in the shorter term.

METHODOLOGY:

• Investigators analysed data from the TUDOR trial, conducted among UK primary care patients with psoriasis and aimed at earlier identification of psoriatic arthritis.
• Analyses were based on 511 patients who received enhanced surveillance.
• The main outcome was the annual incidence of psoriatic arthritis.

TAKEAWAY:

• At baseline, the patients had psoriasis for a mean of about 24 months, and 84.9% had mild disease.
• A total of 14 patients developed psoriatic arthritis by 12 months, for an incidence of 2.74 per 100 patient-years during the first year.
• Another seven patients developed psoriatic arthritis by 24 months, for an incidence of 1.58 per 100 patient-years during the second year.
• Overall, 21 (4.8%) of 438 patients with 24-month follow-up developed psoriatic arthritis, translating to an incidence of 2.20 per 100 patient-years.

IN PRACTICE:

“Studies have shown that delay in diagnosis of psoriatic arthritis is associated with adverse outcome, and a range of newer more effective therapeutic agents for psoriatic arthritis are now available. Hence, accurate estimates of the incidence of psoriatic arthritis in populations targeted for screening are highly desirable,” the authors wrote. “Extended follow-up of the TUDOR cohort with accrual of larger numbers of incident cases will allow risk factors for psoriatic arthritis to be explored in more depth,” they added.

SOURCE:

The study was led by Alex Rudge, MD, University of Bath, Bath, UK, and was published online in the Journal of Rheumatology.

LIMITATIONS:

Limitations included the fairly short follow-up, lack of power to explore risk factors, and uncertain generalisability to all patients managed in primary care.

DISCLOSURES:

The study was funded by the National Institute for Health and Care Research. The authors reported no conflicts of interest.