Materiały źródłowe

• #1 Psoriatic arthritis prognosis: Life expectancy and more

  https://www.medicalnewstoday.com/articles/316832

  Psoriatic arthritis can have a significant effect on a persons life. However, timely and appropriate treatment can help reduce its impact. […] How PsA progresses will depend on various factors, including the type of PsA, its stage at diagnosis, the treatment a person receives, and how they respond to it. […] An effective treatment plan can often prevent progressive damage and help manage symptoms. […] In the early stages, however, it can be difficult to predict the course of the disease. […] Early diagnosis and treatment can help a person manage symptoms of psoriasis and PsA and reduce the risk of flares and future complications. […] PsA does not usually affect life expectancy, but a person with PsA may have a higher risk of other conditions, such as cardiovascular disease. […] For a person with PsA, early diagnosis and treatment are key to staying mobile and continuing to enjoy a good quality of life. […] As scientists develop new treatment options, the outlook for people with PsA is improving.

• #2 Psoriatic arthritis – Wikipedia

  https://en.wikipedia.org/wiki/Psoriatic_arthritis

  The condition can be disabling, severely decreasing physical health. People with PsA may have reduced ability to work. Psychological health may also be decreased as a result of chronic pain, anxiety, depression, and reduced self-esteem. As a result, quality of life may also be significantly reduced. Some of the possible comorbidities (conditions which may occur together with PsA) may reduce life span. […] Studies have found that obesity is a significant risk factor and predictor of disease outcome. Other risk factors associated with an increased risk of developing psoriatic arthritis include severe psoriasis, nail psoriasis, scalp psoriasis, inverse psoriasis, and having a first-degree relative with psoriatic arthritis. […] Psoriatic arthritis tends to appear about 10 years after the first signs of psoriasis. For the majority of people, this is between the ages of 30 and 55, but the disease can also affect children. The onset of psoriatic arthritis symptoms before symptoms of skin psoriasis is more common in children than adults.

• #3 Window of opportunity in psoriatic arthritis: the earlier the better?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10900390/

  In PsA, referral and diagnosis within 1 year is associated with better clinical outcomes, suggesting the presence of a window of opportunity. […] Patients with a short delay were more likely to achieve MDA (OR 2.55, p=0.003) and DAPSA remission (OR 2.35,p=0.004) compared with PsA patients with a long delay. […] This study shows the negative effect of a longer diagnostic delay on clinical outcomes as well as PROs in PsA patients. […] A shorter time to PsA diagnosis is associated with a greater likelihood of achieving MDA and DAPSA remission over time, suggesting the presence of a window of opportunity in PsA.

• #4 Window of opportunity in psoriatic arthritis: the earlier the better? | RMD Open

  https://rmdopen.bmj.com/content/10/1/e004062

  Patients with a short delay were more likely to achieve MDA (OR 2.55, p=0.003) and DAPSA remission (OR 2.35,p=0.004) compared with PsA patients with a long delay. […] In PsA, referral and diagnosis within 1 year is associated with better clinical outcomes, suggesting the presence of a window of opportunity. […] Patients with a diagnostic delay of 1 year are more likely to achieve Disease Activity index for PSoriatic Arthritis remission and Minimal Disease Activity compared with those with a delay of 1 year. […] This study shows the negative effect of a longer diagnostic delay on clinical outcomes as well as PROs in PsA patients. […] A shorter time to PsA diagnosis is associated with a greater likelihood of achieving MDA and DAPSA remission over time, suggesting the presence of a window of opportunity in PsA.

• #5 Window of opportunity in psoriatic arthritis: the earlier the better? | RMD Open

  https://rmdopen.bmj.com/content/10/1/e004062

  Patients with a short delay were more likely to achieve MDA (OR 2.55, p=0.003) and DAPSA remission (OR 2.35,p=0.004) compared with PsA patients with a long delay. […] In PsA, referral and diagnosis within 1 year is associated with better clinical outcomes, suggesting the presence of a window of opportunity. […] Patients with a diagnostic delay of 1 year are more likely to achieve Disease Activity index for PSoriatic Arthritis remission and Minimal Disease Activity compared with those with a delay of 1 year. […] This study shows the negative effect of a longer diagnostic delay on clinical outcomes as well as PROs in PsA patients. […] A shorter time to PsA diagnosis is associated with a greater likelihood of achieving MDA and DAPSA remission over time, suggesting the presence of a window of opportunity in PsA.

• #6 Psoriatic Arthritis – Diagnosis, Treatment, Prognosis and Clinical Manifestations

  https://www.hopkinsarthritis.org/arthritis-info/psoriatic-arthritis/

  Left untreated, it can lead to joint and tendon damage causing decreased function and disability. The goal of treatment is to prevent decreased function, deformities and disability. […] But, studies show that people who develop psoriatic arthritis and have access to rheumatologic treatment within six months, are the people who develop less damage and disability.

• #7 Severe Disease in Patients With Recent-Onset Psoriatic Arthritis. Prediction Model Based on Machine Learning – Dipòsit Digital de Documents de la UAB

  https://ddd.uab.cat/record/286342

  To identify patient- and disease-related characteristics that make it possible to predict higher disease severity in recent-onset PsA. […] Severe disease was defined at each visit as fulfillment of at least 1 of the following criteria: need for systemic treatment, Health Assessment Questionnaire (HAQ) 0.5, polyarthritis. […] The variables predicting severe disease were patient global pain, treatment with synthetic DMARDs, clinical form at diagnosis, high CRP, arterial hypertension, and psoriasis affecting the gluteal cleft and/or perianal area. […] Our prediction model of severe disease advocates rigorous control of pain and inflammation, also addressing cardiometabolic comorbidities, in addition to actively searching for hidden psoriasis.

• #8 Moderate-High Disease Activity in Patients with Recent-Onset Psoriatic Arthritis—Multivariable Prediction Model Based on Machine Learning

  https://www.mdpi.com/2077-0383/12/3/931

  Psoriatic arthritis (PsA) is a chronic inflammatory disease included in the group of spondyloarthritis, although the multifaceted nature of this entity has led it to be addressed in a differentiated and specific manner. According to recent data, the prevalence of PsA in adults is approximately 0.6%, thus making this disease one of the most common in rheumatology clinics. […] Traditional recommendations by EULAR on the management of PsA state the factors indicative of a poor prognosis to be female sex, elevated acute phase reactant values, dactylitis, early structural damage, and a high number of joints involved. Nevertheless, it is difficult to discern whether these and other factors reported in the literature refer more to disease activity itself (inflammatory burden), cumulative damage (functional burden), or the overall impact of the disease, which brings together the previous factors. Indeed, the concept of severity should not be made homonymous with that of inflammatory load. The severity of the disease brings together not only the inflammatory load of the disease but also physical disability, structural damage, and the impact on quality of life, among others. The factor that perhaps weighs the most in this equation, especially at the beginning of the disease, is inflammatory activity, but with the passage of time, this loses its predictive capacity, and there are other aspects (structural damage, comorbidities, deterioration in physical function, etc.) more clearly associated with greater severity.

• #9 In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective Analysis

  https://www.mdpi.com/2077-0383/10/13/2834

  With the availability of effective treatment with targeted synthetic and biologic disease-modifying anti-rheumatic drugs (ts/bDMARDs) for psoriatic arthritis (PsA), it is crucial to identify predictors of access to this treatment since disease onset. […] In univariate analyses, C-reactive protein (RR, 95% CI 1.204 (1.065,1.362)), Visual Analogue Scale (VAS) pain (1.027 (1.005,1.048)), the number of tender joints on 28 joints (1.087 (1.025, 1.153)), and a synovial power Doppler (PD) score > 1 (3.63 (1.307, 10.08)) emerged as significant predictors. C-reactive protein, VAS pain and PD confirmed their predictive value also in multivariate models. […] The purpose of this study is therefore to describe and characterize a population of early peripheral PsA in the context of an Early Arthritis Clinic. In addition, we tried to identify baseline predictors of treatment with ts/bDMARDs within 2 years from diagnosis.

• #10 In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective Analysis

  https://www.mdpi.com/2077-0383/10/13/2834

  In our population, 32 patients required treatment intensification, consistently with previous reports, with the indication for ts/bDMARDs. Among baseline demographic and clinical features, in line with previous studies, CRP, both as continuous variable and with the cut-off of 0.6 mg/dl, resulted in a significant prediction of second line treatment. […] Our study provides one of the few available characterizations of early peripheral PsA, suggesting that organizational models, such as early arthritis clinics, might also have a positive impact on the management of PsA. Higher baseline pain, CRP and the presence of ultrasound-detected synovitis might help identify those patients for whom a more intensive monitoring and treatment escalation could be useful.

• #11 Moderate-High Disease Activity in Patients with Recent-Onset Psoriatic Arthritis—Multivariable Prediction Model Based on Machine Learning

  https://www.mdpi.com/2077-0383/12/3/931

  We detected an inverse relationship between physical activity and higher disease activity, according to DAPSA. It is known that a session of moderate physical exercise lasting 20 to 30 min can reduce the number of TNFα-releasing immune cells by 5%. Furthermore, though intense and acute physical exercise increases IL-6 levels, IL-6 downregulates several proinflammatory cytokines such as TNFα, helping to improve glucose metabolism and increase insulin sensitization to insulin. […] The last factor associated with greater disease activity, according to DAPSA, was female sex. Women with spondylarthritis or PsA usually have greater disease activity (as also shown by our results), a higher degree of pain (a component of DAPSA), a higher impact of the disease, and poorer persistence of biologics.

• #12

  https://link.springer.com/article/10.1007/s10067-021-05799-0

  We aimed to evaluate the (a) potential predictors of first biological disease-modifying anti-rheumatic drug (bDMARD) failure and (b) factors associated with failure of multiple therapies in psoriatic arthritis (PsA). […] Mean time-to-first bDMARD discontinuation was 72 months; 2-year and 5-year retention rates were 75% and 60%, respectively. […] Survival rate was good for anti-TNF and other bDMARDs. […] Female sex was a predictor of first bDMARD discontinuation, unlike mechanism of action, comorbidities, and BMI. […] Drug survival in PsA patients was confirmed to be greater for the first bDMARD administered. […] In case of failure of the first bDMARD, switching/swapping proved a good treatment option, as reflected by a persistent satisfactory effectiveness with second-line bDMARDs and so subsequent switches.

• #13 In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective Analysis

  https://www.mdpi.com/2077-0383/10/13/2834

  With the availability of effective treatment with targeted synthetic and biologic disease-modifying anti-rheumatic drugs (ts/bDMARDs) for psoriatic arthritis (PsA), it is crucial to identify predictors of access to this treatment since disease onset. […] In univariate analyses, C-reactive protein (RR, 95% CI 1.204 (1.065,1.362)), Visual Analogue Scale (VAS) pain (1.027 (1.005,1.048)), the number of tender joints on 28 joints (1.087 (1.025, 1.153)), and a synovial power Doppler (PD) score > 1 (3.63 (1.307, 10.08)) emerged as significant predictors. C-reactive protein, VAS pain and PD confirmed their predictive value also in multivariate models. […] The purpose of this study is therefore to describe and characterize a population of early peripheral PsA in the context of an Early Arthritis Clinic. In addition, we tried to identify baseline predictors of treatment with ts/bDMARDs within 2 years from diagnosis.

• #14 In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective Analysis

  https://www.mdpi.com/2077-0383/10/13/2834

  With the availability of effective treatment with targeted synthetic and biologic disease-modifying anti-rheumatic drugs (ts/bDMARDs) for psoriatic arthritis (PsA), it is crucial to identify predictors of access to this treatment since disease onset. […] In univariate analyses, C-reactive protein (RR, 95% CI 1.204 (1.065,1.362)), Visual Analogue Scale (VAS) pain (1.027 (1.005,1.048)), the number of tender joints on 28 joints (1.087 (1.025, 1.153)), and a synovial power Doppler (PD) score > 1 (3.63 (1.307, 10.08)) emerged as significant predictors. C-reactive protein, VAS pain and PD confirmed their predictive value also in multivariate models. […] The purpose of this study is therefore to describe and characterize a population of early peripheral PsA in the context of an Early Arthritis Clinic. In addition, we tried to identify baseline predictors of treatment with ts/bDMARDs within 2 years from diagnosis.

• #15 Prediction and benefits of minimal disease activity in patients with psoriatic arthritis and active skin disease in the ADEPT trial | RMD Open

  https://rmdopen.bmj.com/content/3/1/e000415

  Objectives To determine the proportion of patients with psoriatic arthritis in the Adalimumab Effectiveness in Psoriatic Arthritis trial achieving minimal disease activity (MDA) and its individual components at 1 or more visits over 144 weeks, identify baseline predictors of MDA achievement, and evaluate the association of MDA status with independent quality of life (QoL)-related patient-reported outcomes (PROs). […] Higher HAQ-DI score was the most consistent baseline factor that decreased the likelihood of achieving MDA and sustained MDA at later time points. Achieving MDA was associated with better independent QoL-related PROs. […] The present study provides further insights into the achievement, prediction and benefits of MDA status in patients treated with adalimumab. […] It further confirms higher baseline Health Assessment Questionnaire-Disability Index as a significant negative predictor for MDA achievement.

• #16 Prediction and benefits of minimal disease activity in patients with psoriatic arthritis and active skin disease in the ADEPT trial | RMD Open

  https://rmdopen.bmj.com/content/3/1/e000415

  MDA achievement was associated with significantly better quality of life-related patient-reported outcomes (PROs) and greater improvements in PROs from baseline. […] Our data provide further support for MDA as a valid treatment target in psoriatic arthritis, since its achievement is associated with meaningful benefits in PROs other than those included in the MDA calculation. […] Higher scores at baseline for TJC, SJC, patient pain, enthesitis and HAQ-DI were significantly associated with lower odds of achieving MDA at most time points, including sustained MDA, by univariate analysis. […] Multivariate analysis confirmed high baseline HAQ-DI score as the most consistent predictor for failure to achieve MDA. […] This analysis, where higher baseline HAQ-DI scores were observed in established disease and associated with lower MDA achievement, further supports the need for early and effective treatment in PsA.

• #17 Moderate-High Disease Activity in Patients with Recent-Onset Psoriatic Arthritis—Multivariable Prediction Model Based on Machine Learning

  https://www.mdpi.com/2077-0383/12/3/931

  Psoriatic arthritis (PsA) is a chronic inflammatory disease included in the group of spondyloarthritis, although the multifaceted nature of this entity has led it to be addressed in a differentiated and specific manner. According to recent data, the prevalence of PsA in adults is approximately 0.6%, thus making this disease one of the most common in rheumatology clinics. […] Traditional recommendations by EULAR on the management of PsA state the factors indicative of a poor prognosis to be female sex, elevated acute phase reactant values, dactylitis, early structural damage, and a high number of joints involved. Nevertheless, it is difficult to discern whether these and other factors reported in the literature refer more to disease activity itself (inflammatory burden), cumulative damage (functional burden), or the overall impact of the disease, which brings together the previous factors. Indeed, the concept of severity should not be made homonymous with that of inflammatory load. The severity of the disease brings together not only the inflammatory load of the disease but also physical disability, structural damage, and the impact on quality of life, among others. The factor that perhaps weighs the most in this equation, especially at the beginning of the disease, is inflammatory activity, but with the passage of time, this loses its predictive capacity, and there are other aspects (structural damage, comorbidities, deterioration in physical function, etc.) more clearly associated with greater severity.

• #18 Moderate-High Disease Activity in Patients with Recent-Onset Psoriatic Arthritis—Multivariable Prediction Model Based on Machine Learning

  https://www.mdpi.com/2077-0383/12/3/931

  Psoriatic arthritis (PsA) is a chronic inflammatory disease included in the group of spondyloarthritis, although the multifaceted nature of this entity has led it to be addressed in a differentiated and specific manner. According to recent data, the prevalence of PsA in adults is approximately 0.6%, thus making this disease one of the most common in rheumatology clinics. […] Traditional recommendations by EULAR on the management of PsA state the factors indicative of a poor prognosis to be female sex, elevated acute phase reactant values, dactylitis, early structural damage, and a high number of joints involved. Nevertheless, it is difficult to discern whether these and other factors reported in the literature refer more to disease activity itself (inflammatory burden), cumulative damage (functional burden), or the overall impact of the disease, which brings together the previous factors. Indeed, the concept of severity should not be made homonymous with that of inflammatory load. The severity of the disease brings together not only the inflammatory load of the disease but also physical disability, structural damage, and the impact on quality of life, among others. The factor that perhaps weighs the most in this equation, especially at the beginning of the disease, is inflammatory activity, but with the passage of time, this loses its predictive capacity, and there are other aspects (structural damage, comorbidities, deterioration in physical function, etc.) more clearly associated with greater severity.

• #19 Psoriatic arthritis – Wikipedia

  https://en.wikipedia.org/wiki/Psoriatic_arthritis

  The condition can be disabling, severely decreasing physical health. People with PsA may have reduced ability to work. Psychological health may also be decreased as a result of chronic pain, anxiety, depression, and reduced self-esteem. As a result, quality of life may also be significantly reduced. Some of the possible comorbidities (conditions which may occur together with PsA) may reduce life span. […] Studies have found that obesity is a significant risk factor and predictor of disease outcome. Other risk factors associated with an increased risk of developing psoriatic arthritis include severe psoriasis, nail psoriasis, scalp psoriasis, inverse psoriasis, and having a first-degree relative with psoriatic arthritis. […] Psoriatic arthritis tends to appear about 10 years after the first signs of psoriasis. For the majority of people, this is between the ages of 30 and 55, but the disease can also affect children. The onset of psoriatic arthritis symptoms before symptoms of skin psoriasis is more common in children than adults.

• #20 Moderate-High Disease Activity in Patients with Recent-Onset Psoriatic Arthritis—Multivariable Prediction Model Based on Machine Learning

  https://www.mdpi.com/2077-0383/12/3/931

  We detected an inverse relationship between physical activity and higher disease activity, according to DAPSA. It is known that a session of moderate physical exercise lasting 20 to 30 min can reduce the number of TNFα-releasing immune cells by 5%. Furthermore, though intense and acute physical exercise increases IL-6 levels, IL-6 downregulates several proinflammatory cytokines such as TNFα, helping to improve glucose metabolism and increase insulin sensitization to insulin. […] The last factor associated with greater disease activity, according to DAPSA, was female sex. Women with spondylarthritis or PsA usually have greater disease activity (as also shown by our results), a higher degree of pain (a component of DAPSA), a higher impact of the disease, and poorer persistence of biologics.

• #21 Severe Disease in Patients With Recent-Onset Psoriatic Arthritis. Prediction Model Based on Machine Learning – Dipòsit Digital de Documents de la UAB

  https://ddd.uab.cat/record/286342

  To identify patient- and disease-related characteristics that make it possible to predict higher disease severity in recent-onset PsA. […] Severe disease was defined at each visit as fulfillment of at least 1 of the following criteria: need for systemic treatment, Health Assessment Questionnaire (HAQ) 0.5, polyarthritis. […] The variables predicting severe disease were patient global pain, treatment with synthetic DMARDs, clinical form at diagnosis, high CRP, arterial hypertension, and psoriasis affecting the gluteal cleft and/or perianal area. […] Our prediction model of severe disease advocates rigorous control of pain and inflammation, also addressing cardiometabolic comorbidities, in addition to actively searching for hidden psoriasis.

• #22 Severe Disease in Patients With Recent-Onset Psoriatic Arthritis. Prediction Model Based on Machine Learning – Dipòsit Digital de Documents de la UAB

  https://ddd.uab.cat/record/286342

  To identify patient- and disease-related characteristics that make it possible to predict higher disease severity in recent-onset PsA. […] Severe disease was defined at each visit as fulfillment of at least 1 of the following criteria: need for systemic treatment, Health Assessment Questionnaire (HAQ) 0.5, polyarthritis. […] The variables predicting severe disease were patient global pain, treatment with synthetic DMARDs, clinical form at diagnosis, high CRP, arterial hypertension, and psoriasis affecting the gluteal cleft and/or perianal area. […] Our prediction model of severe disease advocates rigorous control of pain and inflammation, also addressing cardiometabolic comorbidities, in addition to actively searching for hidden psoriasis.

• #23 Multi-modality data-driven analysis of diagnosis and treatment of psoriatic arthritis | npj Digital Medicine

  https://www.nature.com/articles/s41746-023-00757-3

  Psoriatic arthritis (PsA) is associated with psoriasis, featured by its irreversible joint symptoms. […] Despite the significant impact on the healthcare system, it is still challenging to leverage machine learning or statistical models to predict PsA and its progression, or analyze drug efficacy. […] The independent experiment on the PsA prediction model demonstrates outstanding prediction performance with an AUC score of 0.87 and an AUPR score of 0.89, and the Jackknife validation test on the PsA progression prediction model also suggests the superior performance with an AUC score of 0.80 and an AUPR score of 0.83, respectively. […] Early diagnosis and control of PsA are therefore critically important. […] Predicting the risk of PsA and diagnosing PsA prior to joint symptoms will significantly benefit PsA control.

• #24 Multi-modality data-driven analysis of diagnosis and treatment of psoriatic arthritis | npj Digital Medicine

  https://www.nature.com/articles/s41746-023-00757-3

  To date, no study has been conducted to clearly show the exact mechanism and timing of the occurrence of PsA, which is one of the bottlenecks in the early diagnosis and treatment of PsA. […] We anticipate that the proposed machine learning models and statistical analysis can serve as a steppingstone for the early diagnosis and treatment of PsA and other types of psoriasis. […] The model developed based on machine learning (i.e., AdaBoost with mRMR) has a satisfactory performance in predicting psoriasis progression risk at the three-year time point, which is potential as a model for PsA risk prediction, and the Cox regression model provides a global analysis of the risk tendency from other types of psoriasis to PsA and the key factors related to PsA progression. […] We also identified that compared to other types of drugs in our dataset, IL-17 inhibitors achieve better efficacy in patients with more severe psoriasis, while MTX drugs have a lower ability in preventing the progression from non-PsA to PsA.

• #25 Multi-modality data-driven analysis of diagnosis and treatment of psoriatic arthritis | npj Digital Medicine

  https://www.nature.com/articles/s41746-023-00757-3

  Psoriatic arthritis (PsA) is associated with psoriasis, featured by its irreversible joint symptoms. […] Despite the significant impact on the healthcare system, it is still challenging to leverage machine learning or statistical models to predict PsA and its progression, or analyze drug efficacy. […] The independent experiment on the PsA prediction model demonstrates outstanding prediction performance with an AUC score of 0.87 and an AUPR score of 0.89, and the Jackknife validation test on the PsA progression prediction model also suggests the superior performance with an AUC score of 0.80 and an AUPR score of 0.83, respectively. […] Early diagnosis and control of PsA are therefore critically important. […] Predicting the risk of PsA and diagnosing PsA prior to joint symptoms will significantly benefit PsA control.

• #26 Multi-modality data-driven analysis of diagnosis and treatment of psoriatic arthritis | npj Digital Medicine

  https://www.nature.com/articles/s41746-023-00757-3

  Psoriatic arthritis (PsA) is associated with psoriasis, featured by its irreversible joint symptoms. […] Despite the significant impact on the healthcare system, it is still challenging to leverage machine learning or statistical models to predict PsA and its progression, or analyze drug efficacy. […] The independent experiment on the PsA prediction model demonstrates outstanding prediction performance with an AUC score of 0.87 and an AUPR score of 0.89, and the Jackknife validation test on the PsA progression prediction model also suggests the superior performance with an AUC score of 0.80 and an AUPR score of 0.83, respectively. […] Early diagnosis and control of PsA are therefore critically important. […] Predicting the risk of PsA and diagnosing PsA prior to joint symptoms will significantly benefit PsA control.

• #27 Machine learning identifies right index finger tenderness as key signal of DAS28-CRP based psoriatic arthritis activity | Scientific Reports

  https://www.nature.com/articles/s41598-023-49574-4

  Psoriatic arthritis (PsA) is a chronic inflammatory systemic disease whose activity is often assessed using the Disease Activity Score 28 (DAS28-CRP). […] Machine learning-based permutation importance identified tenderness in the metacarpophalangeal joint of the right index finger as the most informative item of the DAS28-CRP for PsA activity staging. […] These findings represent an important step toward precision medicine that can address outliers. […] Given the established use of DAS28-CRP for evaluating PsA activity, this study is dedicated to an evaluation its application to PsA activity, with a specific emphasis on understanding the significance of individual components within the score for this purpose within predominantly peripheral PsA. […] The supervised analyses focused on the characteristics (features) of PsA patients among the DAS28-CRP items, down to the level of d=58 individual items, that were most informative for the stages of PsA in terms of disease activity.

• #28 Machine learning identifies right index finger tenderness as key signal of DAS28-CRP based psoriatic arthritis activity | Scientific Reports

  https://www.nature.com/articles/s41598-023-49574-4

  The two DAS28-CRP items alone were sufficient to train a random forest classifier to detect whether a patient was in PsA remission or not with a balanced accuracy of 75% and an roc-auc of 89%. […] These results support the previously suggested re-evaluation of DAS28-CRP in PsA, for which this report provides specific guidance on relevant items to focus on.

• #29 Journal of Medical Internet Research – Machine Learning Approaches for Predicting Psoriatic Arthritis Risk Using Electronic Medical Records: Population-Based Study

  https://www.jmir.org/2023/1/e39972/

  Psoriatic arthritis (PsA) is an inflammatory arthritis that is present in 6%-42% of patients with PsO. Approximately 15% of patients with PsO have undiagnosed PsA. Predicting patients with a risk of PsA is crucial for providing them with early examination and treatment that can prevent irreversible disease progression and function loss. […] The findings of this study suggest that the risk prediction model can identify patients with PsO at a high risk of PsA. This model may help health care professionals to prioritize treatment for target high-risk populations and prevent irreversible disease progression and functional loss. […] A CNN model was constructed to identify patients with PsO at a high risk of PsA 6 months in advance using chronological EMRs, with an AUROC of 0.70. Early intervention can prevent PsA, especially in patients with PsO. This model used prescription and medication EMR data for prediction and did not require other information, such as nail lesions, severity, area of cutaneous lesions, or family history.

• #30 Journal of Medical Internet Research – Machine Learning Approaches for Predicting Psoriatic Arthritis Risk Using Electronic Medical Records: Population-Based Study

  https://www.jmir.org/2023/1/e39972/

  The negative predictive value of our PsA model (0.93) was higher than those of the screening tools in Mease et al (0.83-0.91) […] Therefore, the prediction models in this study are useful screening tools for detecting probable or subclinical PsA. […] This study visualized EMRs and temporal information as TPMs and created a computer vision model using CNNs. Our prediction model achieved good performance for predicting PsA risk using standardized and population-level claim data. The predictive models may be used as a screening tool to assist physicians in risk stratification and identifying psoriatic patients with a high risk of PsA.

• #31 Predicting Onset of Psoriatic Arthritis in Patients With Psoriasis

  https://www.dermatologyadvisor.com/news/predicting-onset-of-psoriatic-arthritis-in-patients-with-psoriasis/

  The Psoriasis Epidemiology Screening Tool (PEST) and BMI predicted psoriatic arthritis (PsA) onset over 2 years in patients with psoriasis. […] The study authors wrote that their research is the first step in developing a model that could potentially be used to predict future PsA and be easily adapted for routine use in the dermatology clinic, hopefully leading to early disease identification and improved patient outcomes.

• #32 Remission in psoriatic arthritis: is it possible and how can it be predicted? | Arthritis Research & Therapy | Full Text

  https://arthritis-research.biomedcentral.com/articles/10.1186/ar3021

  Since remission is now possible in psoriatic arthritis (PsA) we wished to examine remission rates in PsA patients following anti tumour necrosis factor alpha (TNF) therapy and to examine possible predictors of response. […] At 12 months remission, defined according to the disease activity score using 28 joint count and CRP (DAS28-CRP), was achieved in 58% of PsA patients compared to 44% of RA patients, significant improvement in outcome measures were noted in both groups (P 0.05). […] DAS28 remission is possible in PsA patients at one year following anti-TNF therapy, at higher rates than in RA patients and is predicted by baseline HAQ. […] Recent studies suggest remission may now be attainable in rheumatoid arthritis (RA) with the advent of anti-TNF therapy, however RA remission has been defined by different criteria (i) DAS28 value of 2.6.

• #33 Remission in psoriatic arthritis: is it possible and how can it be predicted? | Arthritis Research & Therapy | Full Text

  https://arthritis-research.biomedcentral.com/articles/10.1186/ar3021

  In the PsA patients the DAS28 remission rate, computed with four variables using the CRP, at 12 months was 58%. […] A significant improvement in DAS28 was also demonstrated in RA patients from baseline to 12 months, although the overall remission rate of 44% was significantly lower than in the PsA patients. […] Analysis of these matched PsA and RA patient subgroups still demonstrated a significantly higher number of PsA patients attaining remission 63.5% at 12 months compared to the RA group 41.4%. […] In particular, in PsA patients, male gender and the patient-derived indices including HAQ, patient global VAS and early morning stiffness appeared to be associated with remission. […] This is the first prospective study of biologic therapy in a routine clinical inflammatory arthritis cohort to demonstrate a remission rate of over 58% in patients with PsA. […] The remission response in the PsA patients appears to be most strongly associated with the patient-derived outcome measure of function – HAQ.

• #34

  https://link.springer.com/article/10.1007/s10067-021-05799-0

  We aimed to evaluate the (a) potential predictors of first biological disease-modifying anti-rheumatic drug (bDMARD) failure and (b) factors associated with failure of multiple therapies in psoriatic arthritis (PsA). […] Mean time-to-first bDMARD discontinuation was 72 months; 2-year and 5-year retention rates were 75% and 60%, respectively. […] Survival rate was good for anti-TNF and other bDMARDs. […] Female sex was a predictor of first bDMARD discontinuation, unlike mechanism of action, comorbidities, and BMI. […] Drug survival in PsA patients was confirmed to be greater for the first bDMARD administered. […] In case of failure of the first bDMARD, switching/swapping proved a good treatment option, as reflected by a persistent satisfactory effectiveness with second-line bDMARDs and so subsequent switches.

• #35

  https://link.springer.com/article/10.1007/s10067-021-05799-0

  Female sex may constitute a predisposing risk factor for flare and therapeutic switches. […] Discontinuation or switching of biologics due to mechanism of action, comorbidities tolerability and BMI did not seem to impact first bDMARD withdrawal. […] Overall, almost half of PsA patients treated with a first bDMARDs switched to another during the 15 years of follow-up. […] At 2 years and 5 years, the survival rate of the first bDMARD was from really optimal to good in over 50% of the PsA patients, without a significant difference in patients undergoing anti-TNF, anti-IL12/23, and anti-IL17 biological agents. […] Discontinuation or switching of first bDMARD due to tolerability issues or infections occurred rarely in PsA with respect to RA. […] Furthermore, female sex may constitute a predisposing risk factor for flare and therapeutic switches. […] Lack of efficacy does not appear to be a frequent occurrence in PsA vs. other rheumatic diseases such as RA.

• #36

  https://link.springer.com/article/10.1007/s10067-021-05799-0

  We aimed to evaluate the (a) potential predictors of first biological disease-modifying anti-rheumatic drug (bDMARD) failure and (b) factors associated with failure of multiple therapies in psoriatic arthritis (PsA). […] Mean time-to-first bDMARD discontinuation was 72 months; 2-year and 5-year retention rates were 75% and 60%, respectively. […] Survival rate was good for anti-TNF and other bDMARDs. […] Female sex was a predictor of first bDMARD discontinuation, unlike mechanism of action, comorbidities, and BMI. […] Drug survival in PsA patients was confirmed to be greater for the first bDMARD administered. […] In case of failure of the first bDMARD, switching/swapping proved a good treatment option, as reflected by a persistent satisfactory effectiveness with second-line bDMARDs and so subsequent switches.

• #37 Psoriatic arthritis – Wikipedia

  https://en.wikipedia.org/wiki/Psoriatic_arthritis

  The condition can be disabling, severely decreasing physical health. People with PsA may have reduced ability to work. Psychological health may also be decreased as a result of chronic pain, anxiety, depression, and reduced self-esteem. As a result, quality of life may also be significantly reduced. Some of the possible comorbidities (conditions which may occur together with PsA) may reduce life span. […] Studies have found that obesity is a significant risk factor and predictor of disease outcome. Other risk factors associated with an increased risk of developing psoriatic arthritis include severe psoriasis, nail psoriasis, scalp psoriasis, inverse psoriasis, and having a first-degree relative with psoriatic arthritis. […] Psoriatic arthritis tends to appear about 10 years after the first signs of psoriasis. For the majority of people, this is between the ages of 30 and 55, but the disease can also affect children. The onset of psoriatic arthritis symptoms before symptoms of skin psoriasis is more common in children than adults.

• #38 Psoriatic Arthritis: Prognosis, Life Expectancy, and Quality of Life

  https://www.healthline.com/health/psoriatic-arthritis-prognosis-life-expectancy

  PsA can be a serious chronic inflammatory condition that can cause significant pain and, in severe cases, disability. But its possible to manage your condition through medications and lifestyle changes. […] Some research suggests that people with PsA have a slightly shorter life expectancy than the general population. This is similar to other autoimmune conditions, like rheumatoid arthritis. It might be because people with PsA are also at an increased risk of developing heart disease. […] Those with the condition experienced a lower health-related quality of life. They also experienced decreased physical function and an increased risk of mortality. […] Your quality of life can be greatly improved by working closely with our doctor to identify causes of PsA flares and finding the right treatment plan for you.

• #39 Psoriatic Arthritis: Prognosis, Life Expectancy, and Quality of Life

  https://www.healthline.com/health/psoriatic-arthritis-prognosis-life-expectancy

  PsA can be a serious chronic inflammatory condition that can cause significant pain and, in severe cases, disability. But its possible to manage your condition through medications and lifestyle changes. […] Some research suggests that people with PsA have a slightly shorter life expectancy than the general population. This is similar to other autoimmune conditions, like rheumatoid arthritis. It might be because people with PsA are also at an increased risk of developing heart disease. […] Those with the condition experienced a lower health-related quality of life. They also experienced decreased physical function and an increased risk of mortality. […] Your quality of life can be greatly improved by working closely with our doctor to identify causes of PsA flares and finding the right treatment plan for you.

• #40 Prediction and benefits of minimal disease activity in patients with psoriatic arthritis and active skin disease in the ADEPT trial | RMD Open

  https://rmdopen.bmj.com/content/3/1/e000415

  Patients who achieved MDA at week 24 had significantly better PROs reflecting improved QoL and fatigue. Furthermore, the MDA achievers experienced larger improvements from baseline than non-achievers in all PROs measured. The mean change from baseline reached MCID for all PROs in MDA achievers but not MDA non-achievers.

• #41 Prediction and benefits of minimal disease activity in patients with psoriatic arthritis and active skin disease in the ADEPT trial | RMD Open

  https://rmdopen.bmj.com/content/3/1/e000415

  Objectives To determine the proportion of patients with psoriatic arthritis in the Adalimumab Effectiveness in Psoriatic Arthritis trial achieving minimal disease activity (MDA) and its individual components at 1 or more visits over 144 weeks, identify baseline predictors of MDA achievement, and evaluate the association of MDA status with independent quality of life (QoL)-related patient-reported outcomes (PROs). […] Higher HAQ-DI score was the most consistent baseline factor that decreased the likelihood of achieving MDA and sustained MDA at later time points. Achieving MDA was associated with better independent QoL-related PROs. […] The present study provides further insights into the achievement, prediction and benefits of MDA status in patients treated with adalimumab. […] It further confirms higher baseline Health Assessment Questionnaire-Disability Index as a significant negative predictor for MDA achievement.

• #42 Prediction and benefits of minimal disease activity in patients with psoriatic arthritis and active skin disease in the ADEPT trial | RMD Open

  https://rmdopen.bmj.com/content/3/1/e000415

  MDA achievement was associated with significantly better quality of life-related patient-reported outcomes (PROs) and greater improvements in PROs from baseline. […] Our data provide further support for MDA as a valid treatment target in psoriatic arthritis, since its achievement is associated with meaningful benefits in PROs other than those included in the MDA calculation. […] Higher scores at baseline for TJC, SJC, patient pain, enthesitis and HAQ-DI were significantly associated with lower odds of achieving MDA at most time points, including sustained MDA, by univariate analysis. […] Multivariate analysis confirmed high baseline HAQ-DI score as the most consistent predictor for failure to achieve MDA. […] This analysis, where higher baseline HAQ-DI scores were observed in established disease and associated with lower MDA achievement, further supports the need for early and effective treatment in PsA.

• #43 Prediction and benefits of minimal disease activity in patients with psoriatic arthritis and active skin disease in the ADEPT trial | RMD Open

  https://rmdopen.bmj.com/content/3/1/e000415

  MDA achievement was associated with significantly better quality of life-related patient-reported outcomes (PROs) and greater improvements in PROs from baseline. […] Our data provide further support for MDA as a valid treatment target in psoriatic arthritis, since its achievement is associated with meaningful benefits in PROs other than those included in the MDA calculation. […] Higher scores at baseline for TJC, SJC, patient pain, enthesitis and HAQ-DI were significantly associated with lower odds of achieving MDA at most time points, including sustained MDA, by univariate analysis. […] Multivariate analysis confirmed high baseline HAQ-DI score as the most consistent predictor for failure to achieve MDA. […] This analysis, where higher baseline HAQ-DI scores were observed in established disease and associated with lower MDA achievement, further supports the need for early and effective treatment in PsA.

• #44 Moderate-High Disease Activity in Patients with Recent-Onset Psoriatic Arthritis—Multivariable Prediction Model Based on Machine Learning

  https://www.mdpi.com/2077-0383/12/3/931

  We detected an inverse relationship between physical activity and higher disease activity, according to DAPSA. It is known that a session of moderate physical exercise lasting 20 to 30 min can reduce the number of TNFα-releasing immune cells by 5%. Furthermore, though intense and acute physical exercise increases IL-6 levels, IL-6 downregulates several proinflammatory cytokines such as TNFα, helping to improve glucose metabolism and increase insulin sensitization to insulin. […] The last factor associated with greater disease activity, according to DAPSA, was female sex. Women with spondylarthritis or PsA usually have greater disease activity (as also shown by our results), a higher degree of pain (a component of DAPSA), a higher impact of the disease, and poorer persistence of biologics.

• #45 Psoriatic arthritis prognosis: Life expectancy and more

  https://www.medicalnewstoday.com/articles/316832

  Psoriatic arthritis can have a significant effect on a persons life. However, timely and appropriate treatment can help reduce its impact. […] How PsA progresses will depend on various factors, including the type of PsA, its stage at diagnosis, the treatment a person receives, and how they respond to it. […] An effective treatment plan can often prevent progressive damage and help manage symptoms. […] In the early stages, however, it can be difficult to predict the course of the disease. […] Early diagnosis and treatment can help a person manage symptoms of psoriasis and PsA and reduce the risk of flares and future complications. […] PsA does not usually affect life expectancy, but a person with PsA may have a higher risk of other conditions, such as cardiovascular disease. […] For a person with PsA, early diagnosis and treatment are key to staying mobile and continuing to enjoy a good quality of life. […] As scientists develop new treatment options, the outlook for people with PsA is improving.

• #46 Window of opportunity in psoriatic arthritis: the earlier the better?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10900390/

  In PsA, referral and diagnosis within 1 year is associated with better clinical outcomes, suggesting the presence of a window of opportunity. […] Patients with a short delay were more likely to achieve MDA (OR 2.55, p=0.003) and DAPSA remission (OR 2.35,p=0.004) compared with PsA patients with a long delay. […] This study shows the negative effect of a longer diagnostic delay on clinical outcomes as well as PROs in PsA patients. […] A shorter time to PsA diagnosis is associated with a greater likelihood of achieving MDA and DAPSA remission over time, suggesting the presence of a window of opportunity in PsA.

• #47 Remission in psoriatic arthritis: is it possible and how can it be predicted? | Arthritis Research & Therapy | Full Text

  https://arthritis-research.biomedcentral.com/articles/10.1186/ar3021

  In the PsA patients the DAS28 remission rate, computed with four variables using the CRP, at 12 months was 58%. […] A significant improvement in DAS28 was also demonstrated in RA patients from baseline to 12 months, although the overall remission rate of 44% was significantly lower than in the PsA patients. […] Analysis of these matched PsA and RA patient subgroups still demonstrated a significantly higher number of PsA patients attaining remission 63.5% at 12 months compared to the RA group 41.4%. […] In particular, in PsA patients, male gender and the patient-derived indices including HAQ, patient global VAS and early morning stiffness appeared to be associated with remission. […] This is the first prospective study of biologic therapy in a routine clinical inflammatory arthritis cohort to demonstrate a remission rate of over 58% in patients with PsA. […] The remission response in the PsA patients appears to be most strongly associated with the patient-derived outcome measure of function – HAQ.

• #48 Multi-modality data-driven analysis of diagnosis and treatment of psoriatic arthritis | npj Digital Medicine

  https://www.nature.com/articles/s41746-023-00757-3

  To date, no study has been conducted to clearly show the exact mechanism and timing of the occurrence of PsA, which is one of the bottlenecks in the early diagnosis and treatment of PsA. […] We anticipate that the proposed machine learning models and statistical analysis can serve as a steppingstone for the early diagnosis and treatment of PsA and other types of psoriasis. […] The model developed based on machine learning (i.e., AdaBoost with mRMR) has a satisfactory performance in predicting psoriasis progression risk at the three-year time point, which is potential as a model for PsA risk prediction, and the Cox regression model provides a global analysis of the risk tendency from other types of psoriasis to PsA and the key factors related to PsA progression. […] We also identified that compared to other types of drugs in our dataset, IL-17 inhibitors achieve better efficacy in patients with more severe psoriasis, while MTX drugs have a lower ability in preventing the progression from non-PsA to PsA.

• #49 Journal of Medical Internet Research – Machine Learning Approaches for Predicting Psoriatic Arthritis Risk Using Electronic Medical Records: Population-Based Study

  https://www.jmir.org/2023/1/e39972/

  The negative predictive value of our PsA model (0.93) was higher than those of the screening tools in Mease et al (0.83-0.91) […] Therefore, the prediction models in this study are useful screening tools for detecting probable or subclinical PsA. […] This study visualized EMRs and temporal information as TPMs and created a computer vision model using CNNs. Our prediction model achieved good performance for predicting PsA risk using standardized and population-level claim data. The predictive models may be used as a screening tool to assist physicians in risk stratification and identifying psoriatic patients with a high risk of PsA.

• #50 Psoriatic arthritis prognosis: Life expectancy and more

  https://www.medicalnewstoday.com/articles/316832

  Psoriatic arthritis can have a significant effect on a persons life. However, timely and appropriate treatment can help reduce its impact. […] How PsA progresses will depend on various factors, including the type of PsA, its stage at diagnosis, the treatment a person receives, and how they respond to it. […] An effective treatment plan can often prevent progressive damage and help manage symptoms. […] In the early stages, however, it can be difficult to predict the course of the disease. […] Early diagnosis and treatment can help a person manage symptoms of psoriasis and PsA and reduce the risk of flares and future complications. […] PsA does not usually affect life expectancy, but a person with PsA may have a higher risk of other conditions, such as cardiovascular disease. […] For a person with PsA, early diagnosis and treatment are key to staying mobile and continuing to enjoy a good quality of life. […] As scientists develop new treatment options, the outlook for people with PsA is improving.

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