Background Psoriatic arthritis (PsA) contributes to enormous burden of disease and thus early correct diagnosis and adequate therapeutic management are essential for physicians in practice; however, There have been several studies highlighting the inadequate diagnosis and suboptimal therapies for PsA worldwide and physicians generally report difficulties in managing psoriasis.
Objectives To analyze the real-world clinical practice of PsA in Taiwan, and assess physicians' adopted methods and difficulties of diagnosis, therapeutic consideration and strategy, in addition to rationales for biologic agents and unmet needs.
Methods A nationwide cross-sectional observational study in Taiwan was conducted by means of the face-to-face in depth interviews with the 80 physicians, composed of 50 rheumatologists and 30 dermatologists, from November 2014 to January 2015.
Results The major adopted diagnostic examinations for PsA are arthritis performance, psoriasis and nail dystrophy, roentgenological studies, personal and family history; however, more dermatologists rely on RF for initial diagnosis (p<0.05). The difficulties for diagnosis, considerations on therapeutic management and current prescription were reported and displayed some interdisciplinary difference. Rationales for biological agent selection were investigated and physicians generally favored etanercept in terms of milder symptoms or more conservative treatment. The main unmet needs for current biologic therapies for PsA included the aspects of better efficacy, safety, sustainability and oral administration.
Conclusions The nationwide study is the first survey for real-world clinical practice of PsA in Asia and provides detailed messages about the diagnostic difficulties and therapeutic consideration, especially rationales and unmet needs on current biologic therapies, which may offer possible directions for new drug development. We also made interdisciplinary comparison, hence in order to improve comprehensive care.
Liu JT, Yeh HM, Liu SY, Chen KT. Psoriatic arthritis: Epidemiology, diagnosis, and treatment. World J Orthop 2014;5:537–43.
van de Kerkhof PC, Reich K, Kavanaugh A, et al. Physician perspectives in the management of psoriasis and psoriatic arthritis: results from the population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis survey. J Eur Acad Dermatol Venereol 2015;29:2002–10.
Disclosure of Interest None declared