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Early identification of axial psoriatic arthritis among patients with psoriasis: a prospective multicentre study
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  • Published on: 22 November 2022
    Correspondence on ‘Early identification of axial psoriatic arthritis among patients with psoriasis: a prospective multicentre study’
    • Xiao-Jun Shi, Rheumatology Physician Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine
    • Other Contributors:
      • Qiang Tong, Rheumatology Physician
      • Xiu-Juan Hou, Rheumatology Physician
      • Shu-Feng Wei, Rheumatology Physician
      • Chen Li, Rheumatology Physician

    With great interest, we read the study by Proft et al. 1In this prospective multicenter study, the authors applied a dermatologist-centered screening tool followed by a structured rheumatologic examination, including MRI of the sacroiliac joints and spine, for the early identification of psoriatic arthritis with axial involvement (axPsA). We endorse the authors for completing an important clinical study, the results of which could have important implications for the early identification of axPsA in patients with psoriasis. However, there are some aspects that need to be focused on and discussed.
    First, there is some controversy regarding the definition of axPsA. Some studies have emphasized the importance of imaging, and the presence of sacroiliac arthritis with grade 3 unilaterally or grade 2 and above bilaterally, or spinal syndesmophyte(s) according to CASPAR criteria is defined as axPsA.2 It has also been suggested that axPsA requires meeting the modified New York criteria of AS criteria or applying the Assessment of SpondyloArthritis International Society (ASAS) classification criteria for axial spondyloarthritis (axSpA), which require the presence of inflammatory back pain (IBP) in the patient. However, back pain is not always present in patients with axPsA. The use of chronic back pain as the primary screening condition is debatable. One study showed that up to 44% to 55% of patients with axPsA had only imaging involvement (including sacroiliac joints or spine...

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    Conflict of Interest:
    None declared.