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  • EULAR points to consider for the definition of clinical and imaging features suspicious for progression from psoriasis to psoriatic arthritis

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Psoriatic arthritis
EULAR points to consider for the definition of clinical and imaging features suspicious for progression from psoriasis to psoriatic arthritis
  1. Alen Zabotti1,
  2. Gabriele De Marco2,3,
  3. Laure Gossec4,5,
  4. Xenofon Baraliakos6,
  5. Daniel Aletaha7,
  6. Annamaria Iagnocco8,
  7. Paolo Gisondi9,
  8. Peter V Balint10,
  9. Heidi Bertheussen11,
  10. Wolf-Henning Boehncke12,
  11. Nemanja S Damjanov13,
  12. Maarten de Wit14,
  13. Enzo Errichetti15,
  14. Helena Marzo-Ortega2,3,
  15. Mikhail Protopopov16,
  16. Lluis Puig17,
  17. Rubén Queiro18,
  18. Piero Ruscitti19,
  19. Laura Savage20,
  20. Georg Schett21,
  21. Stefan Siebert22,
  22. Tanja A Stamm23,
  23. Paul Studenic7,
  24. Ilaria Tinazzi24,
  25. Filip E Van den Bosch25,
  26. Annette van der Helm-van Mil26,27,
  27. Abdulla Watad28,
  28. Josef S Smolen7,
  29. Dennis G McGonagle2,3
  1. 1 Department of Medical and Biological Sciences, Azienda sanitaria universitaria Friuli Centrale, Udine, Italy
  2. 2 Leeds Musculoskeletal Biomedical Research Centre, Chapel Allerton Hospital, Leeds, UK
  3. 3 Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
  4. 4 INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France
  5. 5 APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France
  6. 6 Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany
  7. 7 Department of Rheumatology, Medical University of Vienna, Wien, Austria
  8. 8 Scienze Cliniche e Biologiche, Università degli Studi di Torino, Torino, Italy
  9. 9 Department of Medicine, Section of Dermatology and Venereology, Università degli Studi di Verona, Verona, Italy
  10. 10 3rd Department of Rheumatology, National Institute for Rheumatology and Physiotherapy, Budapest, Hungary
  11. 11 Patient Research Partner, Oslo, Norway
  12. 12 Dermatology, Geneva University Hospitals, Geneve, Switzerland
  13. 13 Rheumatology, University of Belgrade Faculty of Medicine, Beograd, Serbia
  14. 14 Medical Humanities, Amsterdam University Medical Centres, Duivendrecht, The Netherlands
  15. 15 Department of Medical and Biological Sciences University Hospital "Santa Maria della Misericordia", Azienda sanitaria universitaria Friuli Centrale, Udine, Italy
  16. 16 Department of Gastroenterology, Infectiology and Rheumatology, Charite Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany
  17. 17 Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
  18. 18 Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Spain
  19. 19 University of L'Aquila Department of Clinical Sciences and Applied Biotechnology, L'Aquila, Italy
  20. 20 Chapel Allerton Hospital Department of Dermatology, Leeds, UK
  21. 21 Rheumatology, Erlangen University Hospital, Erlangen, Germany
  22. 22 Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UK
  23. 23 Section for Outcomes Research, Medical University of Vienna, Wien, Austria
  24. 24 Unit of Rheumatology, Don Calabria Sacred Heart Hospital, Negrar, Italy
  25. 25 Rheumatology, Ghent University, Gent, Belgium
  26. 26 Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  27. 27 Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands
  28. 28 Internal Medicine, Sheba Medical Center at Tel Hashomer, Tel Hashomer, Israel
  1. Correspondence to Dr Dennis G McGonagle, University of Leeds Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, LS7 4SA, UK; d.g.mcgonagle{at}leeds.ac.uk

Abstract

Background The transition from psoriasis (PsO) to psoriatic arthritis (PsA) and the early diagnosis of PsA is of considerable scientific and clinical interest for the prevention and interception of PsA.

Objective To formulate EULAR points to consider (PtC) for the development of data-driven guidance and consensus for clinical trials and clinical practice in the field of prevention or interception of PsA and for clinical management of people with PsO at risk for PsA development.

Methods A multidisciplinary EULAR task force of 30 members from 13 European countries was established, and the EULAR standardised operating procedures for development for PtC were followed. Two systematic literature reviews were conducted to support the task force in formulating the PtC. Furthermore, the task force proposed nomenclature for the stages before PsA, through a nominal group process to be used in clinical trials.

Results Nomenclature for the stages preceding PsA onset, 5 overarching principles and 10 PtC were formulated. Nomenclature was proposed for three stages towards PsA development, namely people with PsO at higher risk of PsA, subclinical PsA and clinical PsA. The latter stage was defined as PsO and associated synovitis and it could be used as an outcome measure for clinical trials evaluating the transition from PsO to PsA. The overarching principles address the nature of PsA at its onset and underline the importance of collaboration of rheumatologists and dermatologists for strategies for prevention/interception of PsA. The 10 PtC highlight arthralgia and imaging abnormalities as key elements of subclinical PsA that can be used as potential short-term predictors of PsA development and useful items to design clinical trials for PsA interception. Traditional risk factors for PsA development (ie, PsO severity, obesity and nail involvement) may represent more long-term disease predictors and be less robust for short-term trials concerning the transition from PsO to PsA.

Conclusion These PtC are helpful to define the clinical and imaging features of people with PsO suspicious to progress to PsA. This information will be helpful for identification of those who could benefit from a therapeutic intervention to attenuate, delay or prevent PsA development.

  • psoriatic arthritis
  • synovitis
  • inflammation

Data availability statement

Data are available on reasonable request. No data are available. No data are available.

http://dx.doi.org/10.1136/ard-2023-224148

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    Data availability statement

    Data are available on reasonable request. No data are available. No data are available.

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    Footnotes

    • AZ and GDM are joint first authors.

    • Handling editor Dimitrios T Boumpas

    • Twitter @MProtopopov, @StefanSiebert1, @Stiddyo

    • AZ and GDM contributed equally.

    • Contributors All authors have contributed to this work and approved the final version. DMG is the guarantor.

    • Funding Funded by EULAR grant QoC 002.

    • Competing interests AZ: speakers bureau: AbbVie, Novartis, Janssen, Lilly, UCB, Amgen, paid instructor for: AbbVie, Novartis, UCB, all support for the present manuscript: EULAR fellowship; GDM: EULAR fellowship; LG: consultant of: AbbVie, Amgen, BMS, Celltrion, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB, grant/research support from: Sandoz, UCB; XB: speakers bureau: AbbVie, BMS, MSD, Sandoz, Novartis, Pfizer, Galapagos, UCB, Lilly, paid instructor for: AbbVie, BMS, MSD, Sandoz, Novartis, Pfizer, Galapagos, UCB, Lilly, consultant of: AbbVie, BMS, MSD, Sandoz, Novartis, Pfizer, Galapagos, UCB, Lilly, grant/research support from: AbbVie, MSD, Novartis; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid: Editorial Board Member of Annals of Rheumatic Diseases, ASAS President. DA received grants, speaker fees or consultancy fees from AbbVie, Gilead, Galapagos, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Sandoz and Sanof; AI: payment or honoraria for lectures, presentations, speakers bureau, manuscript writing or educational events AbbVie, Alfa-sigma, BMS, Celgene, Celltrion, Eli Lilly, Galapagos, Gilead, Janssen, MSD, Novartis, Pfizer, Sanofi Genzyme, SOBI grant/research support from: Pfizer, AbbVie, Novartis; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid: EULAR President, member of the EULAR Board, member of EULAR Advocacy Committee; PG: payment or honoraria for lectures, presentations, speakers bureau, manuscript writing or educational events AbbVie, Almirall, Amgen, UCB, Sanofi, Pfizer, Novartis, Eli Lilly, Jannsen, Leo Pharma; PVB: none; HB: none declared; W-HB: speakers bureau: AbbVie, Almirall, BMS, Janssen, Leo, Lilly, Novartis and UCB, consultant of: AbbVie, Almirall, BMS, Janssen, Leo, Lilly, Novartis and UCB; NSD: none declared; MdW: payment or honoraria for lectures, presentations, speakers bureau, manuscript writing or educational events: UCB; EE: consultant of: AbbVie, Janssen, Novartis, Amgen; HM-O: speakers bureau: AbbVie, Biogen, Eli Lilly, Janssen, Moonlake, Novartis, Pfizer, Takeda and UCB Pharma, consultant of: AbbVie, Biogen, Eli Lilly, Janssen, Moonlake, Novartis, Pfizer, Takeda and UCB Pharma, grant/research support from: Janssen, Novartis and UCB; MP: support for attending meetings and/or travel: Pfizer, AbbVie, UCB; LP: speakers bureau: Janssen, Lilly, Novartis, UCB, consultant of: AbbVie, Almirall, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, Leo Pharma, Lilly, Novartis, Pfizer, Sandoz, Sanofi, UCB, grant/research support from: AbbVie, Almirall, Amgen, Boehringer Ingelheim, Leo Pharma, Lilly, Novartis, Pfizer, Sanofi, UCB; RQ: grants or contracts from any entity: Novartis, Janssen, Pfizer; payment or honoraria for lectures, presentations, speakers bureau, manuscript writing or educational events: Amgen, Janssen, Eli Lilly, Novartis, UCB, Pfizer; PR: none declared; LS: speakers bureau: AbbVie, Almirall, Amgen, Aspire Pharma, Biogen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Celltrion, Fresensius Kabi, Galderma, Janssen, Leo, Lilly, Novartis, Pfizer, MSD, Sanofi, Takeda, UCB, Consultant of: AbbVie, Boehringer Ingelheim, Bristol Myers Squibb, Fresensius Kabi, Janssen, Lilly, Novartis, UCB, grant/research support from: Janssen, Pfizer; GS: none declared; SS: speakers bureau: AbbVie, GSK, Janssen, UCB, consultant of: AbbVie, Amgen, Eli Lilly, Janssen, UCB, grant/research support from: Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, GSK, Janssen and UCB; TAS: speakers bureau: AbbVie, Roche, Sanofi, Takeda and Novartis, grant/research support from: AbbVie and Roche; PS: speakers bureau: AstraZeneca; IT: speakers bureau: Janssen, Pfizer; FEVdB: none declared; AvdH-vM: none declared; AW: payment or honoraria for lectures, presentations, speakers bureau, manuscript writing or educational events: Janssen Neopharm, Eli Lilly Novartis, AbbVie; consulting fees: Novartis, AbbVie, Janssen; JSS: consulting fees: AbbVie,Galapagos/Gilead, Novartis-Sandoz, BMS, Samsung Sanofi, Chugai R-Pharma, Lilly; payment or honoraria for lectures, presentations, speakers bureau, manuscript writing or educational events: Samsung, Lilly, Chugai R-Pharma, MSD, Janssen Novartis-Sandoz; DGMcG: speakers bureau: AbbVie, Celgene, Janssen, Merck, Novartis, Pfizer, UCB, consultant of: AbbVie, Celgene, Janssen, Merck, Novartis, Pfizer, UCB, grant/research support from: AbbVie, Celgene, Janssen, Merck, Novartis, Pfizer.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the 'Methods' section for further details.

    • Provenance and peer review Not commissioned; externally peer reviewed.