Table 4

Research agenda

Axial involvement in PsA
  • Do spinal and peripheral involvements respond similarly or differently?

Enthesitis, dactylitis
  • More data need to be attained on the response of dactylitis or enthesitis to different therapies when compared with arthritis and skin disease.

  • How does dactylitis or enthesitis affect physical function, health-related quality of life, social participation or cardiovascular risk?

  • To what extent does their inclusion in composite measures increase or decrease validity and sensitivity to change?

Skin involvement
  • More data need to be attained on the response of psoriasis to different therapies when compared with arthritis and other musculoskeletal symptoms.

  • How does skin involvement affect physical function or cardiovascular risk?

  • To what extent does its inclusion in composite measure increase or decrease validity and sensitivity to change?

  • To what extent do skin changes affect quality of life, work participation and social inclusion beyond the respective effects of arthritis and other musculoskeletal manifestations?

Imaging
  • Is imaging useful for follow-up in axial SpA and PsA?

  • Should imaging remission be a treatment target in axial SpA and PsA?

Functioning/disabillity
  • What is the impact of functioning/disability in composite measures developed for PsA?

Strategic trials
  • Strategic trials in axial SpA and at least one additional strategic trial in PsA.

Maintenance of response
  • How can response be maintained?

  • Can the dose of the therapy employed be reduced or the interval of applications be expanded and outcome maintained?

Care by specialists
  • Is care of axial SpA, peripheral SpA or PsA by a specialist (such as a rheumatologist) advantageous for outcomes when compared with care by a non-specialist?

Patient
  • Is outcome different when patients are informed in a structured way when compared with more general means of information?

Harmonisation
  • Nomenclature should be harmonised—remission vs inactive disease; minimal disease activity vs low disease activity, etc.

Structural damage
  • Does achievement of the treatment target result into prevention or retardation of structural damage development in the spine/peripheral joints in SpA?

Biomarkers
  • We need better biomarkers of disease activity than CRP for both axial SpA and PsA.

  • AS, ankylosing spondylitis; CRP, C-reactive protein; PsA, psoriatic arthritis; SpA, spondyloarthritis.