In healthcare, physical activity can be monitored in two ways: self-monitoring by the patient himself or external monitoring by health professionals. Regarding self-monitoring, wearable activity trackers allow automated passive data collection that educate and motivate patients. Wearing an activity tracker can improve walking time by around 1500 steps per day. However, there are concerns about measurement accuracy (e.g., lack of a common validation protocol or measurement discrepancies between different devices). For external monitoring, many innovative electronic tools are currently used in rheumatology to help support physician time management, to reduce the burden on clinic time, and to prioritize patients who may need further attention. In inflammatory arthritis, such as rheumatoid arthritis, regular monitoring of patients to detect disease flares improves outcomes. In a pilot study applying machine learning to activity tracker steps, we showed that physical activity was strongly linked to disease flares and that patterns of physical activity could be used to predict flares with great accuracy, with a sensitivity and specificity above 95%. Thus, automatic monitoring of steps may lead to improved disease control through potential early identification of disease flares. However, activity trackers have some limitations when applied to rheumatic patients, such as tracker adherence, lack of clarity on long-term effectiveness, or the potential multiplicity of trackers.

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Background:Psoriatic arthritis (PsA) is a multidimensional inflammatory disease with a great geographic variability and a global average prevalence estimated at 133 every 100,000 subjects according to a recent systematic review and meta-analysis (1). Registries and cohorts reflect more closely real-world data than randomized controlled trials (RCTS) and may indicate ongoing interest of each country on PsA.Objectives:The purpose of this study is to assess how recent registries and PsA related cohorts reflect its worldwide prevalence.Methods:A systematic literature review was performed in Pubmed Medline (PROSPEROCRD42020175745) to identify all articles reporting on either registries or longitudinal cohorts in PsA, published between 2010 and March 2020. Registries centered on drugs or not PsA-specific, trials and long term extension studies were excluded. The data collection comprised registries’ and cohorts’ originating countries, patient characteristics and the clinical outcome measures reported. Statistics were descriptive.Results:Of 673 articles, 73 were relevant for analysis, corresponding to 27 registries or PsA specific cohorts, with the participation of 30 countries. The overall number of patients was 16,183 with a mean of 599 per study. Overall, 50.1% were men, weighted mean age was 50,6 years and weighted mean disease duration was 6.9 years.Most of the registries were based in Europe (67%) or North America (26%) whereas Africa was underrepresented (Figure 1). USA was the most represented country participating in 6 registries. Mean age and mean disease duration were shorter in international registries (Table 1). Caspar diagnostic criteria were the most frequently used, mainly in the national registries (86,4%), whereas the use of diagnostic criteria was more heterogenous in the international registries.Conclusion:Recent registries and PsA specific cohorts do not cover the worldwide spectrum of the disease.References:[1]Scotti L, Franchi M, Marchesoni A, Corrao G. Prevalence and incidence of psoriatic arthritis: A systematic review and meta-analysis. Semin Arthritis Rheum. 2018 Aug;48(1):28-34Table 1.Description of 27 ongoing PsA registries or PsA cohorts, comparing nationwide and international registriesNATIONWIDE REGISTRIES (N=22)INTERNATIONAL REGISTRIES (N=5)WOMEN (%) 49,4 50,8MEAN AGE, WEIGTHED (YEARS) 52,32 48,09MEAN DISEASE DURATION, WEIGHTED (YEARS) 8,59 5,86CASPAR DIAGNOSTIC CRITERIA (%) 86,4 40Figure 1.Geographical distribution of PsA registriesDisclosure of Interests:None declared.