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BackgroundThe Psoriatic arthritis UnclutteRed screening Evaluation (PURE-4), culturally adapted to Spanish language following the standardized methodology,[1]was recommended by experts due to the reduced number of items,[2]its high sensitivity/specificity and the feasibility to implement in clinical practice.ObjectivesTo confirm the presence/absence of psoriatic arthritis (PsA) according to rheumatologist criteria in patients (pts) with psoriasis (Pso) 1 year after having answered the PURE-4 questionnaire in the dermatology consultation.MethodsCross-sectional, observational, multicenter study conducted with primary data collection under conditions of routine clinical practice in Spain. Adult pts (≥18 years old) with Pso diagnosis that voluntarily accepted to participate. Two cross-sectional evaluations. Assessment I allowed to validate the Spanish version of the PURE-4 questionnaire and its results were previously communicated.[3]Data from assessment II (pts without PsA in assessment I were evaluated by the rheumatologist 1 year ±2 months later and performed the PsA diagnostic confirmation according to her/his criteria and collected clinical characteristics) are presented here.Results268 patients pts were included in assessment I, 223 (83.2%) of them without a PsA diagnosis. 219 pts were evaluable in assessment II, as they go to the second visit to rheumatologist: 56.2% male, with a mean (SD) age of 46.8 (12.5) years, a mean (SD) time from Pso diagnosis of 18.7 (12.8) years. Mean (SD) PURE-4 score was 2.4 (1.1) for pts with PsA and 1.2 (1.2) for pts without PsA diagnosis. Among pts who did assessment II, PsA diagnosis was confirmed in 12 (5.5%) pts. Area under the receiver-operating characteristic (ROC) curve was 0.7618 (95% CI: 0.6530, 0.8706) (n=217), confirming the good quality of the questionnaire (Figure 1). Using the Youden index, it was identified a score ≥2 indicative of a possible early presence of PsA, same as in assessment I. PURE-4 questionnaire showed a sensitivity of 75.0% and a specificity of 62.9%. In 63.6% of the cases, the PURE-4 questionnaire classified pts in the same way as the rheumatologist, with a negative predictive value of 97.7%.ConclusionAssessment II findings together with the assessment I results, demonstrate the good PsA screening properties of the PURE-4 questionnaire, starting with a ≥2 score, differing from the original questionnaire (≥1).[4]Questions of the PURE-4 questionnaire referring to dactylitis, both buttocks pain and peripheral joint pain with swelling (before age 50) were the most “discriminative” of PsA. The study reinforce the recommendation to assess annually, or ideally every 6 months, the possible PsA presence,[5]as early PsA identification thanks to simple tools such as PURE-4 could help to prevent irreversible joint damage of this disease.References[1]Belinchón I, et al. Actas Dermosifiliogr. 2020;111(8):655-64.[2]Urruticoechea-Arana A, et al. PLoS One. 2021;16(3): e0248571.[3]Queiro Silva R, et al. Ann Rheum Dis. 2022;81:862-3.[4]Audureau E, et al. J Eur Acad Dermatol Venereol. 2018;32(11):1950-3.[5]Belinchón I, et al. Actas Dermosifiliogr. 2020;111(10):835-46.Figure 1.Area under the ROC curve (assessment II)AUC, area under the curve; Se, sensitivity; Sp, specificity.AcknowledgementsThe authors thank IQVIA and Carmen Barrull and Marco Pinel for providing medical editorial assistance with this presentation.Disclosure of InterestsRubén Queiró Silva Grant/research support from: received honoraria as part of the scientific committee of the PURE-4 study, Isabel Belinchón Speakers bureau: consultant and/or speaker for and/or participated in clinical trials sponsored by companies that manufacture drugs used for the treatment of psoriasis, including Janssen Pharmaceuticals Inc, Almirall SA, Lilly, AbbVie, Novartis, Celgene, Biogen, Amgen, Leo-Pharma, Pfizer-Wyeth, BMS, UCB and MSD, Consultant of: consultant and/or speaker for and/or participated in clinical trials sponsored by companies that manufacture drugs used for the treatment of psoriasis, including Janssen Pharmaceuticals Inc, Almirall SA, Lilly, AbbVie, Novartis, Celgene, Biogen, Amgen, Leo-Pharma, Pfizer-Wyeth, BMS, UCB and MSD, Grant/research support from: consultant and/or speaker for and/or participated in clinical trials sponsored by companies that manufacture drugs used for the treatment of psoriasis, including Janssen Pharmaceuticals Inc, Almirall SA, Lilly, AbbVie, Novartis, Celgene, Biogen, Amgen, Leo-Pharma, Pfizer-Wyeth, BMS, UCB and MSD, Anna Lopez-Ferrer Speakers bureau: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, Boehringer Ingelheim, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, UCB, Consultant of: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, Boehringer Ingelheim, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, UCB, Grant/research support from: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, Boehringer Ingelheim, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, UCB, Marta Ferran i Farrés Speakers bureau: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, UCB, Consultant of: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, UCB, Grant/research support from: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, UCB, Raquel Rivera Díaz Speakers bureau: consultant, researcher and/or speaker for AbbVie, Almirall, Celgene Corporation, GSK, Janssen-Cilag, Lilly, LEO Pharma, MSD, Novartis, Pfizer and UCB, Consultant of: consultant, researcher and/or speaker for AbbVie, Almirall, Celgene Corporation, GSK, Janssen-Cilag, Lilly, LEO Pharma, MSD, Novartis, Pfizer and UCB, Grant/research support from: consultant, researcher and/or speaker for AbbVie, Almirall, Celgene Corporation, GSK, Janssen-Cilag, Lilly, LEO Pharma, MSD, Novartis, Pfizer and UCB, David Vidal Sarro Speakers bureau: advisor and/or researcher and/or speaker for AbbVie, Janssen, Lilly, Novartis and UCB, Consultant of: advisor and/or researcher and/or speaker for AbbVie, Janssen, Lilly, Novartis and UCB, Grant/research support from: advisor and/or researcher and/or speaker for AbbVie, Janssen, Lilly, Novartis and UCB, lourdes rodriguez freire Speakers bureau: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, BMS, Boehringer, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer and UCB, Consultant of: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, BMS, Boehringer, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer and UCB, Grant/research support from: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, BMS, Boehringer, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer and UCB, Pablo de la Cueva Dobao Speakers bureau: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, BMS, Boehringer, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi, UCB, Consultant of: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, BMS, Boehringer, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi, UCB, Grant/research support from: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, BMS, Boehringer, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi, UCB, Jorge Santos Juanes Speakers bureau: speaker for, received scholarships, and participated in advisory sessions for Novartis, Lilly, Janssen, Abbvie, Amgen, and Sanofi, Consultant of: speaker for, received scholarships, and participated in advisory sessions for Novartis, Lilly, Janssen, Abbvie, Amgen, and Sanofi, Grant/research support from: speaker for, received scholarships, and participated in advisory sessions for Novartis, Lilly, Janssen, Abbvie, Amgen, and Sanofi, Vicenç Rocamora Duran Speakers bureau: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, UCB, Consultant of: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, UCB, Grant/research support from: advisor and/or researcher and/or speaker for Abbvie, Almirall, Amgen, Celgene, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, UCB, Guillermo Guinea Uzábal Employee of: Novartis employee, Víctor Martín Vázquez Employee of: Novartis employee, Lara Gómez Labrador Employee of: Novartis employee.

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