Are the classification criteria for psoriatic arthritis better than existing criteria for diagnosing psoriatic arthritis? Comment on the article by Taylor et al

Abstract

measured in a more accessible compartment, are a compatible surrogate for the hormonal environment of the knee joint.This new information also does not yet establish whether our observed associations represent the response to a receptor-mediated process (as in the case of lower estradiol concentrations) or a cytokine-based response (as in the lower urinary 2-hydroxyestrone concentrations), or potentially, both mechanisms. There is little evidence that 2-hydroxyestrogens have binding affinity to the estrogen receptor (4,5), but they appear to have additional important properties, including participation in oxidation/reduction actions (6), and may modulate arachidonic acid metabolism and the cyclooxygenase 1 (COX-1) and COX-2 enzymes.

Sensitivity of the classification of psoriatic arthritis criteria in early psoriatic arthritis

“…Recognizing this, the CASPAR Study Group recently developed new classification criteria for PsA (2). The CASPAR criteria were derived from a study of a large cohort of patients from North America, Europe, Australasia, and Africa, which was to date the largest and most comprehensive approach by an international group to develop classification criteria for any rheumatic disease (14). The criteria are simple and highly specific (98.7%), and had a sensitivity of 91.4% in the original study.…”

“…However, the main limitation of the study was that the patients with PsA included in the study had longstanding disease (mean disease duration 12.5 years). It was therefore thought that the criteria might not perform well in patients with early disease (2, 14). To address this issue, the present study was undertaken to test the sensitivity of the criteria in early‐onset PsA.…”

Risk Factors for Progression from Subclinical to Clinical Phase of Psoriatic Arthritis: A Case–Control Study

“…There is still no universally accepted diagnostic criterion for PsA since it was categorized as an independent disease by the American College of Rheumatology in 1964 [5]. At present, the classification Criteria for Psoriatic Arthritis (CASPAR) [6] have been widely applied in clinical studies of PsA, owing largely to their high sensitivity and specificity [7]. However, it was originally put forward based on PsA patients with chronic conditions and requiring the presence of an inflammatory musculoskeletal precondition.…”

Conceitos atuais e relevantes sobre artrite psoriásica

“…All patterns and degrees of arthritis can occur in patients with minimal skin lesions or with generalized exfoliative psoriasis. [18][19][20][21] According to the initial description by Moll and Wright in 1973, 22 the articular manifestations of PsA were classifi ed into fi ve clinical forms or distinct subgroups: monoarticular or asymmetrical oligoarticular with dactylitis, in 70% of the patients; symmetrical polyarticular similar to rheumatoid arthritis (RA), in 25% of the patients; classical form, predominantly affecting the distal interphalangeal joints, in 5%-10%; arthritis mutilans, in 5%; and spondylitic form, in 5%-40% of the patients. Further studies 23 have shown a large variation in those incidences: 16%-70% for asymmetrical oligoarthritis; 15%-78% for the polyarticular form; 1%-17% for the classical form; 2%-16% for arthritis mutilans; and 2%-27% for the spondylitic form.…”