Classification criteria for psoriatic arthritis: Development of new criteria from a large international study

Abstract

The CASPAR criteria are simple and highly specific but less sensitive than the Vasey and Espinoza criteria.

Absence of a classically activated macrophage cytokine signature in peripheral spondylarthritis, including psoriatic arthritis

“…Although the SpA patients were primarily selected according to the presence of peripheral disease, 32 of the 47 patients had inflammatory back pain and 15 of the 47 patients clearly had sacroiliitis according to conventional radiographs. A separate cohort of 15 patients with PsA according to the ClASsification of Psoriatic ARthritis criteria (14) was also studied. All patients had active disease with effusion of at least 1 knee joint, which was punctured to obtain synovial fluid (SF).…”

National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening

“…126 The CASPAR criteria include established inflammatory articular disease with at least 3 points from the following features: current psoriasis, a history of psoriasis (unless current psoriasis was present), a family history of psoriasis (unless current psoriasis was present or there was a history of psoriasis), dactylitis, juxtaarticular new bone formation, rheumatoid factor negativity, and nail dystrophy. Current psoriasis was assigned a score of 2 while all other features were assigned a score of 1.…”

Classification of rheumatologic opinion on early inflammatory arthritis: Harmonization of a heterogeneous standard

“…Early referral to rheumatology recommendations (27)(28)(29), common inclusion criteria for early IA cohorts (13,23-25,30 -34), and classification criteria for prevalent IA conditions (15)(16)(17)35,36) were identified from the literature as potential early IA classification methods. The following 3 classification methods were selected for investigation: 1) early referral recommendation to rheumatology for rheumatoid arthritis (ERRR) (27), i.e., at least 3 swollen joints, a positive squeeze test for the metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joints, or at least 30 minutes of morning stiffness; 2) common early arthritis cohort inclusion criteria (CEAC), i.e., at least 2 swollen joints (30 -33) and 6 -52 weeks of symptom duration (13,(23)(24)(25)30,34); and 3) fulfillment of either the American College of Rheumatology (ACR; formerly the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) (15) or the European Spondylarthropathy Study Group (ESSG) classification criteria for spondylarthritis (SpA) (16).…”

“…The ACR and ESSG classification criteria represent widely recognized classification schemes for prevalent IA conditions and were included as a negative control for associations between rheumatologic opinion and established disease. General classification criteria for SpA were included (16) rather than diagnosis-specific criteria (17,35,36). The classification methods were selected independently from and blinded to the rheumatologists' case assessments.…”

“…The suboptimal sensitivity of laboratory markers (7)(8)(9) and questionable specificity of individual clinical parameters (10 -14) render early diagnosis a challenge. In turn, combinations of laboratory and clinical markers per classification criteria for prevalent forms of specific IA diagnoses (15)(16)(17) have low sensitivity for incident disease (18 -21). The definition of the term "early" is also variable (22)(23)(24)(25)(26).…”