Early Psoriatic Arthritis

McHugh, Neil

doi:10.1016/j.rdc.2015.07.005

Cited by 22 publications

(11 citation statements)

References 42 publications

(42 reference statements)

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“…Early diagnosis of PsA is important because a delayed diagnosis significantly contributes to negative patient outcomes [10,11]. Patients with untreated PsA, even with a 6-month delay from symptom onset to the first rheumatology visit [12], may develop peripheral joint erosions, progressive joint damage, and severe physical limitations [13].…”

Section: Introductionmentioning

confidence: 99%

Patient perspectives on the pathway to psoriatic arthritis diagnosis: results from a web-based survey of patients in the United States

et al. 2020

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Background: There are limited real-world data on the diagnostic experiences of patients with psoriatic arthritis (PsA), including medical care sought and potential barriers to diagnosis. We aim to describe patient experiences related to receiving a PsA diagnosis. Methods: Ours was a mixed-method, 2-phase study. Phase 1 comprised concept elicitation and cognitive interviews with clinical experts and adults diagnosed with PsA to develop a cross sectional, web-based survey. US adults with a self-reported PsA diagnosis were recruited through a patient support community (CreakyJoints), an online patient research registry (ArthritisPower), and social media outreach. In Phase 2, the online survey collected data on sociodemographics, clinical symptoms, disease burden, and diagnosis history of survey respondents with PsA. Results: Of the 203 respondents included, 172 (84.7%) were female, and the mean (SD) age was 51.6 (10.8) years. The time between seeking medical attention and receiving a diagnosis was < 6 months for 69 respondents, 6 months to 4 years for 68 respondents, and ≥ 5 years for 66 respondents. Most respondents sought care from general practitioners (79.8%) and rheumatologists (66.5%). Common initial symptoms that led respondents to seek medical attention were joint pain (70.0%) and stiffness (53.7%). Among the initial symptoms that led respondents to seek care, joint pain, swollen joints, and sausage-like fingers or toes (indicating dactylitis) were more common among respondents with shorter time to diagnosis, whereas stiffness, fatigue, enthesitis (indicated by foot problems, tendon and ligament pain), and back pain were more common among respondents with longer time to diagnosis. Common misdiagnoses were psychosomatic issues (26.6%) and osteoarthritis (21.7%). Respondents with shorter times to diagnosis had lower frequencies of misdiagnosis. Conclusions: Respondents with PsA reported delays in diagnosis and misdiagnoses on their journey to a PsA diagnosis. Symptom differences, such as enthesitis and stiffness, were noted among respondents with shorter vs longer time to diagnosis. Increased understanding of diagnostic barriers may lead to earlier diagnosis and appropriate management to improve outcomes.

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Section: Introductionmentioning

confidence: 99%

Patient perspectives on the pathway to psoriatic arthritis diagnosis: results from a web-based survey of patients in the United States

et al. 2020

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“…Many pharmacological treatments are available for the management of PsA, including MTX and other synthetic and biological DMARDs [10]. Recent evidence suggests that patients who undertake early ‘aggressive’ treatment, with more frequent assessment and escalation in medication, can reach ‘low disease activity’ or even remission (the absence of signs or symptoms of disease activity) [11]. However, it is important to recognize that the condition can be clinically mild, requiring minimal or no pharmacological treatment.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and initial management in psoriatic arthritis: a qualitative study with patients

Dures

Bowen²,

Brooke³

et al. 2019

Rheumatology Advances in Practice

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Objectives PsA is an inflammatory condition that can cause pain, fatigue, swelling and joint stiffness. The consequences include impaired physical function, a high psychosocial burden, reduced quality of life and work disability. The presenting symptoms can be non-specific and varied, leading to delays in diagnosis or referral to specialist teams. The aim of this study was to explore patients' experiences of being diagnosed and the initial management of PsA. Methods The study used a qualitative design, with data collected in one-to-one, face-to-face semi-structured interviews. Results Fifteen newly diagnosed patients (<24 months) from three hospital sites in the southwest of England participated. Interviews were transcribed, anonymized and analysed using inductive thematic analysis. The following two main themes with sub-themes represent the data: symptom onset to specialist care: ‘it was the blind leading the blind’ (making sense of symptoms; mis-diagnosis and missed opportunities; and fast and easy access to expertise); and diagnosis as a turning point: ‘having somebody say you've got something wrong with you, I was euphoric’ (validation and reassurance; weighing up treatment options; taking on self-management; and acknowledging loss and change). Conclusion Participants were already dealing with functional limitations and were highly distressed and anxious by the time they received their diagnosis. Physical and mental outcomes could be improved by the implementation of existing psoriasis management guidelines and strategies for earlier referral from primary care to rheumatology and by the development of guidelines on educational, self-management and psychological support provision soon after diagnosis.

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“…Obviously, the mean score was higher in psoriatic subjects respect to controls (despite being smartphone addicted or not) as the well‐known pathogenetic and clinical association with PsA and the possible presence of state of early non‐symptomatic PsA. Indeed, literature is constantly enriching of studies evaluating screening tools, questionnaires and instrumental investigations (especially ultrasound examination) for a prompt detection and treatment of subclinical early PsA . However, ultrasound score for inflammatory disease of hand joints was significantly higher in psoriasis or control groups with smartphone addiction showing that smartphone overuse may be an independent risk factor for developing hand joints arthritis.…”

Section: Discussionmentioning

confidence: 99%

The effect of smartphone addiction on hand joints in psoriatic patients: an ultrasound‐based study

Megna

Gisonni

Napolitano

et al. 2017

Acad Dermatol Venereol

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Early Psoriatic Arthritis

Cited by 22 publications

References 42 publications

Patient perspectives on the pathway to psoriatic arthritis diagnosis: results from a web-based survey of patients in the United States

Patient perspectives on the pathway to psoriatic arthritis diagnosis: results from a web-based survey of patients in the United States

Diagnosis and initial management in psoriatic arthritis: a qualitative study with patients

The effect of smartphone addiction on hand joints in psoriatic patients: an ultrasound‐based study

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