The Need for Biological Outcomes for Biological Drugs in Psoriatic Arthritis

Tan, Ai Lyn; McGonagle, Dennis

doi:10.3899/jrheum.151296

Cited by 4 publications

(3 citation statements)

References 29 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[H1] Dactylitis scoring methods In addition to dactylitis forming one of the classification criteria components of CASPAR for PsA 5 , the number of PsA clinical outcome measures has increased rapidly over the past few years 18 . Dactylitis scores are important inclusions in most of these measures, including the Composite Psoriatic Disease Activity Index (CPDAI) and the Psoriatic Arthritis Disease Activity Score (PASDAS) 19,20 .…”

mentioning

confidence: 99%

Pathophysiology, assessment and treatment of psoriatic dactylitis

et al. 2019

Self Cite

View full text Add to dashboard Cite

Dactylitis is diffuse swelling of the digits that is usually related to an underlying inflammatory or infiltrative disorder. Psoriatic arthritis (PsA) is the most common severe disease thought to cause dactylitis. Our understanding of the pathogenesis of PsA-related dactylitis comes from experimental animal models of PsA-like disease, as well as advances in imaging and other clinical studies. Clinical trials in PsA have increasingly included dactylitis as an important secondary outcome measure. These studies indicate that cytokines drive multi-locus microanatomical pan-digital pathology. Given the importance of pro-inflammatory cytokines, the pathogenesis of dactylitis is best understood as an initial aberrant innate immune response to biomechanical stress or injury, with subsequent adaptive immune mechanisms amplifying the dactylitis inflammatory response. Regarding the treatment of dactylitis, no studies have been conducted using dactylitis as the primary outcome measure, and the current knowledge comes from analysis of dactylitis as a secondary outcome measure.

show abstract

mentioning

confidence: 99%

Pathophysiology, assessment and treatment of psoriatic dactylitis

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Dr Tan highlighted the two main areas of application for imaging in SpA, namely in clinical practice and in the research setting [ 16–18 ]. The clinical use of imaging in SpA is supported by EULAR, who outlined its usefulness; in particular, the use of MRI and US [ 19 ].…”

Section: Lecturesmentioning

confidence: 99%

BSR Spondyloarthritis Course, 27 February 2020. Spondyloarthritis: pathogenesis, diagnosis and management

Marzo‐Ortega

Tan

McGonagle

et al. 2020

Rheumatology Advances in Practice

Self Cite

View full text Add to dashboard Cite

High-quality continuous medical education is essential to maintain excellence in healthcare delivery, upskilling professionals and improving patient outcomes. This is particularly relevant when addressing rare disease groups such as the Spondyloarthritis, a group of heterogeneous inflammatory conditions that affect joints and other organs such as the skin, bowel and the eye. Professional bodies such as the British Society for Rheumatology (BSR) are well placed to deliver this type of education. In 2020 the BSR ran a dedicated SpA course aimed at rheumatology health care professionals wishing to update their basic knowledge in SpA with a review of the latest advances in the field. Here, we summarise the proceedings of the meeting and discuss the value of such an initiative.

show abstract

“…The challenges of diagnosis in early PsA are not confined to the heterogeneity of disease, which is evident from the variety of outcome measures available (2). In contrast to RA, there are no biomarkers such as anti-citrullinated peptide antibody (ACPA) or rheumatoid factor (RF) to identify early PsA and therefore diagnosis is dependent upon identification of specific clinical features.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Imaging in Psoriatic Arthritis: What Have We Learnt in the Last Five Years?

et al. 2020

Self Cite

View full text Add to dashboard Cite

Psoriatic arthritis (PsA) is a complex heterogeneous disease with multiple inter-related pathologies such as synovitis, enthesitis, tendinopathy, and dactylitis. Clinical assessment is limited in its detail to assess pathology, thus in recent years, ultrasound (US) has become more popular, given its high sensitivity to detect inflammatory arthritis and ability to inform clinical decisions. Although a qualitative technique, US findings can be graded semi-quantitatively for grayscale (GS) and power Doppler (PD). Synovitis is frequently present in inflammatory arthritis pathologies, and in PsA, recent evidence shows a propensity for tendon and entheseal lesions. The presence of flexor tenosynovitis and flexor tendon insertional enthesopathy at accessory pulleys is supportive of the “Deep Koebner” concept. Peri-tendinous inflammation—mutual to PsA or rheumatoid arthritis (RA), is associated with soft tissue oedema with PD signal frequently at the flexor tendon compartments in PsA. Research on enthesitis in PsA/PsO has improved understanding in subclinical and clinical PsA, explored associations with progression to PsA, and investigated links to prognosis assessment. Dactylitis is a pathognomonic PsA lesion where US has enhanced knowledge of the disease course and pathology of lesions such as: flexor tenosynovitis; synovitis; and soft tissue oedema. Increased US sensitivity has also brought innovation including promising automated ultrasound scanning techniques. So, what have we learnt in recent years and what are the unmet needs to focus future research initiatives in this disabling disease? This narrative review article assesses the neoteric evidence, bringing into context the knowledge gained and highlighting potential areas of research.

show abstract

The Need for Biological Outcomes for Biological Drugs in Psoriatic Arthritis

Cited by 4 publications

References 29 publications

Pathophysiology, assessment and treatment of psoriatic dactylitis

Pathophysiology, assessment and treatment of psoriatic dactylitis

BSR Spondyloarthritis Course, 27 February 2020. Spondyloarthritis: pathogenesis, diagnosis and management

Ultrasound Imaging in Psoriatic Arthritis: What Have We Learnt in the Last Five Years?

Contact Info

Product

Resources

About