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Core items to be included in a definition of moderate psoriatic arthritis: literature review and expert opinion

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Abstract

Evidence-based treatment recommendations for psoriatic arthritis (PsA) suggest that treatment should be individualised but acknowledge the difficulty of correctly defining levels of activity (mild, moderate and severe). The aim of this study was to define the parameters or disease characteristics that should be included in a future definition of moderate PsA. Mixed. methods: (1) literature review to identify previous assessment tools used to classify patients into mild, moderate and severe forms, and (2) survey of rheumatologists, and experts in PsA, to obtain their opinion on the degree of validation and applicability of published definitions and tools, and on the parameters that should be included in a future definition of moderate PsA. We propose eight domains/items to be included in a definition of moderate PsA: number of active joints and inflamed entheses, physician global assessment (by visual analogue scale), dactylitis, body surface area (BSA) affected by psoriasis, psoriasis in special locations, and absence of hip involvement. The Disease Activity Index for Psoriatic Arthritis (DAPSA) score would be supported as part of this definition, as would the Psoriatic Arthritis Impact of Disease (PsAID) index. This study proposes a set of items/domains to be included in a definition of moderate PsA based on literature and expert opinion, which can be the starting point for further development and validation studies of the proposed items.

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Funding

Amgen provided funding in the past to conduct the literature review and survey by Instituto de Salud Musculoesquelética but did not collaborate in the writing or publishing this manuscript.

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Authors and Affiliations

  1. Rheumatology, Hospital Universitario Son Espases, Carretera de Valldemossa, 79, Palma, Illes Balears, Nord, 07120, Spain

    Ana Urruticoechea-Arana

  2. Rheumatology, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain

    José Luis Álvarez-Vega

  3. Rheumatology, Hospital Universitario de Basurto, Bilbao, Spain

    Maria Luz García-Vivar

  4. Rheumatology, Complejo Hospitalario Universitario de A Coruña, La Coruña, Spain

    José Antonio Pinto-Tasende

  5. Instituto de Salud Musculoesquelética (Inmusc), Madrid, Spain

    María Jesús García de Yébenes & Loreto Carmona

  6. Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Spain

    Rubén Queiro

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Contributions

AUA designed the study and selected the panel. LC, MJGdY, JLAV, MLGV, JAPT and RQ critically reviewed the literature and generated input for the survey items. AUA and JAPT circulated the survey to their respective expert groups. All authors contributed to the manuscript.

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Correspondence to Ana Urruticoechea-Arana.

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Urruticoechea-Arana, A., Álvarez-Vega, J.L., García-Vivar, M.L. et al. Core items to be included in a definition of moderate psoriatic arthritis: literature review and expert opinion. Rheumatol Int (2024). https://doi.org/10.1007/s00296-024-05644-y

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