Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics - 23/10/13
, Dafna D. Gladman, MD b, Kim A. Papp, MD, PhD c, Majed M. Khraishi, MD d, Diamant Thaçi, MD e, Frank Behrens, MD e, Robert Northington, PhD f, Joanne Fuiman, MS f, Eustratios Bananis, PhD f, Robert Boggs, PhD f, Daniel Alvarez, MD fAbstract |
Background |
Prompt identification and treatment of psoriatic arthritis (PsA) in patients with psoriasis is critical to reducing the risk of joint damage, disability, and comorbidities.
Objective |
We sought to estimate PsA prevalence in patients with plaque psoriasis in 34 dermatology centers in 7 European and North American countries.
Methods |
Consecutive patients were evaluated by dermatologists for plaque psoriasis and subsequently by rheumatologists for PsA. PsA prevalence was estimated primarily based on rheumatologists' assessment of medical history, physical examination, and laboratory tests.
Results |
Of 949 patients evaluated, 285 (30%) had PsA (95% confidence interval 27-33) based on rheumatologists' assessment. PsA diagnosis changed in 1.2% of patients when diagnostic laboratory tests were added to medical history and physical examination. Of 285 patients given the diagnosis of PsA, 117 (41%) had not been previously given the diagnosis.
Limitations |
Bias may have been introduced by lack of standardized diagnostic criteria and unbalanced recruitment based on country populations.
Conclusions |
In this study, almost a third of patients with psoriasis seen in dermatology centers had PsA as determined by rheumatologists. More than a third of patients with PsA had not been previously given the diagnosis. Clinical evaluation alone is often sufficient basis for PsA diagnosis, but laboratory test results may be helpful in some patients.
Le texte complet de cet article est disponible en PDF.Key words : assessment, dermatologist, diagnosis, laboratory test, prevalence, psoriasis, psoriatic arthritis, rheumatologist
Plan
| The PREPARE study was sponsored by Pfizer Inc. Editorial/medical writing support was provided by Donna McGuire of UBC Scientific Solutions and was funded by Pfizer Inc. |
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| Disclosure: Dr Mease received grant support and/or honoraria for consultations or speaking engagements from Abbott, Amgen, Biogen Idec, Bristol Myers Squibb, Celgene, Crescendo, Forest, Genentech, Janssen, Lilly, Merck, Novartis, Pfizer Inc, UCB, and Vertex. Dr Gladman received grant support from Abbot, Amgen, Bristol Myers Squibb, Janssen, Pfizer Inc, and UCB. Dr Khraishi received unrestricted educational grants from Pfizer Canada. Dr Thaçi received honoraria for consultations or speaking engagements from Abbott, Amgen, Astellas, Biogen Idec, Celgene, Janssen, Leo, Lilly, MSD, Novartis, and Pfizer Inc. Dr Behrens received grant support and/or honoraria for consultations or speaking engagements from Abbott, Biotest, Chugai, MorphoSys, Pfizer Inc, Roche, and UCB. Dr Northington is an employee of inVentiv Health, paid contractors to Pfizer Inc in providing statistical support for the PREPARE study and the development of this manuscript. Dr Boggs was an employee of Pfizer Inc at the time of study conduct and manuscript development. Ms Fuiman, Dr Bananis, and Dr Alvarez are current employees of Pfizer Inc and owners of Pfizer Inc stock. Dr Papp has no conflicts of interest to declare. |
Vol 69 - N° 5
P. 729-735 - novembre 2013 Retour au numéro
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