The ATTRACT study: screening for the early identification of axial psoriatic arthritis in a cohort of Italian psoriatic patients.

Autor: Luchetti Gentiloni MM; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Paci V; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.; Internal Medicine Residency Programme, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Cimaroli I; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.; Internal Medicine Residency Programme, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Agostinelli A; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.; Internal Medicine Residency Programme, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Giannoni M; Dermatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Campanati A; Dermatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Diotallevi F; Dermatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Carotti M; Radiology Clinic, Department of Radiological Sciences, Polytechnic University of Marche, Ancona, Italy., Sessa F; Neuroradiology Clinic, Department of Radiological Sciences, Polytechnic University of Marche, Ancona, Italy., Sordillo R; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.; Internal Medicine Residency Programme, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Macchini C; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.; Internal Medicine Residency Programme, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Fiorini F; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.; Internal Medicine Residency Programme, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Massaccesi L; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.; Internal Medicine Residency Programme, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Ciferri M; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Gigli M; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.; Internal Medicine Residency Programme, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Marconi V; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.; Internal Medicine Residency Programme, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Perini L; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.; Internal Medicine Residency Programme, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Marani A; Dermatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Giovagnoni A; Radiology Clinic, Department of Radiological Sciences, Polytechnic University of Marche, Ancona, Italy., Polonara G; Neuroradiology Clinic, Department of Radiological Sciences, Polytechnic University of Marche, Ancona, Italy., Offidani AM; Dermatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Benfaremo D; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy., Proft F; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité-Universitätsmedizin, Berlin, Germany., Poddubnyy D; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité-Universitätsmedizin, Berlin, Germany., Moroncini G; Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
Jazyk: angličtina
Zdroj: Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2024 Aug 01; Vol. 63 (8), pp. 2152-2161.
DOI: 10.1093/rheumatology/kead566
Abstrakt: Objective: There is growing interest in the early identification of patients with axial PsA (axPsA). We aimed to evaluate whether a dermatology-based screening strategy could help to identify axPsA patients.
Methods: The dermatologist-centred screening (DCS) questionnaire was administrated by dermatologists to consecutive patients fulfilling the inclusion criteria [(i) age ≥18 years and (ii) clinical diagnosis of psoriasis made by a dermatologist] to identify patients eligible (affirmative answers 1-3c of the DCS) for rheumatological evaluation. Clinical, laboratory, genetic and imaging data were collected from all referred patients.
Results: Among the 365 patients screened, 265 fulfilled the inclusion criteria and 124/265 (46.8%) were eligible for rheumatological referral. Diagnosis of axPsA, with or without peripheral PsA (pPsA), was made in 36/124 (29.0%) patients; pPsA without axial involvement was found in 21/124 (16.9%) patients. Back pain at screening was recorded in 174 (66%) patients, with 158 (60%) reporting a back pain duration longer than 3 months and 140 (53%) reporting back pain onset before the age of 45 years. Active inflammatory and/or structural post-inflammatory changes in the sacroiliac joints and/or spine were observed in all axPsA patients. Patients with PsA showed a numerically longer duration of back pain and higher CRP levels in comparison with patients with psoriasis without PsA.
Conclusion: The DCS tool proved to be a valuable screening strategy for detecting and characterizing patients with axPsA in a real-life cohort of psoriasis patients in a dermatological setting and helped to identify a substantial number of patients affected by undiagnosed pPsA.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology.)
Databáze: MEDLINE