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Caso F, Costa L, Megna M, Cascone M, Maione F, Giacomelli R, Scarpa R, Ruscitti P. Early psoriatic arthritis: clinical and therapeutic challenges. Expert Opin Investig Drugs 2024:1-21. [PMID: 39041193 DOI: 10.1080/13543784.2024.2383421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 07/18/2024] [Indexed: 07/24/2024]
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is a chronic immunoinflammatory disease of the enthesis and adjacent synovium, skin, and nail, which early diagnosis may be crucial for starting a prompt therapeutic intervention. Theoretically, early treatment offers the advantage of acting on the reduction of the articular damage progression since initial phases of the disease. AREAS COVERED This review explores the challenges of clinical-diagnostic aspects and the underlying pathophysiology of early PsA phases, as well as the evidence evaluating the impact of early intervention on disease outcomes. EXPERT OPINION Main instruments for early PsA diagnosis include recognizing synovial-entheseal inflammatory signs at onset, improving screening PsA high-risk subjects, and increasing disease knowledge of physicians and patients with psoriasis or familial history. PsA continues to significantly impact on the Quality of Life of patients affected by the disease, making necessary to deeply study clinical manifestations, risk factors, and underlying immunoinflammatory mechanisms, as well as to identify biomarkers for early identification. Additionally, it remains a need to increase more evidence on understanding how early treatment of PsA and of psoriasis might influence the course of the disease.
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Affiliation(s)
- Francesco Caso
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luisa Costa
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Mario Cascone
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Francesco Maione
- ImmunoPharmaLab, Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Roberto Giacomelli
- Research and Clinical Unit of immunorheumatology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Raffaele Scarpa
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Piero Ruscitti
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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Watad A, McGonagle D. Towards early diagnosis of axial psoriatic arthritis. Rheumatology (Oxford) 2024; 63:2042-2043. [PMID: 38262342 DOI: 10.1093/rheumatology/keae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 12/07/2023] [Indexed: 01/25/2024] Open
Affiliation(s)
- Abdulla Watad
- Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK
| | - Dennis McGonagle
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK
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Luchetti Gentiloni MM, Paci V, Cimaroli I, Agostinelli A, Giannoni M, Campanati A, Diotallevi F, Carotti M, Sessa F, Sordillo R, Macchini C, Fiorini F, Massaccesi L, Ciferri M, Gigli M, Marconi V, Perini L, Marani A, Giovagnoni A, Polonara G, Offidani AM, Benfaremo D, Proft F, Poddubnyy D, Moroncini G. The ATTRACT study: screening for the early identification of axial psoriatic arthritis in a cohort of Italian psoriatic patients. Rheumatology (Oxford) 2024; 63:2152-2161. [PMID: 37878802 PMCID: PMC11292137 DOI: 10.1093/rheumatology/kead566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/25/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023] Open
Abstract
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.
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Affiliation(s)
| | - Valentino Paci
- 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
| | - Ilaria Cimaroli
- 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
| | - Alice Agostinelli
- 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
| | - Melania Giannoni
- Dermatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Anna Campanati
- Dermatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Federico Diotallevi
- Dermatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Marina Carotti
- Radiology Clinic, Department of Radiological Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Francesco Sessa
- Neuroradiology Clinic, Department of Radiological Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Raffaella Sordillo
- 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
| | - Cristina Macchini
- 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
| | - Federico Fiorini
- 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
| | - Leonardo Massaccesi
- 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
| | - Monia Ciferri
- Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Marco Gigli
- 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
| | - Valentina Marconi
- 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
| | - Lucia Perini
- 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
| | - Andrea Marani
- Dermatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Andrea Giovagnoni
- Radiology Clinic, Department of Radiological Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Gabriele Polonara
- Neuroradiology Clinic, Department of Radiological Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Anna Maria Offidani
- Dermatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Devis Benfaremo
- Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Fabian Proft
- Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité-Universitätsmedizin, Berlin, Germany
| | - Denis Poddubnyy
- Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité-Universitätsmedizin, Berlin, Germany
| | - Gianluca Moroncini
- Medical Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
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Alascio L, Azuaga-Piñango AB, Frade-Sosa B, Sarmiento-Monroy JC, Ponce A, Farietta S, Gómez-Puerta JA, Sanmartí R, Cañete JD, Ramírez J. Axial Disease in Psoriatic Arthritis: A Challenging Domain in Clinical Practice. Diagnostics (Basel) 2024; 14:1637. [PMID: 39125513 PMCID: PMC11311426 DOI: 10.3390/diagnostics14151637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/24/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024] Open
Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory condition affecting about one-third of individuals with psoriasis. Defining axial involvement in PsA (axPsA) remains debated. While rheumatologists guide clinical practice, consensus on axPsA is still lacking. This paper explores historical and upcoming definitions from the Axial Involvement in Psoriatic Arthritis (AXIS) study, which aims to establish a validated axPsA definition. Epidemiological data reveal diverse axPsA prevalence rates, emphasizing its complex relationship with peripheral arthritis and enthesitis. Unique genetic, clinical, and radiological features differentiate axPsA from ankylosing spondylitis (AS), necessitating refined classification criteria. The recommendations from the Assessment of Spondylarthritis international Society (ASAS) provide valuable guidance due to the limited direct evidence. Emerging therapies, including interleukin-23 (IL-23) inhibitors or Janus kinase (JAK) inhibitors, are under investigation for axPsA. Currently, secukinumab, an interleukin-17 (IL-17) inhibitor, is an evidence-based option for axPsA management. However, given the variability in individual patient responses and disease manifestations, personalized, evidence-based treatment approaches remain essential for optimizing patient outcomes. In the final section, two real-life cases illustrate the challenges in managing axPsA, emphasizing the importance of tailored therapies. Achieving precision in defining axPsA remains a formidable task, making detailed criteria essential for effective strategies and improving patient outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Julio Ramírez
- Arthritis Unit, Rheumatology Department, Hospital Clínic Barcelona, Villarroel Street, 170, 08036 Barcelona, Spain; (L.A.); (A.B.A.-P.); (B.F.-S.); (J.C.S.-M.); (A.P.); (S.F.); (J.A.G.-P.); (R.S.); (J.D.C.)
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Watts S, Nagib LG, Bamford S, Sheraz A, Tahir H. A Patient Survey Exploring the Burden of Inflammatory Back Pain in Patients With Known Psoriasis. Cureus 2024; 16:e51968. [PMID: 38333437 PMCID: PMC10853012 DOI: 10.7759/cureus.51968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 02/10/2024] Open
Abstract
Background In the United Kingdom, diagnostic delay remains a challenge in axial spondyloarthritis (axSpA). Psoriasis is a frequently identified extra-musculoskeletal manifestation associated with axSpA. In this study, we aimed to determine the prevalence of inflammatory back pain (IBP) in psoriasis patients at a specialized psoriasis dermatology clinic in a London NHS Trust. Our primary goal was to identify psoriasis patients with IBP who were not referred to a rheumatologist, potentially leading to axSpA diagnostic delays. Additionally, we aimed to investigate factors contributing to these delays and strategies to address them. Methodology A patient survey consisting of 22 questions was used to assess the prevalence of IBP among 66 psoriasis patients attending a weekly specialized psoriasis dermatology clinic within a London NHS Trust between May and July 2023. The survey comprised patient demographic information along with inquiries about the existence of back pain exceeding three months. The Berlin Criteria was utilized to identify IBP among patients who reported experiencing back pain for over three months. Additionally, the survey sought information on prior diagnosis of axSpA and whether participants had consulted healthcare professionals regarding their back pain. Results Of the 66 patients invited, 51 (77%) completed the survey. The average age of the patients was 50 years (range = 19-74 years), with 58.8% being female. The mean duration of psoriasis was 15.7 years (range = 2-44 years). Overall, 45% (23/51) reported back pain lasting over three months. Among the patients who reported back pain for more than three months, 13 met the Berlin Criteria for IBP (25% of the total surveyed), and only four of these patients had a diagnosis of axSpA. Notably, seven patients (14% of the total surveyed) potentially had undiagnosed axSpA. General practitioners (GPs) were commonly consulted for back pain, yet only 39% of those with prolonged back pain had seen a rheumatologist. Despite experiencing prolonged back pain, 17% of patients had not sought healthcare advice for their symptoms. Conclusions This study highlights that IBP is a common yet underdiagnosed comorbidity in psoriasis patients. Dermatologists, GPs, and other allied healthcare professionals play a crucial role in detecting early axSpA. However, limited awareness of IBP hinders its identification in psoriasis patients and subsequent referral to rheumatologists. This highlights the need for improving awareness and education regarding axSpA among dermatologists and allied healthcare professionals as well as the public and patients to ensure timely diagnosis. The development of simple and easy-to-administer screening questionnaires to aid non-rheumatologists in identifying patients with IBP together with simplified referral pathways would increase onward referrals of appropriate patients to rheumatologists.
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Affiliation(s)
- Sophia Watts
- Dermatology, Royal Free London NHS Foundation Trust, London, GBR
| | - Lydia G Nagib
- Medicine, Royal Free London NHS Foundation Trust, London, GBR
| | - Sian Bamford
- Physiotherapy, Royal Free London NHS Foundation Trust, London, GBR
| | - Adil Sheraz
- Dermatology, Royal Free London NHS Foundation Trust, London, GBR
| | - Hasan Tahir
- Division of Medicine, University College London, London, GBR
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Barnett R, Gaffney K, Sengupta R. Diagnostic delay in axial spondylarthritis: A lost battle? Best Pract Res Clin Rheumatol 2023; 37:101870. [PMID: 37658016 DOI: 10.1016/j.berh.2023.101870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 09/03/2023]
Abstract
Diagnostic delay in axial spondylarthritis (axSpA) remains an unacceptable worldwide problem; with evidence suggesting significant detrimental impact both clinically on the individual, and economically on society. There is therefore, a need for global action across various healthcare professions that come into contact with patients living, and suffering, with undiagnosed axSpA. Recent estimates of the median diagnostic delay suggest that globally, individuals with axSpA wait between 2 and 6 years for a diagnosis - revealing a clear benchmark for improvement. This timespan presents a window of opportunity for earlier diagnosis and intervention, which will likely improve patient outcomes. This review describes the current diagnostic delay as estimated across countries and over time, before presenting evidence from published strategies that may be implemented to improve this delay across primary and secondary care, including for specialties treating extra-musculoskeletal manifestations of axSpA (ophthalmology, gastroenterology, dermatology). Ongoing campaigns tackling delayed diagnosis in axSpA are also highlighted.
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Affiliation(s)
- Rosemarie Barnett
- Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK; Rheumatology Department, Royal National Hospital for Rheumatic Diseases & Brownsword Therapies Centre, Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath, BA1 3NG, UK.
| | - Karl Gaffney
- Rheumatology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norfolk & Norwich, University Hospital, Colney Lane, Norwich NR4 7UY, UK.
| | - Raj Sengupta
- Rheumatology Department, Royal National Hospital for Rheumatic Diseases & Brownsword Therapies Centre, Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath, BA1 3NG, UK.
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Abstract
Axial symptoms (i.e., back pain) are common in the general population. At the same time 25-70% of patients with psoriatic arthritis (PsA) exhibit signs of inflammatory axial involvement (axial PsA). The presence of unexplained chronic (duration ≥ 3 months) back pain in a patient with psoriasis or PsA should trigger evaluation of the presence of axial involvement. Evaluation of axial involvement normally involves imaging of the axial skeleton (sacroiliac joints and/or spine) in addition to clinical and laboratory evaluation. Symptomatic patients with confirmed axial PsA are treated with a combination of non-pharmacologic and pharmacologic methods including the use of non-steroidal anti-inflammatory drugs, tumour necrosis factor, interleukin 17, and Janus kinase inhibitors. Interleukin 23 blockade might also be effective in the axial domain of PsA; a dedicated clinical study is ongoing at present. Safety considerations, patient preference, as well as the presence of other disease manifestations (especially of extra-musculoskeletal manifestations-clinically relevant psoriasis, acute anterior uveitis, inflammatory bowel disease), define the choice of a specific drug or drug class.
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Affiliation(s)
- Denis Poddubnyy
- Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
- Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany.
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Proft F, Käding H. Same, same or different? Commonalities and differences between spondyloarthritis and its subsets of axial and peripheral spondyloarthritis with psoriatic arthritis and its diverse phenotypes. RMD Open 2023; 9:e002872. [PMID: 37028815 PMCID: PMC10083843 DOI: 10.1136/rmdopen-2022-002872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/23/2023] [Indexed: 04/09/2023] Open
Affiliation(s)
- Fabian Proft
- Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Henriette Käding
- Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany
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Regierer AC, Weiß A, Proft F, Baraliakos X, Behrens F, Poddubnyy D, Schett G, Lorenz HM, Worsch M, Strangfeld A. Comparison of patients with axial PsA and patients with axSpA and concomitant psoriasis: an analysis of the German register RABBIT-SpA. RMD Open 2023; 9:e002837. [PMID: 36898762 PMCID: PMC10008170 DOI: 10.1136/rmdopen-2022-002837] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) show certain overlaps: A subset of patients with PsA can develop axial involvement (axial PsA, axPsA), while a subset of patients with axSpA presents with psoriasis (axSpA+pso). Treatment strategy for axPsA is mostly based on axSpA evidence. OBJECTIVES To compare demographic and disease-specific parameters of axPsA and axSpA+pso. METHODS RABBIT-SpA is a prospective longitudinal cohort study. AxPsA was defined based on (1) clinical judgement by rheumatologists; (2) imaging (sacroiliitis according to modified New York criteria in radiographs or signs of active inflammation in MRI or syndesmophytes/ankylosis in radiographs or signs of active inflammation in spine MRI). axSpA was stratified into axSpA+pso and axSpA without pso. RESULTS Psoriasis was documented in 181/1428 axSpA patients (13%). Of 1395 PsA patients, 359 (26%) showed axial involvement. 297 patients (21%) fulfilled the clinical definition and 196 (14%) the imaging definition of axial manifestation of PsA. AxSpA+pso differed from axPsA regardless whether clinical or imaging definition was used. axPsA patients were older, more often female and less often HLA-B27+. Peripheral manifestations were more often present in axPsA than in axSpA+pso, whereas uveitis and inflammatory bowel disease were more common in axSpA+pso. Burden of disease (patient global, pain, physician global) was similar among axPsA and axSpA+pso patients. CONCLUSIONS AxPsA differs from axSpA+pso in its clinical manifestations, irrespective of whether axPsA is defined clinically or by imaging. These findings support the hypothesis that axSpA and PsA with axial involvement are distinct entities, so extrapolation of treatment data from randomised controlled trials in axSpA should be performed with caution.
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Grants
- RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Celltrion, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB, and Viatris.
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Affiliation(s)
| | - Anja Weiß
- Epidemiology Unit, German Rheumatism Research Center, Berlin, Germany
| | - Fabian Proft
- Department of Gastroenterology, Infectiology and Rheumatology (Including Nutrition Medicine), Charité Universitätsmedizin, Berlin, Germany
| | | | - Frank Behrens
- Institute for Translational Medicine & Pharmacology ITMP, Frankfurt am Main, Germany
| | - Denis Poddubnyy
- Epidemiology Unit, German Rheumatism Research Center, Berlin, Germany
- Department of Gastroenterology, Infectiology and Rheumatology (Including Nutrition Medicine), Charité Universitätsmedizin, Berlin, Germany
| | - Georg Schett
- Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Hanns-Martin Lorenz
- Department of Internal Medicine V Hematology Oncology Rheumatology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Anja Strangfeld
- Epidemiology Unit, German Rheumatism Research Center, Berlin, Germany
- Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin, Berlin, Germany
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Phillips R. New screening tool developed to aid diagnosis of axial PsA. Nat Rev Rheumatol 2022; 18:551. [PMID: 36076013 DOI: 10.1038/s41584-022-00840-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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