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D’Angelo S, Atzeni F, Benucci M, Bianchi G, Cantini F, Caporali RF, Carlino G, Caso F, Cauli A, Ciccia F, D’Agostino MA, Dagna L, Dejaco C, Epis OM, Ferrucci MG, Franceschini F, Fusaro E, Gabini M, Gerli R, Giacomelli R, Govoni M, Gremese E, Guggino G, Iagnocco A, Iannone F, Laganà B, Lubrano E, Montecucco C, Peluso R, Ramonda R, Rossini M, Salvarani C, Sebastiani GD, Sebastiani M, Selmi C, Tirri E, Marchesoni A. Management of psoriatic arthritis: a consensus opinion by expert rheumatologists. Front Med (Lausanne) 2023; 10:1327931. [PMID: 38098852 PMCID: PMC10720668 DOI: 10.3389/fmed.2023.1327931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/16/2023] [Indexed: 12/17/2023] Open
Abstract
Background Psoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal disease involving several articular and extra-articular structures. Despite the important progresses recently made in all of the aspects of this disease, its management is still burdened by unresolved issues. The aim of this exercise was to provide a set of statements that may be helpful for the management of PsA. Methods A group of 38 Italian rheumatologists with recognized expertise in PsA selected and addressed the following four topics: "early PsA," "axial-PsA," "extra-articular manifestations and comorbidities," "therapeutic goals." Relevant articles from the literature (2016-2022) were selected by the experts based on a PubMed search. A number of statements for each topic were elaborated. Results Ninety-four articles were selected and evaluated, 68 out of the 1,114 yielded by the literature search and 26 added by the Authors. Each of the four topic was subdivided in themes as follows: transition from psoriasis to PsA, imaging vs. CASPAR criteria in early diagnosis, early treatment for "early PsA"; axial-PsA vs. axialspondyloarthritis, diagnosis, clinical evaluation, treatment, standard radiography vs. magnetic resonance imaging for "axial PsA"; influence of inflammatory bowel disease on the therapeutic choice, cardiovascular comorbidity, bone damage, risk of infection for "comorbidities and extra-articular manifestations"; target and tools, treat-to-target strategy, role of imaging for "therapeutic goals." The final document consisted of 49 statements. Discussion The final product of this exercise is a set of statements concerning the main issues of PsA management offering an expert opinion for some unmet needs of this complex disease.
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Affiliation(s)
- Salvatore D’Angelo
- Rheumatology Department of Lucania, San Carlo Hospital of Potenza, Potenza, Italy
| | - Fabiola Atzeni
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, Messina, Italy
| | | | - Gerolamo Bianchi
- Division of Rheumatology, Department of Medical Specialties, Azienda Sanitaria Locale 3 Genovese, Genova, Italy
| | | | - Roberto Felice Caporali
- Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giorgio Carlino
- Rheumatology Service, ASL LE-DSS Casarano and Gallipoli, Gallipoli, Italy
| | - Francesco Caso
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Alberto Cauli
- Rheumatology Unit, Department of Medicine and Public Health, AOU and University of Cagliari, Cagliari, Italy
| | - Francesco Ciccia
- Rheumatology Section, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Antonietta D’Agostino
- Department of Rheumatology, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, IRCSS, Rome, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Christian Dejaco
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
- Department of Rheumatology, Teaching Hospital of the Paracelsius Medical University, Brunico Hospital (ASAA-SABES), Brunico, Italy
| | - Oscar Massimiliano Epis
- Division of Rheumatology, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Franco Franceschini
- Rheumatology and Clinical Immunology Unit, Dipartimento Continuità di Cure e Fragilità, ASST Spedali Civili di Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Enrico Fusaro
- Rheumatology Unit, University Hospital AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marco Gabini
- Rheumatology Unit, Santo Spirito Hospital, Pescara, Italy
| | - Roberto Gerli
- Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Roberto Giacomelli
- Research Unit of Immuno-Rheumatology, Department of Medicine, School of Medicine, University of Rome "Campus Biomedico", Rome, Italy
- Fondazione Policlinico Campus Bio-Medico, Rome, Italy
| | - Marcello Govoni
- Rheumatology Unit, Department of Medical Sciences, Azienda Ospedaliero-Universitaria S. Anna-Ferrara, University of Ferrara, Ferrara, Italy
| | - Elisa Gremese
- Clinical Immunology Unit, Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Annamaria Iagnocco
- Academic Rheumatology Centre, Department of Clinical and Biological Sciences, Università degli Studi di Torino, Turin, Italy
| | - Florenzo Iannone
- DiMePRe-J, Rheumatology Unit, Università degli studi di Bari “Aldo Moro”, Bari, Italy
| | - Bruno Laganà
- Department of Clinical and Molecular Medicine, Sapienza University of Rome-S. Andrea University Hospital, Rome, Italy
| | - Ennio Lubrano
- Academic Rheumatology Unit, Department of Medicine and Health Sciences "Vincenzo Tiberio", Università Degli Studi del Molise, Campobasso, Italy
| | - Carlomaurizio Montecucco
- Department of Internal Medicine and Therapeutics, Rheumatology Unit, University of Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Rosario Peluso
- Department of Clinical Medicine and Surgery, School of Medicine, University Federico II of Naples, Naples, Italy
| | - Roberta Ramonda
- Rheumatology Unit+ EULAR Center of Excellence in Rheumatology, Department of Medicine-DIMED, University of Padova, Padua, Italy
| | - Maurizio Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Carlo Salvarani
- Azienda USL-IRCCS di Reggio Emilia, Università di Modena e Reggio Emilia, Reggio Emilia, Italy
| | | | - Marco Sebastiani
- Rheumatology Unit, CHIMOMO, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Selmi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Department of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy
| | - Enrico Tirri
- Rheumatology Unit, Ospedale del Mare, Naples, Italy
| | - Antonio Marchesoni
- Rheumatology, Humanitas San Pio X, Milan, Italy
- Ospedale S. Maria Nuova, Reggio Emilia, Italy
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Limongelli G, Iucolano S, Monda E, Elefante P, De Stasio C, Lubrano I, Caiazza M, Mazzella M, Fimiani F, Galdo M, De Marchi G, Esposito M, Rubino M, Cirillo A, Fusco A, Esposito A, Trama U, Esposito S, Scarano G, Sepe J, Andria G, Orlando V, Menditto E, Chiodini P, Iolascon A, Franzese A, Sanduzzi Zamparelli A, Tessitore A, Romano A, Venosa A, Nunzia Olivieri A, Bianco A, La Manna A, Cerbone AM, Spasiano A, Agnese Stanziola A, Colao A, De Bellis A, Gambale A, Toriello A, Tufano A, Ciampa A, Maria Risitano A, Pisani A, Russo A, Volpe A, De Martino B, Amato B, De Fusco C, Piscopo C, Selleri C, Tucci C, Pignata C, Cioffi D, Melis D, Pasquali D, De Brasi D, Spitaleri D, De Brasi D, Russo D, Martellotta D, De Michele E, Varricchio E, Miraglia Del Giudice E, Coscioni E, Cimino E, Pane F, Tranfa F, Pollio F, Lonardo F, Nuzzi F, Simonelli F, Trojsi F, Habetswallner F, Valentini G, Cerbone G, Parenti G, Tedeschi G, Capasso G, Battista Rossi G, Gaglione G, Sarnelli G, Argenziano G, Bellastella G, De Michele G, Fiorentino G, Spadaro G, Scala I, Santoro L, Zeppa L, Auricchio L, Elio Adinolfi L, Alessio M, Amitrano M, Savanelli MC, Russo MG, Ferrucci MG, Carbone MT, Pellecchia MT, Salerno M, Melone M, Del Donno M, Vitale M, Triggiani M, Della Monica M, Lo Presti M, Tenuta M, Mignogna MD, Schiavulli M, Zacchia M, Brunetti-Pierri N, Iovino P, Moscato P, Iandoli R, Scarpa R, Russo R, Troisi S, Sbordone S, Perrotta S, Fecarotta S, Sampaolo S, Cicalese V. Diagnostic issues faced by a rare disease healthcare network during Covid-19 outbreak: data from the Campania Rare Disease Registry. J Public Health (Oxf) 2021; 44:586-594. [PMID: 33982102 PMCID: PMC8194710 DOI: 10.1093/pubmed/fdab137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/06/2021] [Accepted: 04/12/2021] [Indexed: 12/16/2022] Open
Abstract
Background The aims of this study were: to investigate the capacity of the rare disease healthcare network in Campania to diagnose patients with rare diseases during the outbreak of Covid-19; and to shed light on problematic diagnoses during this period. Methods To describe the impact of the Covid-19 pandemic on the diagnosis of patients with rare diseases, a retrospective analysis of the Campania Region Rare Disease Registry was performed. A tailored questionnaire was sent to rare disease experts to investigate major issues during the emergency period. Results Prevalence of new diagnoses of rare disease in March and April 2020 was significantly lower than in 2019 (117 versus 317, P < 0.001 and 37 versus 349, P < 0.001, respectively) and 2018 (117 versus 389, P < 0.001 and 37 versus 282, P < 0.001, respectively). Eighty-two among 98 rare disease experts completed the questionnaire. Diagnostic success (95%), access to diagnosis (80%) and follow-up (72%), lack of Personal Protective Equipment (60%), lack of Covid-19 guidelines (50%) and the need for home therapy (78%) were the most important issues raised during Covid-19 outbreak. Conclusions This study describes the effects of the Covid-19 outbreak on the diagnosis of rare disease in a single Italian region and investigates potential issues of diagnosis and management during this period.
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Affiliation(s)
| | - Stefano Iucolano
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Emanuele Monda
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Pasquale Elefante
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Chiara De Stasio
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Imma Lubrano
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Martina Caiazza
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | | | - Fabio Fimiani
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Maria Galdo
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Giulia De Marchi
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Martina Esposito
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Marta Rubino
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Annapaola Cirillo
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Adelaide Fusco
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Augusto Esposito
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Ugo Trama
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Salvatore Esposito
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Gioacchino Scarano
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Joseph Sepe
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Generoso Andria
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Valentina Orlando
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Enrica Menditto
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Paolo Chiodini
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
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