A preclinical phase exists in patients with psoriatic arthritis before diagnosis

[Fred]

This study suggests there is a preclinical phase in patients with psoriatic arthritis prior to the diagnosis.

Quote:

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Objective:
To assess whether the presence of nonspecific musculoskeletal symptoms, their degree, and change over time predict the development of psoriatic arthritis (PsA) in a prospective cohort of psoriasis patients without arthritis at baseline.

Methods:
This prospective cohort study involved patients with psoriasis who were assessed at baseline to exclude the presence of clinical PsA. The study participants were reassessed annually to determine if they had developed PsA. The presence of musculoskeletal symptoms and the patients’ assessments of pain, fatigue, stiffness, physical function, and psychological distress were recorded at each visit. Cox proportional hazards models were used to assess what symptoms predicted the development of PsA.

Results:
A total of 57 of 410 psoriasis patients developed PsA. At baseline, the presence of arthralgia in women (hazard ratio (hr) 2.59, P = 0.02), heel pain (HR 4.18, P = 0.02), high fatigue score (HR 2.36, P = 0.007), and high stiffness score (HR 2.03, P = 0.045) predicted subsequent development of PsA. In addition, an increase from baseline in fatigue score (HR 1.27, P = 0.001), pain score (HR 1.34, P < 0.001), and stiffness score (HR 1.21, P = 0.03), and a worsening in physical function score (HR 0.96, P = 0.04) predicted the development of PsA.

Conclusion:
A preclinical phase exists in patients with PsA prior to the diagnosis of the disease. This phase is characterized by nonspecific musculoskeletal symptoms, including joint pain, fatigue, and stiffness.

Source: onlinelibrary.wiley.com

*American College of Rheumatology

[jiml]

That's a very interesting study, it says they were reassessed annually but doesn't give a timescale, or if it does I missed that....I'm wondering at what point in the study did they start to notice the signs, and if spotted early will it make any difference to the development of the disease....
Is it helpful having a prediction of psoriatic arthritis, if there's nothing that can be done to prevent it ?

[Fred]

That's a very interesting study, it says they were reassessed annually but doesn't give a timescale, or if it does I missed that....I'm wondering at what point in the study did they start to notice the signs.

It says they were reassessed annually so I'm assuming it was a 12 month time scale.

and if spotted early will it make any difference to the development of the disease....

Spotting it early won't make a difference on it's development unless treated, but they would be able to see if it is getting worse.

Is it helpful having a prediction of psoriatic arthritis, if there's nothing that can be done to prevent it ?

You can't prevent it, but you can treat it and maybe make some adjustments to life style so I would say it's helpful.

[Caroline]

What kind of change of lifestyle would you think, Fred?

[Fred]

What kind of change of lifestyle would you think, Fred?

For me none. I prefer to enjoy my life and do what I enjoy.

But some could benefit by changing their lifestyle. Foods, Alcohol, Tobacco, Exercise, Etc.

And I did say "Maybe"