Psoriatic arthritis: New tool may help predict a person's risk

Evan Walker
Evan Walker TheMediTary.Com |
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A new computerized tool may help in predicting a person’s likelihood of developing psoriatic arthritis. Richard Newstead/Getty Images
  • Psoriatic arthritis is a common condition affecting around 1 in 3 people with psoriasis.
  • Currently, diagnosing and predicting the condition is challenging.
  • Recently, scientists have developed an online tool they say can predict psoriatic arthritis risk.

Psoriasis, an immune-mediated inflammatory skin condition, affects around Health">60 million people worldwide.

Most commonly associated with skin lesions — often in the form of plaques — psoriasis also increases the risk of other health issues.

For instance, people with psoriasis are more likely to experience obesity, heart disease, non-alcoholic fatty liver disease, type 2 diabetes, metabolic syndrome, and mental Health conditions.

One of the most common co-morbidities, affecting up to 30% of people with a psoriasis diagnosis, is psoriatic arthritis.

The researchers have made an online version of the PRESTO calculator for clinicians and patients to use.

After filling out an online form, the tool generates a risk score for either the 1 year or 5 year projections.

This tool uses data that clinicians routinely collect, which means there is no need for additional lab tests or clinic visits.

Medical News Today spoke with one of the paper’s authors, Lihi Eder, PhD, an associate professor at the University of Toronto in Canada.

“This is the first prediction score to estimate the risk of an individual patient with psoriasis to develop PsA that completely rely on readily available, clinical information and can be applied in any clinic setting,” Eder said.

So far, she said, the tool has been well received.

“The webpage has been accessed by clinicians and researchers from all across the world. So far, the feedback is very positive,” Eder said.

Medical News Today also contacted Maham Khan, a consultant dermatologist at the Cadogan Clinic. She was asked about the importance of catching PsA earlier.

“Several studies and clinical trials have consistently suggested that early intervention in PsA leads to better patient outcomes,” Khan said.

Khan added that earlier treatment is linked to less damage to joints in the long term and better control of symptoms such as joint pain, swelling, and stiffness.

“Early intervention may slow down the progression of PsA, potentially preventing or delaying the development of severe complications,” she noted.

Estimating risk with PRESTO may also help tailor treatment plans to fit a person’s individual risk factors, which may also improve outcomes.

The researchers acknowledged that their tool was designed using a relatively small pool of data. This limited their ability to analyze by sex, race, and ethnic group. It is possible that more nuanced patterns might emerge once they have more data.

Also, because the researchers recruited from within clinics, their participants mostly had moderate to severe psoriasis and risk factors for PsA might differ in people with less severe symptoms.

The researchers plan on expanding their current work.

“We plan to validate the PRESTO score in an external cohort of psoriasis patients. We are currently completing the data collection for this,” Eder said.

“PRESTO could have several valuable applications,” said Khan. “It may help identify individuals with psoriasis who are at a higher risk.”

In addition, she said “the tool could assist healthcare professionals in implementing preventive measures for high-risk individuals, potentially reducing the likelihood of PsA development.”

Fitzpatrick agrees that the tool will be helpful, but it is not yet perfect.

“It will certainly be useful, in particular for clinicians who can’t access other ways to assess patients,” he said. “The study shows that this tool will correctly predict PsA in around seven out of 10 patients, which is good, but it still means we will miss three out of 10. At this stage, it’s the best we have.”

Currently, there are no biomarkers for PsA, which is why predicting and diagnosing this condition are still challenging.

Fitzpatrick is part of a group called HIPPOCRATES, which is currently launching a large, multi-site, pan-European study into PsA called HPOS.

He said the group hopes to “identify and validate clinical and molecular risk factors for the development of psoriatic arthritis.”

PRESTO is likely to be a useful tool for doctors, but in the future experts hope that HPOS will finally uncover even more accurate prediction and diagnosis.

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