Patients ‘very skilled’ at monitoring own non-musculoskeletal psoriatic arthritis features
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WASHINGTON — Dactylitis, psoriasis and other non-musculoskeletal manifestations of psoriatic arthritis can be accurately monitored through patient self-reporting, according to data presented at ACR Convergence 2024.
The findings validated a set of patient-reported outcome measures for non-musculoskeletal manifestations of PsA recently introduced to DANBIO, a Danish nationwide clinical registry.
“Clinicians are busy in the clinic, so even though they find it important to record manifestations like skin and nail psoriasis, dactylitis and uveitis, this doesn’t necessarily happen,” Louise Nielung, MD, of Rigshospitalet Glostrup and the University of Copenhagen, told Healio. “That’s when the idea was born to have these manifestations registered by the patients themselves.”
The specific outcome measures consisted of questions asking patients to report whether they had dactylitis, skin or nail psoriasis, or uveitis, as well as to describe the extent of skin psoriasis and number of digits impacted by dactylitis. To validate these measures, Nielung and colleagues administered the questions to 300 patients (mean age, 54 years; 51% women) and compared their answers to “gold standard” physician assessments, they wrote.
According to the researchers, patients’ dactylitis counts were on average 0.7 units higher than physician assessments, and there was 90.1% agreement on the presence and extent of psoriasis. Additionally, the researchers reported good agreement between patients and physicians on the absence of non-musculoskeletal manifestations, which was indicated by high specificity calculations, they wrote.
After an interim analysis showed that 20% of respondents incorrectly reported having dactylitis, a photo of dactylitis was included with the question. According to the researchers, agreement between physician and patient assessments “improved markedly” with the inclusion of the photo.
“This is actually not too surprising, as dactylitis can be challenging to report even for clinicians,” Nielung said. “However, the fact that the inclusion of an image of dactylitis helped patients respond more accurately was fantastic.”
Overall, the patient-reported outcome measures were shown to be “a great tool for screening the patients in the clinic,” Nielung said. She added that the answers can be used in future register studies, and to help clinicians in routine care.
“The most significant finding, especially for clinicians, is that patients are very skilled at reporting when they do not have a manifestation,” Nielung said. “This makes our patient-reported outcome measures valuable for screening a patient before a consultation, so the clinician knows what to focus on during the consultation and what can be quickly addressed.”
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Nielung L. Abstract #1671. Presented at: ACR Convergence 2024; Nov. 14-19, 2024; Washington, D.C.
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