Prompt diagnosis of psoriatic arthritis crucial

October 29th 2014 is World Psoriasis Day, a global event that aims to give an international voice to the 125 million people with psoriasis/psoriatic arthritis. This year, the Irish Skin Foundation will launch the #SaySomething campaign to empower people with psoriasis to speak up and say something if their treatment isn’t working or their psoriasis is getting them down. Through this campaign, the Irish Skin Foundation hope to highlight the impact that living with a chronic long term condition like psoriasis can have on all areas of life.

Research led by Conway Fellow, Professor Oliver FitzGerald in St Vincent’s University Hospital shows that a delay of more than 6 months from initial symptoms to a diagnosis of psoriatic arthritis leads to poorer outcomes for patients.

Psoriatic arthritis (PsA) is a chronic, progressive inflammatory disease that damages and erodes the joints quickly if left untreated yet many psoriasis patients remain undiagnosed with the disorder. Three percent of the population globally suffer from psoriasis and a high percentage of these patients also develop this form of arthritis.

The rheumatology team at St Vincent’s University Hospital studied a group of 283 patients with a confirmed diagnosis of PsA for more than 10 years. They compared patient demographics, clinical and laboratory information, x-ray images and patient reported outcomes between groups who were diagnosed by a rheumatologist up to 6 months, 1 year or 2 years after the first symptoms appeared.

The findings of this study, published earlier this year in the top-ranking rheumatology journal, Annals of the Rheumatic Diseases, indicate that even a delay of 6 months from initial onset of the disease means that patients are at risk of developing joint erosions and experience poorer physical function in the long term. Patients who were diagnosed after 1 year of initial symptoms were less likely to experience remission after drug treatment and had poorer physical quality of life.

“This is the first time that a study has been carried out with a group of PsA patients on the negative impact of various time delays before they see a rheumatology care team. Our results clearly show that there will be a great chance of successfully treating this disease and preventing repairable joint damage if patients see us within 6 months of the initial symptoms of the disease”, commented Professor FitzGerald, Newman Clinical Research Fellow in UCD School of Medicine & Medical Science.

“We view it as an important challenge to raise awareness of inflammatory arthritis and improve health outcomes for our patients. Public awareness initiatives like the annual World Psoriasis Day are an important component to this effort.”

Reference: Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis.Haroon M, Gallagher P, Fitzgerald O.Ann Rheum Dis. 2014 Feb 27. doi: 10.1136/annrheumdis-2013-204858. [Epub ahead of print]. PMID: 24525911