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The following is a summary of “Difficult-to-Treat Concept in Psoriatic Arthritis: Analysis of 2 Potential Definitions in a Large Group of Patients. A Cross-Sectional Study,” published in the October 2024 issue of Rheumatology by Perrotta et al.
Researchers conducted a prospective study to assess the performance and agreement of 2 proposed criteria for identifying difficult-to-treat (D2T) psoriatic arthritis (PsA) in a patient group.
They conducted a cross-sectional analysis of 2 longitudinal cohorts of patients with PsA who met the Classification Criteria for Psoriatic Arthritis (CASPAR) criteria and had at least 1 year of follow-up. Detailed medical histories were collected, and physical examinations were performed. The proposed D2T PsA criteria were applied, and performance was tested using an external validator (absence of patient acceptable symptom state + physician global assessment ≥ 6 cm) and agreement between the 2 sets of criteria.
The results showed that 378 patients with PsA (219 male/159 female), with a mean age of 58 years (range: 19-75), were evaluated. About 19.8% of 78 patients met the Perrotta D2T criteria, while 58 patients (15.3%) met the Kumthekar D2T criteria. Both criteria had comparable performance, with low sensitivity (Perrotta: 37.8%, Kumthekar: 29.7%) but good specificity (Perrotta: 82.1%, Kumthekar: 86.2%). The agreement between the 2 criteria was substantial (Fleiss kappa 0.72), indicating they identify nearly the same group of patients.
Investigators concluded that 2 sets of criteria showed comparable performance and substantial agreement in identifying difficult-to-treat PsA, indicating potential for further research.
Source: jrheum.org/content/51/10/985
