Photo Credit: Iri-s

A precise clinical definition of severity in PsA is needed, according to a study in Rheumatology and Therapy. Ennio Lubrano, MD, PhD, from the University of Molise, and colleagues conducted a retrospective analysis of a longitudinal cohort, evaluating severity with the modified Composite Psoriatic Disease Activity Index. The researchers classified patients who scored 3 or higher in at least one domain as having severe PsA. Of 177 evaluated patients, 64 (36.1%) had severe PsA at baseline, and 18 patients (10.1%), all men, continued to meet the criteria for severe PsA at the end of follow-up (P<0.01). These patients had worse disease activity, pain, function, and overall impact of PsA. Male sex and the severity of skin involvement at baseline were significantly associated with severe PsA. The study also suggested that the concept of severity and disease activity are not interchangeable, given the slight agreement between severe PsA and the absence of minimal disease activity (Cohen’s k=0.174; 0.084-0.264). Dr. Lubrano and colleagues emphasized the need for a precise clinical definition of severity in PsA to improve outcomes.