Measurement properties and clinical utility of the PASE-P for psoriatic arthritis screening in Brazilian patients with psoriasis
DOI:
https://doi.org/10.34117/bjdv12n3-039Keywords:
psoriasis, psoriatic arthritis, screening questionnaire, early diagnosisAbstract
Background: Approximately 15% of psoriasis (Ps) patients followed by a dermatologist have undiagnosed psoriatic arthritis (PsA). Questionnaires, such as the Psoriatic Arthritis Screening and Evaluation (PASE) tool, can be crucial in identifying these patients. Objective: Evaluate the performance of PASE-P (Portuguese version) as a screening tool for PsA in Ps patients. Methods: A retrospective study using cross-sectional data with Ps patients in a dermatology clinic. Instruments (PASE-P, PASI, DLQI and NAPSI) were applied to all participants. Results: A total of 63 patients were included, of whom 57.1% were men, with an average age of 53.7 years. After applying PASE-P, 33 patients (52.4%) had a CASPAR score of ≥3 and were classified as positive for PsA. Hypertension was the most prevalent comorbidity (33.3%). Median PASE-P scores were 24 (21 – 33) for the CASPAR ≥3 group, and 29 (23 – 36) for the CASPAR <3 group, with no significant difference, p=0.38; qualitative analysis showed a difference in radiographs findings, p<0.01. PASE-P sensitivity and specificity were assessed at various cut points. With threshold scores of 44, 38 and 22, sensitivity and specificity were 12.1% and 80.0%, 18.2% and 76.7%, 69.7% and 20.0%, respectively. PASE-P had an AUC curve of 0.58. Conclusion: PASE-P did not prove to be an adequate isolated tool to screen PsA in a group of Ps, but it can be an ally to identify these patients, especially when additional radiographs variables are included.
References
WHO. Global report on. Glob Rep Psoriasis [Internet]. 2016;978:1–26. Available from: http://www.who.int/about/licensing/copyright_form/index.html%0Ahttp://www.who.int/about/licensing/
Stern RS, Nijsten T, Feldman SR, Margolis DJ, Rolstad T. Psoriasis is common, carries a substantial burden even when not extensive, and is associated with widespread treatment dissatisfaction. J Investig Dermatology Symp Proc. 2004 Mar;9(2):136–9. num
Parisi R, Iskandar IYK, Kontopantelis E, Augustin M, Griffiths CEM, Ashcroft DM. National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ. 2020 May;369:m1590.
Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN. Psoriasis. Lancet. 2021;397(10281):1301–15.
Fredriksson T, Pettersson U. Severe psoriasis--oral therapy with a new retinoid. Dermatologica. 1978;157(4):238–44.
Husni ME, Merola JF, Davin S. The psychosocial burden of psoriatic arthritis. Semin Arthritis Rheum. 2017 Dec;47(3):351–60.
Ogdie A, Walsh JA, Chakravarty SD, Peterson S, Lo KH, Kim L, et al. The effect of intravenous golimumab on health-related quality of life and work productivity in patients with active psoriatic arthritis: results of the Phase 3 GO-VIBRANT trial. Clin Rheumatol. 2021 Sep;40(9):3667–77.
Singh JA, Guyatt G, Ogdie A, Gladman DD, Deal C, Deodhar A, et al. 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. J Psoriasis Psoriatic Arthritis. 2019;4(1):31–58.
Villani AP, Rouzaud M, Sevrain M, Barnetche T, Paul C, Richard MA, et al. Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: Systematic review and meta-analysis. J Am Acad Dermatol. 2015;73(2):242–8.
Ranza R, Carneiro S, Qureshi AA, Martins G, Rodrigues JJ, Romiti R, et al. Prevalence of psoriatic arthritis in a large cohort of Brazilian patients with psoriasis. J Rheumatol. 2015;42(5):829–34.
Li S-S, Du N, He S-H, Liang X, Li T-F. Exploring the Association Between History of Psoriasis (PSO) and Disease Activity in Patients with Psoriatic Arthritis (PsA). Rheumatol Ther. 2022.
Ritchlin CT, Colbert RA, Gladman DD. Psoriatic Arthritis. N Engl J Med. 2017 Mar;376(10):957–70.
Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H. Classification criteria for psoriatic arthritis: Development of new criteria from a large international study. Arthritis Rheum. 2006;54(8):2665–73.
Piaserico S, Gisondi P, Amerio P, Amoruso G, Campanati A, Conti A, et al. Validation and field performance of the Italian version of the psoriatic arthritis screening and evaluation (PASE) questionnaire. Acta Derm Venereol. 2016;96:96–101.
Corder G, Foreman D. Comparing two unrelated samples: The Mann−Whitney U-Test and the Kolmogorov−Smirnov two-sample test [Internet]. 2nd ed. Nonparametric Statistics: A Step-By-Step Approach. John Wiley & Sons, Inc.; 2014. 1–288 p. Available from: https://www.wiley.com/en-us/Nonparametric+Statistics%3A+A+Step+by+Step+Approach%2C+2nd+Edition-p-9781118840313
Wadhwa RR, Marappa-Ganeshan R. T Test. Exp Des Anal [Internet]. 2023;10–2. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553048/
Dominguez PL, Husni ME, Holt EW, Tyler S, Qureshi AA. Validity, reliability, and sensitivity-to-change properties of the psoriatic arthritis screening and evaluation questionnaire. Arch Dermatol Res. 2009;301(8):573–9.
Costa CZ, Goldenstein-Schainberg C, Carneiro S, Rodrigues JJ, Romiti R, Barros TBM, et al. Semantic and psychometric validation of the Brazilian Portuguese version (PASE-P) of the Psoriatic Arthritis Screening and Evaluation questionnaire. PLoS One. 2018;13(10):1–10.
Urruticoechea-Arana A, Benavent D, Leo ´n F, Almodovar R, Belinchón I, de la Cueva P, et al. Psoriatic arthritis screening: A systematic literature review and experts’ recommendations. PLoS ONE. 2021; 16(3): e0248571.
Dominguez P, Husni ME, Garg A, Qureshi AA. Psoriatic Arthritis Screening and Evaluation ( PASE ) Questionnaire and the Role of Dermatologists : A Report from the GRAPPA 2009 Annual Meeting. 2011;2009–11.
Husni ME, Meyer KH, Cohen DS, Mody E, Qureshi AA. The PASE questionnaire: Pilot-testing a Psoriatic Arthritis Screening and Evaluation tool. J Am Acad Dermatol. 2007;57(4):581–7.
Carneiro S, Palominos PE, Anti SMA, Assad RL, Gonçalves RSG, Chiereghin A, et al. Brazilian Society of Rheumatology 2020 guidelines for psoriatic arthritis. Adv Rheumatol [Internet]. 2021;61(1). Available from: https://doi.org/10.1186/s42358-021-00219-y
Iragorri N, Hazlewood G, Manns B, Danthurebandara V, Spackman E. Psoriatic arthritis screening: a systematic review and meta-analysis. Rheumatology (Oxford). 2019 Apr;58(4):692–707.
Poggenborg RP, Østergaard M, Terslev L. Imaging in Psoriatic Arthritis. Rheum Dis Clin North Am. 2015 Nov;41(4):593–613.
Crespo-Rodríguez AM, Sanz Sanz J, Freites D, Rosales Z, Abasolo L, Arrazola J. Role of diagnostic imaging in psoriatic arthritis: how, when, and why. Insights Imaging. 2021 Aug;12(1):121.
FitzGerald O, Ogdie A, Chandran V, Coates LC, Kavanaugh A, Tillett W, et al. Psoriatic arthritis. Nat Rev Dis Prim [Internet]. 2021;7(1). Available from: http://dx.doi.org/10.1038/s41572-021-00293-y
Jacobson JA, Girish G, Jiang Y, Resnick D. Radiographic evaluation of arthritis: inflammatory conditions. Radiology. 2008 Aug;248(2):378–89.
Ballegaard C, Skougaard M, Guldberg-Møller J, Nissen C V., Amris K, Jørgensen TS, et al. Comorbidities, pain and fatigue in psoriatic arthritis, psoriasis and healthy controls: A clinical cohort study. Rheumatol (United Kingdom). 2021;60(7):3289–300.
Højgaard P, Ellegaard K, Nielsen SM, Christensen R, Guldberg-Møller J, Ballegaard C, et al. Pain Mechanisms and Ultrasonic Inflammatory Activity as Prognostic Factors in Patients With Psoriatic Arthritis: A Prospective Cohort Study. Arthritis Care Res. 2019;71(6):798–810.
