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A proposed checklist for a definition of moderate PsA includes the number of active joints and the presence of dactylitis, among other factors.

A study published in Rheumatology International proposes a set of items, developed based on current literature and experts’ opinions, that could be included in a definition of moderate psoriatic arthritis. According to investigators, such a definition would be the starting point for further development and validation studies of the proposed items.

“Evidence-based treatment recommendations for PsA suggest that treatment should be individualized but acknowledge the difficulty of correctly defining levels of activity (mild, moderate, and severe),” Rubén Queiro, MD, PhD, and colleagues wrote. “The aim of this study was to define the parameters or disease characteristics that should be included in a future definition of moderate PsA.

The study team aimed to refine the definition of moderate PsA by identifying key parameters and characteristics that should be considered. The research involved a two-pronged approach, including a literature review and a survey of experts. The literature review focused on existing assessment tools used to classify PsA severity into mild, moderate, and severe categories. The expert survey sought opinions on the validation and applicability of these definitions and tools and on the parameters that should be included in defining moderate PsA.

Definition Should Include Active Joints, Dactylitis

Dr. Queiro and colleagues proposed the following domains for defining moderate PsA:

• Number of active joints and inflamed entheses;
  • Physician global assessment using a visual analogue scale;
  • Presence of dactylitis;
  • Body surface area affected by psoriasis;
  • Psoriasis in special locations; and
  • Absence of hip involvement.

Further, the Disease Activity Index for Psoriatic Arthritis score and the Psoriatic Arthritis Impact of Disease index should be incorporated into this definition.

According to Dr. Queiro and colleagues, the proposed strategy aims to provide a more structured and validated approach to categorizing moderate PsA, serving as a foundation for future development and validation studies.