The remainder of the session included high-yield case discussions of the approach to a patient with solitary enthesitis and treatment decisions in patients with oligoarticular disease who may or may not evolve over time.
As Dr. Coates noted, the future of the field will likely benefit from a better understanding of the similarities and differences in subpopulations of patients with varying joint involvement and from the use of composite measures to evaluate response to therapy. As the old adage goes, PsA is more than skin deep. And rheumatologists’ understanding of the condition needs to become increasingly nuanced to positively affect the lives of patients with this disease.
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Jason Liebowitz, MD, recently completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his MD. He is currently in practice with Arthritis, Rheumatic, and Back Disease Associates, New Jersey.
References
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- Coates LC, FitzGerald O, Gladman DD, et al. Reduced joint counts misclassify patients with oligoarticular psoriatic arthritis and miss significant numbers of patients with active disease. Arthritis Rheum. 2013 Jun;65(6): 1504–1509.
- Helliwell PS, Porter G, Taylor WJ, et al. Polyarticular psoriatic arthritis is more like oligoarticular psoriatic arthritis than rheumatoid arthritis. Ann Rheum Dis. 2007 Jan;66(1):113–117.
- Jones SM, McHugh NJ. Subgroups in psoriatic arthritis. Br J Rheumatol. 1994 Aug;33(8):789.
- Wakefield RJ, Green MJ, Marzo-Ortega H, et al. Should oligoarthritis be reclassified? Ultrasound reveals a high prevalence of subclinical disease. Ann Rheum Dis. 2004 Apr;63(4):382–385.
- Runarsdottir EE, Gunnarsdottir AI, Love TJ, et al. The majority of patients with psoriatic arthritis are not eligible for randomized clinical trials. Clin Exp Rheumatol. 2018 Nov–Dec;36(6):1068–1073.