PEST and BMI predictive factors for Development of Psoriatic arthritis in Psoriasis

Psoriasis Epidemiology Screening Tool (PEST) and body mass index (BMI) are the important factors in predicting the development of Psoriatic Arthritis in patients with Psoriasis for over 2 years as per new research that was published in the 'Journal of the American Academy of Dermatology.'

Psoriasis can affect an individual in a variety of ways. It includes cutaneous and psoriatic arthritis. Persons with psoriasis can develop psoriatic arthritis at any time, causing severe disability. Hence to identify the characteristics that predict psoriatic arthritis (PsA) onset among patients with psoriasis (PsO) researchers from the U.S.A conducted a study model which helps to predict the 2-year risk of development of psoriatic arthritis in psoriatic patients aiding in the early diagnosis and management.  

 A prospective cohort of patients from the CorEvitas Psoriasis Registry participated in the study. Patients without PsA at enrollment were taken and were followed up for 24 months. Unregularized and regularized logistic regression models were developed and tested using descriptive variables to predict dermatologist-identified PsA at 24 months. Model performance was compared using the area under the receiver-operating-characteristic curve (AUC), sensitivity, and specificity. 

Key findings: 

• A total of 1489 patients were included.
• Nine unique predictive models were developed and tested.
• The optimal model, including Psoriasis Epidemiology Screening Tool (PEST), body mass index (BMI), modified Rheumatic Disease Comorbidity Index, work status, alcohol use, and patient-reported fatigue predicted onset of PsA within 24 months. 
• A parsimonious model including PEST and BMI had similar performance.  

Despite the limitations in the study like the PsA misclassification bias by dermatologists, researchers concluded from the study that PEST and BMI were important factors in predicting the development of PsA in patients with PsO over 2 years. This study model could be foundational for future PsA risk model development. 

For further reading, click here: https://doi.org/10.1016/j.jaad.2022.07.060 

Ogdie A, Harrison RW, McLean RR, et al. Prospective Cohort Study of Psoriatic Arthritis Risk in Patients With Psoriasis in a Real-World Psoriasis Registry [published online ahead of print, 2022 Aug 17]. J Am Acad Dermatol. 2022; S0190-9622(22)02543-9.