Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory disease that develops in up to 30% of patients with psoriasis. In the vast majority of cases, cutaneous symptoms precede musculoskeletal complaints. Progression from psoriasis to PsA is characterized by subclinical synovio-entheseal inflammation and often non-specific musculoskeletal symptoms that are frequently unreported or overlooked. With the development of increasingly effective therapies and a broad drug armamentarium, prevention of arthritis development through careful clinical monitoring has become priority. Identifying high-risk psoriasis patients before PsA onset would ensure early diagnosis, increased treatment efficacy, and ultimately better outcomes; ideally, PsA development could even be averted. However, the current model of care for PsA offers only limited possibilities of early intervention. This is attributable to the large pool of patients to be monitored and the limited resources of the health care system in comparison. The use of digital technologies for health (eHealth) could help close this gap in care by enabling faster, more targeted and more streamlined access to rheumatological care for patients with psoriasis. eHealth solutions particularly include telemedicine, mobile technologies, and symptom checkers. Telemedicine enables rheumatological visits and consultations at a distance while mobile technologies can improve monitoring by allowing patients to self-report symptoms and disease-related parameters continuously. Symptom checkers have the potential to direct patients to medical attention at an earlier point of their disease and therefore minimizing diagnostic delay. Overall, these interventions could lead to earlier diagnoses of arthritis, improved monitoring, and better disease control while simultaneously increasing the capacity of referral centers.
Highlights
Psoriasis (PsO) is a common chronic inflammatory skin disease affecting 1–3% of the general population [1]
Diagnosis of Psoriatic arthritis (PsA) is fundamental, since a diagnostic delay as little as 6 months is associated with a poorer response to treatment, whereas early intervention with immune-modulating or anti-inflammatory drugs is linked with improved clinical and radiographic outcomes [4]
Modern MoCs for PsO and PsA emphasize the importance of patient engagement and selfmanagement [103]
Summary
Filippo Fagni 1,2, Johannes Knitza 1,2, Martin Krusche 3, Arnd Kleyer 1,2, Koray Tascilar 1,2 and David Simon 1,2*. Reviewed by: Alen Zabotti, Università degli Studi di Udine, Italy Meghna Jani, The University of Manchester, United Kingdom. Specialty section: This article was submitted to Rheumatology, a section of the journal
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