The journey of patients with psoriasis and psoriatic arthritis

Abstract

IntroductionTo describe the journey of patients with psoriatic arthritis (PsA), and psoriasis (PsO) with special emphasis on diagnosis and treatment delays. Materials and methodsAll patients with PsA registered between 2000 and 2016 were included. Mean lag time between first musculoskeletal symptom and diagnosis of PsA, between first musculoskeletal symptom and first physician encounter, mean lag time to first DMARD and mean lag time between PsO diagnosis and PsA diagnosis were calculated. Descriptive statistics are reported. Variables associated with a delay in PsA diagnosis >1 year were analyzed in multivariable analysis. ResultsOne hundred and eighty nine patients were included (139 PsA and 50 PsO), mean age 60.8 years (SD: 16.3), 57% were males. Mean lag time between first musculoskeletal symptom and diagnosis of PsA was 1.9 (SD: 4.7) years. In 90 patients (97%), the diagnosis of PsO preceded the diagnosis of PsA, a mean time of 14.3 years (SD: 13.9). Forty-nine patients (35%) had a delay of PsA diagnosis ≥1 year. Of the PsA patients, 84.7% received cDMARDs as first line therapy. The mean lag time between PsA diagnosis and initiation of DMARDs was 2 years (SD: 7.6). In logistic regression analysis no variable was independently associated with a delay equal or greater than 1 year in PsA diagnosis. ConclusionsA significant delay in consultation and diagnosis of PsA was evident in this single center study in a third of patients. None of the variables studied was associated with a delay in diagnosis greater than one year.