Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects skin and joints, often associated with extra-articular manifestations. The complexity of disease and the involvement of different domains have led to the development of different clinical indices aimed to assess the disease activity in each domain. Furthermore, composite indices, able to evaluate disease activity with a single parameter, were developed. The aim of this article was to brief review the different tools to assess disease activity in skin, joint, and enthesis and to review the current evidence on the comparison of the performance of the composite indices in PsA.
ScarpaRCasoFCostaLPelusoRDel PuenteAOlivieriI. Psoriatic disease 10 years later. J Rheumatol. 2017;44(9):1298–1301.
4.
PerrottaFMMarchesoniALubranoE. Minimal disease activity and remission in psoriatic arthritis patients treated with anti-TNF-α drugs. J Rheumatol. 2016;43(2):350–355. doi:10.3899/jrheum.150805.
5.
LubranoEPerrottaFMKavanaughA. An overview of low disease activity and remission in psoriatic arthritis. Clin Exp Rheumatol. 2015;33(5 suppl 93):S51–S54.
6.
LubranoEParsonsWJPerrottaFM. Assessment of response to treatment, remission, and minimal disease activity in axial psoriatic arthritis treated with tumor necrosis factor inhibitors. J Rheumatol. 2016;43(5):918–923. doi:10.3899/jrheum-0.85.
7.
PerrottaFMLubranoE. Subcutaneous anti-TNF alfa induced sustained minimal disease activity and remission in psoriatic arthritis patients: a retrospective study. Postgrad Med. 2016;128(7):693–696. doi:10.1080/00325481.2016.1220809.
8.
LubranoEPerrottaFM. Beyond TNF inhibitors: new pathways and emerging treatments for psoriatic arthritis. Drugs. 2016;76(6):663–673. doi:10.1007/s40265-016-0557-4.
9.
GladmanDRigbyWAzevedoVF. Tofacitinib for psoriatic arthritis in patients with an inadequate response to TNF inhibitors. N Engl J Med. 2017;377(16):1525–1536. doi:10.1056/NEJMoa1615977.
10.
CostaLDel PuenteAPelusoR. Small molecule therapy for managing moderate to severe psoriatic arthritis. Expert Opin Pharmacother. 2017;18(15):1557–1567. doi:10.1080/14656566.2017.1378343.
11.
FredrikssonTPetterssonU. Severe psoriasis—oral therapy with a new retinoid. Dermatologica. 1978;157(4):238–244.
12.
RitchieDMBoyleJAMcInnesJM. Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med. 1968;37(147):393–406.
13.
ManderMSimpsonJMMcLellanAWalkerDGoodacreJADickWC. Studies with an enthesis index as a method of clinical assessment in ankylosing spondylitis. Ann Rheum Dis. 1987:46(3);197–202.
14.
Van der HeijdeDBellamyNCalinADougadosMKhanMAVan der LindenS. Preliminary core sets for endpoints in ankylosing spondylitis. Assessments in Ankylosing Spondylitis Working Group. J Rheumatol. 1997;24(11):2225–2229.
15.
BraunJBrandtJListingJ. Treatment of active ankylosing spondylitis with infliximab: a randomised controlled multicentre trial. Lancet. 2002;359(9313):1187–1193.
16.
Heuft-DorenboschLSpoorenbergAvan TubergenA. Assessment of enthesitis in ankylosing spondylitis. Ann Rheum Dis. 2003;62(2):127–132.
17.
HealyPJHelliwellPS. Measuring clinical enthesitis in psoriatic arthritis: assessment of existing measures and development of an instrument specific to psoriatic arthritis. Arthritis Rheum. 2008;15(5);686–691.
18.
GladmanDDCookRJSchentagC. Clinical assessment of patients with psoriatic arthritis: results of a reliability study of the Spondyloarthritis Research Consortium of Canada. J Rheumatol. 2004;31(6):1126–1131.
19.
van der HeijdeDBraunJDeodharA. Comparison of three enthesitis indices in a multicentre, randomized, placebo-controlled trial of golimumab in ankylosing spondylitis (GO-RAISE). Rheumatology (Oxford). 2013;52(2):321–325.
20.
MeasePJ. Measures of psoriatic arthritis: Tender and Swollen Joint Assessment, Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Modified Nail Psoriasis Severity Index (mNAPSI), Mander/Newcastle Enthesitis Index (MEI), Leeds Enthesitis Index (LEI), Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht Ankylosing Spondylitis Enthesis Score (MASES), Leeds Dactylitis Index (LDI), Patient Global for Psoriatic Arthritis, Dermatology Life Quality Index (DLQI), Psoriatic Arthritis Quality of Life (PsAQOL), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Psoriatic Arthritis Response Criteria (PsARC), Psoriatic Arthritis Joint Activity Index (PsAJAI), Disease Activity in Psoriatic Arthritis (DAPSA), and Composite Psoriatic Disease Activity Index (CPDAI). Arthritis Care Res. 2011;63(suppl 1):S64–S85.
21.
LaurentMRPanayiGSShepherdP. Circulating immune complexes, serum immunoglobulins, and acute phase proteins in psoriasis and psoriatic arthritis. Ann Rheum Dis. 1981;40(1):66–69.
22.
PunziLPodswiadekMOlivieroF. Laboratory findings in psoriatic arthritis. Reumatismo. 2007;59(suppl 1):52–55.
23.
GeneraliEScirèCAFavalliEGSelmiC. Biomarkers in psoriatic arthritis: a systematic literature review. Expert Rev Clin Immunol. 2016;12(6):651–660.
24.
TillettWEderLGoelN. Enhanced patient involvement and the need to revise the core set—report from the Psoriatic Arthritis Working Group at OMERACT 2014. J Rheumatol. 2015;42(11):2198–2203.
25.
HelliwellPSFitzGeraldOFransenJ. The development of candidate composite disease activity and responder indices for psoriatic arthritis (GRACE project). Ann Rheum Dis. 2013;72(6):986–991.
26.
HelliwellPSWaxmanR. Modification of the Psoriatic Arthritis Disease Activity Score (PASDAS). Ann Rheum Dis. 2018;77(3):467–468. doi:10.1136/annrheumdis-2016-211010.
27.
SchoelsMMAletahaDAlastiFSmolenJS. Disease activity in psoriatic arthritis (PsA): defining remission and treatment success using the DAPSA score. Ann Rheum Dis. 2016;75(5):811–818.
28.
CoatesLCFransenJHelliwelPS. Defining disease activity in psoriatic arthritis: a proposed objective target for treatment. Ann Rheum Dis. 2010;69(1):48–53.
29.
CoatesLHelliwellP. Validation of minimal disease activity criteria for psoriatic arthritis using interventional trial data. Arthritis Care Res. 2010;62(7);965–969.
30.
CoatesLCookRLeeKaChandranVGladmanD. Frequency, predictors, and prognosis of sustained minimal disease activity in an observational psoriatic arthritis cohort. Arthritis Care Res (Hoboken). 2010;62(7):970–976.
31.
CoatesLCHelliwellPS. Defining low disease activity states in psoriatic arthritis using novel composite disease instruments. J Rheumatol. 2016;43(2):371–375.
32.
LubranoEPerrottaFM. Defining low disease activity states in psoriatic arthritis using novel composite disease instruments. J Rheumatol. 2016;43(9):1765–1766.
33.
LubranoEDe SocioAPerrottaFM. Comparison of composite indices tailored for psoriatic arthritis treated with csDMARD and bDMARD: a cross-sectional analysis of a longitudinal cohort. J Rheumatol. 2017;44(8):1159–1164.
34.
HelliwellPSKavanaughA. Comparison of composite measures of disease activity in psoriatic arthritis using data from an interventional study with golimumab. Arthritis Care Res (Hoboken). 2014;66(5):749–756.
35.
SalaffiFCiapettiACarottiMGaspariniSGutierrezM. Disease activity in psoriatic arthritis: comparison of the discriminative capacity and construct validity of six composite indices in a real world. Biomed Res Int. 2014;2014:528105.
36.
GarrettSJenkinsonTKennedyGWhitelockHGaisfordPCalinA. A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Activity Index. J Rheumatol. 1994;21(12):2286–2291.
37.
LukasCLandewéRSieperJ; Assessment of SpondyloArthritis International Society; Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis. Ann Rheum Dis. 2009;68(1):18–24.
38.
MachadoPLandewéRLieE; Assessment of SpondyloArthritis International Society. Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores. Ann Rheum Dis. 2011;70(1):47–53.
39.
KılıçGKılıçENasK. Comparison of ASDAS and BASDAI as a measure of disease activity in axial psoriatic arthritis. Clin Rheumatol. 2015;34(3):515–521. doi:10.1007/s10067-014-2734-8.
40.
LubranoEPerrottaFMParsonsWJMarchesoniA. Patient’s global assessment as an outcome measure for psoriatic arthritis in clinical practice: a surrogate for measuring low disease activity?J Rheumatol. 2015;42(12):2332–2338.
41.
CauliAGladmanDDMathieuA. GRAPPA 3PPsA Study Group; Patient global assessment in psoriatic arthritis: a multicenter GRAPPA and OMERACT study. J Rheumatol. 2011;38(5):898–903.
42.
SmolenJSSchölsMBraunJ. Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force. Ann Rheum Dis. 2018;77(1):3–17.
