Clinical Management of Psoriatic Arthritis in Spain: The CALIPSO Study

Abstract

Objective: To describe the clinical management of psoriatic arthritis for patients being treated by dermatologists and rheumatologists in Spain.

Methods: Multicenter, retrospective, naturalistic observational study in which demographic and clinical variables were recorded for patients diagnosed with psoriatic arthritis. Data referred to the previous 12 months and were collected during a single visit with the physician.

Results: A total of 266 patients were enrolled; 78.1% were being treated by rheumatologists and 21.9% by dermatologists. The data covered 1138 visits. The main reason for consulting a physician was to monitor psoriatic arthritis (82.7% of the visits). The most widely used examination was to determine the tender- and swollen-joint count (73.1%). The tests most frequently ordered were acute-phase reactants: erythrocyte sedimentation rate (79.8%) and C reactive protein level (74.5%). Affected body surface area and the Psoriasis Area and Severity Index were the main assessments used by dermatologists. Rheumatologists tended to examine the joints and record biochemical markers. A disease-modifying antirheumatic drug was prescribed for 71.1% of the patients; 51.8% were prescribed a biologic agent (61.5% in combination with another treatment). Treatment approach differed by specialty and was modified if response was nil or partial (the rationale for 45.1% of all changes).

Conclusion: Differences in the management of psoriatic arthritis in dermatology and rheumatology were evident in both diagnostic and treatment approaches. These 2 specialties should cooperate to establish common practice guidelines for use in Spain.

Keywords: Artritis psoriásica; Clinical practice guidelines; Manejo y atención del paciente; Patient care and management; Patrones de práctica clínica médica; Psoriatic arthritis.