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Pathway to biomarker discovery in psoriatic arthritis. Chandran Vinod Expert review of clinical immunology INTRODUCTION:Biomarkers may help influence long-term outcomes of psoriatic disease by improving the objective assessment of the presence and severity of psoriatic arthritis (PsA) and by guiding treatment selection. However, there are no validated biomarkers for PsA. AREAS COVERED:Beginning with a brief overview of the clinical features of PsA and concepts about biomarkers and risk prediction in medicine, this narrative review covers the recent developments in the field of PsA biomarker research including biomarkers for identifying patients with psoriasis who are at high risk for developing PsA, for PsA diagnosis, joint damage, treatment response, and disease activity. The limitations of current research and potential solutions for the near future are discussed. EXPERT OPINION:Although some progress is being made, a concerted international collaborative effort by all stakeholder - patients and advocacy organizations, clinicians, researchers, industry partners, and regulatory agencies with adequate funding ideally from a private-public partnership will be required such that robust biomarkers for this heterogeneous disease are brought to market. Use of multi-omic approaches with innovative data collection and analytic technologies is beginning and in conjunction with novel targeted therapies portend a bright future for patients with psoriatic disease. 10.1080/1744666X.2020.1752667
Is axial psoriatic arthritis distinct from ankylosing spondylitis with and without concomitant psoriasis? Feld Joy,Ye Justine Yang,Chandran Vinod,Inman Robert D,Haroon Nigil,Cook Richard,Gladman Dafna D Rheumatology (Oxford, England) OBJECTIVE:The aim of this study was to compare patients with ankylosing spondylitis with psoriasis (ASP) and without psoriasis (AS), to axial PsA (axPsA) patients. METHODS:Two adult cohorts were recruited from the AS clinic: ASP and AS. These two cohorts were compared with two adult cohorts recruited from the PsA clinic: axPsA (radiographic sacroiliitis: ⩾bilateral grade 2 or unilateral grade 3 or 4); and Peripheral PsA. All patients were followed prospectively according to the same protocol. The demographic, clinical and radiographic variables were compared. Adjusted means were used to account for varying intervals between visits. A logistic regression was performed and adjusted for follow-up duration. RESULTS:There were 477 axPsA patients, 826 peripheral PsA, 675 AS and 91 ASP patients included. AS patients were younger (P < 0.001), more male and HLA-B*27 positive (76%, 72% vs 64%, P ⩽ 0.001, 82%, 75%, vs 19%, P = 0.001). They had more back pain at presentation (90%, 92% vs 19%, P = 0.001), worse axial disease activity scores (bath ankylosing spondylitis disease activity index: 4.1, 3.9 vs 3.5 P = 0.017), worse back metrology (bath ankylosing spondylitis metrology index: 2.9, 2.2 vs 1.8, P < 0.001), worse physician global assessments (2.4, 2.2 vs 2.1, P < 0.001), were treated more with biologics (29%, 21% vs 7%, P = 0.001) and had a higher grade of sacroiliitis (90%, 84% vs 51%, P < 0.001). Similar differences were detected in the comparison of ASP to axPsA and in a regression model. CONCLUSION:AS patients, with or without psoriasis, seem to be different demographically, genetically, clinically and radiographically from axPsA patients. axPsA seems to be a distinct entity. 10.1093/rheumatology/kez457
Response to: 'Can biomarkers differentiate psoriatic arthritis from osteoarthritis?' by Tian . Chandran Vinod,Cook Richard J,Gladman Dafna D Annals of the rheumatic diseases 10.1136/annrheumdis-2019-215762