FRI0575 Evaluation of screening questionnaires for psoriasic arthritis in a sample of patients with psoriasis in a third level hospital

Background Psoriatic arthritis (PsA) is an erosive joint inflammatory disease associated with psoriasis. Between 5% and 35% of patients with psoriasis may develop PsA. Screening questionnaires have been developed for dermatologists in order to make them suspect which patients should be referred to the rheumatologist for evaluation. Objectives To know the percentage of patients with PsA detected by the questionnaires in a group of psoriasis patients coming from an outpatient dermatology clinics. Methods The study was carried out in the rheumatology unit in collaboration with dermatology. Patients with cutaneous psoriasis who had not previously been diagnosed of any type of arthritis, from a dermatology clinic, were recruited consecutively. Patients were invited to participate in the study and referred to the rheumatology research unit where they signed the informed consent. Then, the questionnaires were administered. Results From November 2014 to December 2015, 53 patients were recruited: 30 women and 23 men. The mean age was 44 (±13) years. The average duration of psoriasis was 11 (±9) years. 61% had affected nails and skin. 11% of patients received no treatment for psoriasis and 13% received treatment with MTX or PUVA. The mean PASI was 3 (±4). The quality of life, measured by DLQI, was 1 (±2). 50% of patients had all the screening questionnaires positive. EARP was the questionnaire that tested positive in a higher percentage of patients, 70%. 68% of the patients had some painful joint and only 8% had some inflammation. Only 9 patients met CASPAR classification criteria and were diagnosed as PsA, of which 56% were in topical treatment by dermatology. These 9 patients had higher PASI than those undiagnosed and were the only ones who had swollen joints. The screening questionnaire that detected all these 9 patients was the EARP, but it was positive in 65% of patients who did not meet CASPAR criteria. Conclusions The percentage of patients with PsA who was identified by EARP questionnaire was 100%, but with a high proportion of FP. PASE detected 33%, TOPAS 55% and PEST 44%. Therefore, questionnaires available are useless in daily clinical practice, due to lack of specificity or sensitivity. The development of a small questionnaire for dermatologist based on CASPAR criteria could be more effective References [1] Stern RS, Nijsten T, Feldman SR, Margolis DJ, Rolstad T. Psoriasis is common, carries a substantial burden even when not extensive, and is associated with widespread treatment dissatisfaction. J Investig Dermatol Symp Proc. 2004Mar;9(2):136–9. [2] High prevalence of psoriatic arthritis in patients with severe psoriasis with suboptimal performance of screeesinoning questionnaires. Ann Rheum Dis2013;72:736–740. Disclosure of Interest None declared