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Diagnostic Delay in Psoriatic Arthritis: A Population-based Study.

Paras Karmacharya1, Kerry Wright2, Sara J Achenbach3

  • 1P. Karmacharya, MBBS, K. Wright, MBBS, D. Bekele, MBBS, F.C. Ernste, MD, J.M. Davis III, MD, MS, Division of Rheumatology, Mayo Clinic; paraskarmacharya@gmail.com.

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|February 16, 2021
PubMed
Summary

More than half of psoriatic arthritis (PsA) patients experience diagnostic delays exceeding two years. Younger age, higher BMI, and enthesitis are linked to longer delays, while sebopsoriasis is associated with quicker diagnosis.

Keywords:
delaydiagnosispsoriatic arthritisspondyloarthritis

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Area of Science:

  • Rheumatology and Immunology
  • Epidemiology
  • Dermatology

Background:

  • Psoriatic arthritis (PsA) is a chronic inflammatory disease affecting joints and skin.
  • Timely diagnosis of PsA is crucial for effective management and preventing joint damage.
  • Diagnostic delays in PsA can lead to disease progression and poorer patient outcomes.

Purpose of the Study:

  • To investigate demographic and clinical factors associated with delayed diagnosis in psoriatic arthritis (PsA).
  • To identify characteristics that predict a diagnostic delay of over two years in PsA patients.
  • To assess trends in diagnostic delay for PsA over a 17-year period.

Main Methods:

  • Retrospective analysis of a population-based cohort of incident adult PsA patients (2000-2017).
  • Diagnostic delay defined as time from patient-reported symptom onset to physician diagnosis.
  • Logistic regression models used to identify factors associated with a diagnostic delay exceeding two years.

Main Results:

  • Over half (55%) of the 164 PsA patients experienced a diagnostic delay of more than two years.
  • Earlier age at symptom onset, higher body mass index (BMI), and presence of enthesitis were associated with longer diagnostic delays (> 2 years).
  • Sebopsoriasis was associated with a reduced likelihood of diagnostic delay.

Conclusions:

  • Diagnostic delays for psoriatic arthritis remain a significant issue, with no observed improvement between 2000 and 2017.
  • Specific patient characteristics, including younger age, higher BMI, and enthesitis, are predictive of prolonged diagnostic delays.
  • The presence of sebopsoriasis may facilitate earlier diagnosis of PsA.