Assessing flares in patients with psoriatic arthritis using questionnaires

Area of Science:

• Rheumatology
• Patient-Reported Outcomes
• Clinical Trial Methodology

Background:

• Psoriatic arthritis (PsA) disease flares require accurate assessment tools.
• The Psoriatic Arthritis FLARE Questionnaire was developed to specifically study PsA flares.
• Validation of the FLARE Questionnaire and comparison with existing instruments like PsAID-12 are crucial.

Purpose of the Study:

• To validate the Psoriatic Arthritis FLARE Questionnaire for PsA flare assessment.
• To compare the performance of the FLARE Questionnaire against the Psoriatic Arthritis Impact of Disease 12-item Questionnaire (PsAID-12).
• To determine if PsAID-12 is sufficient for assessing PsA disease flares.

Main Methods:

• A cross-sectional study involving 150 adult PsA patients.
• Data collection included patient-reported outcomes (PsAID-12), clinical examinations, and the FLARE Questionnaire.
• Internal consistency, test-retest reliability, and agreement were assessed for the FLARE Questionnaire.
• Receiver operating characteristic (ROC) curve analysis compared the FLARE Questionnaire and PsAID-12 against a self-reported flare question.

Main Results:

• The FLARE Questionnaire demonstrated good internal consistency (α = 0.88) and test-retest reliability (ICC = 0.76).
• ROC analysis showed similar performance between the FLARE Questionnaire (AUC = 0.90) and PsAID-12 (AUC = 0.83).
• A PsAID-12 cut-off of ≥3.13 provided a good balance of sensitivity (0.72) and specificity (0.79) for identifying flares.

Conclusions:

• The FLARE Questionnaire is a reliable tool for assessing PsA flares.
• The Psoriatic Arthritis Impact of Disease 12-item Questionnaire (PsAID-12) demonstrates comparable efficacy to the FLARE Questionnaire in identifying PsA flares.
• PsAID-12 can be utilized for defining PsA flares, offering a potentially simpler assessment option.