Psoriatic arthritis is a type of arthritis that affects 150,000 people in the UK. Its main symptoms are joint pain, stiffness and swelling; and patients are often diagnosed late, which can lead to irreversible joint damage. .
One in three people with the skin condition psoriasis (which causes thick patches of skin that are red and itchy) will develop psoriatic arthritis. Detecting people with psoriasis who are more likely to develop psoriatic arthritis is essential for early diagnosis and treatment to prevent joint damage. However, we do not currently have a way of detecting those who are more likely to develop psoriatic arthritis.
Aim
To assess the incidence and prevalence of psoriatic arthritis and psoriasis.
To create a tool that can be used to predict which people with psoriasis are more likely to develop psoriatic arthritis at 1/5/10 years.
Psoriatic arthritis (PsA) affects around 150,000 people in the UK, and millions worldwide. It has a huge impact on the lives of people living with it and costs the NHS £360 million in direct healthcare costs. Around 1 in 3 people who have psoriasis will develop PsA.
People with PsA are often diagnosed late which can lead to irreversible joint damage. Detecting people with psoriasis who are more likely to develop PsA is essential to aid early diagnosis and prevent long-term damage. However, we do not currently know or have a way of assessing which people with psoriasis are more likely to develop PsA.
The aim of this project is to predict the risk of developing PsA in people with psoriasis. The objectives include to determine the incidence and prevalence of PsA and psoriasis, to determine the number of people with psoriasis who develop PsA and, to identify risk factors for the development of PsA at up to 10 years and creation of a prediction model.
A population-based retrospective cohort study using routinely collected clinical data from CPRD GOLD and CPRD AURUM linked to HES APC-ONS data, and Patient-level Index of Multiple Deprivation will be used. There will be two main cohorts: incident diagnosis of PsA and incident diagnosis of psoriasis. The outcome will be PsA diagnosis. The known predictors of PsA identified (e.g., raised BMI, nail psoriasis) will be studied. Follow-up will include from first diagnosis to the earliest of death, transfer-out, or end of data availability.
Analysis will include estimation of incidence and prevalence rates, risk factors selected by Lasso will be fitted into a logistic regression and C statistics (discrimination) and observed/expected plots (calibration) will be used for validation.
The prediction model will enable early identification and treatment of people with PsA, preventing long-term damage and disabilities.
Psoriasis; psoriatic arthritis.
Daniel Prieto-Alhambra - Chief Investigator - University of Oxford
Marta Pineda Moncusi - Corresponding Applicant - University of Oxford
Antonella Delmestri - Collaborator - University of Oxford
Arani Vivekanantham - Collaborator - University of Oxford
Edward Burn - Collaborator - University of Oxford
Laura Coates - Collaborator - University of Oxford
Ross Williams - Collaborator - Erasmus University Medical Center ( EMC )
Sara Khalid - Collaborator - University of Oxford
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation