Psoriatic arthritis (PsA) is a chronic inflammatory disease that causes joint pain, stiffness and swelling. Symptoms can vary widely, making the disease difficult to diagnose. Roughly 30% of individuals with psoriasis (PsO), a skin condition, have PsA. In the seven major pharmaceutical markets (7MM: France, Germany, Italy, Japan, Spain, the UK and the US), GlobalData epidemiologists found that only two-thirds of PsA cases will be diagnosed by the end of 2033, with the US experiencing the highest number of undiagnosed cases due to the large number of PsA cases in this market.
According to GlobalData epidemiologists, total prevalent cases (diagnosed and undiagnosed) of PsA in those aged 18 and above are expected to reach 3.1 million by 2033 in the 7MM; a concerning one-third will remain undiagnosed. This gap is likely being driven, in part, by underdiagnosis due to subpar utilisation of imaging tests used for screening. In a recent German study published by Pinter and colleagues in the Journal der Deutschen Dermatologischen Gesellschaft, imaging tests – in particular ultrasounds and magnetic resonance imaging (MRIs) – were not routinely used for early detection of PsA in suspected cases. This national prospective, cross-sectional survey was conducted across 48 dermatological centers in Germany between 2016 and 2018, and195 adults with moderate-severe PsO and suspected PsA were recruited.
Study results found that questionnaires and imaging techniques were inadequately used in around 45% of cases. Ultrasounds and MRIs were rarely performed, with utilisation of approximately 6%. In contrast, X-rays were the most commonly used screening tool (roughly 15%). This is unexpected since bone changes are not typically observed in early PsA, and MRIs/ultrasounds are more specific in diagnosing early soft tissue inflammation.
The results of this study are concerning, as they indicate that misuse of screening tools and subsequent underdiagnosis of PsA can easily occur, even amongst specialists. The accurate and timely identification of PsA cases is critical for improving patient outcomes. Future efforts should prioritise implementing standardised PsA screening methods and diagnostic criteria. Physician awareness and educational programmes should also be improved to ensure appropriate imaging techniques are utilised, resulting in more effective PsA screening and earlier disease detection.
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By GlobalData