EXAMINING THE CRUCIAL COALITION BETWEEN DERMATOLOGY AND RHEUMATOLOGY IN PSORIATIC ARTHRITIS

Size: px
Start display at page:

Download "EXAMINING THE CRUCIAL COALITION BETWEEN DERMATOLOGY AND RHEUMATOLOGY IN PSORIATIC ARTHRITIS"

Transcription

1 EXAMINING THE CRUCIAL COALITION BETWEEN DERMATOLOGY AND RHEUMATOLOGY IN PSORIATIC ARTHRITIS ACTIVITY 1: EARLY COLLABORATION IN THE TREATMENT OF PSA Key Slides

2 COMMON COMORBIDITIES OF PSORIATIC DISEASE Psoriatic arthritis Depression Obstructive sleep apnea Uveitis NASH Cardiovascular disease Metabolic syndrome Hypertension Diabetes Dyslipidemia Obesity NASH = nonalcoholic steatohepatitis. Kimball AB, et al. J Am Acad Dermatol. 2008;58(6): ; Reich K. J Eur Acad Dermatol Venereol. 2012;26(Suppl 2):3-11; Carrascosa, et al. J Am Acad Dermatol. 2005;53(4):573; Roberts KK, et al. Aliment Pharmacol Ther. 2015;41(3):

3 TIPS FOR DIFFERENTIATION Finding Psoriatic arthritis Osteoarthritis Gout RA AS Psoriasis Nail dystrophy Enthesitis Less often Dactylitis Less often Peripheral disease Asymmetric Varies Asymmetric Symmetric - Axial disease + - Less often - + DIP involvement Morning stiffness >45 min Rheumatoid factor Minority of cases - - Majority of cases - RA = rheumatoid arthritis, AS = ankylosing spondylitis, DIP = distal interphalangeal.

4 CASPAR CRITERIA Criterion Test Points Current Psoriatic skin or scalp disease present today as judged by a qualified health professional 2 Psoriasis History A history of psoriasis that may be obtained from patient or qualified health professional 1 Family history A history of psoriasis in a first- or second-degree relative according to patient report 1 Nail changes Typical psoriatic nail dystrophy, including onycholysis, pitting, and hyperkeratosis, observed on current physical examination 1 1 Negative RF test By any method (except latex), according to local laboratory reference range Current Swelling of an entire digit 1 Dactylitis History A history of dactylitis recorded by a qualified health professional 1 Radiological evidence of juxta-articular new bone formation Ill-defined ossification near joint margins (excluding osteophyte formation) on plain X-ray of hand or foot Taylor W, et al. Arthritis Rheum. 2006;54(8): ; Coates LC, et al. Arthritis Rheum. 2012;64(10):

5 SCREENING QUESTIONNAIRES Tool Structure Psychometrics EARP epasq PASE PEST ToPAS 14 questions Self-administered 10 items + joint diagram Self-report 15 items Self-administered 5 items + joint diagram Self-administered 11 items + pictures/diagram Self-administered Sensitivity 85.2% Specificity 91.6% Sensitivity 97.6% Specificity 75% Sensitivity 82% Specificity 73% Sensitivity 97% Specificity 79% Sensitivity 86.8% Specificity 93.1% Husni ME, et al. J Am Acad Dermatol. 2007;57(4): ; Gladman DD, et al. Ann Rheum Dis. 2009;68(4): ; Ibrahim GH, et al. Clin Exp Rheumatol. 2009;27(3): ; Tinazzi I, et al. Rheumatology (Oxford). 2012;51(11): ; Khraishi M, et al. J Cutan Med Surg. 2011;15(3):

6 OVERARCHING PRINCIPLES OF EULAR AND GRAPPA GUIDELINES EULAR Psoriatic arthritis is a heterogeneous disease, which may require multidisciplinary treatment GRAPPA Ultimate goals of therapy: - Lowest possible disease activity - Optimize functional status and QoL and prevent structural damage - Minimize complications - Rheumatologists should primarily care for musculoskeletal manifestations - In significant skin involvement, rheumatologist and dermatologist should collaborate Assessment should consider all domains of disease: - Peripheral arthritis - Axial disease - Enthesitis - Dactylitis - Psoriasis - Nail disease - Pain, function, QoL Multidisciplinary and multispecialty assessment most beneficial Primary goal of treatment is to maximize QoL through symptom control, prevention of structural damage, and normalization of function Extra-articular manifestations and comorbidities should be taken into account when managing patients with psoriatic arthritis Clinical assessment includes patient-reported measures, thorough history and physical examination, supplemented by laboratory studies and imaging Comprehensive assessment of all relevant comorbidities should be performed

7 CASE: JEREMY 38-year-old bartender Overweight History of hypertension 9-year history of plaque psoriasis Primarily elbows and trunk BSA = 2% Managed by his primary care physician using topical agents Current medications Hydrochlorothiazide 25 mg daily Clobetasol propionate cream BSA = body surface area

8 CASE: JEREMY Noticed pain and stiffness in fingers of right hand ~1 year ago Progressed to left knee pain and stiffness after 6 months, at which point he told his primary care physician Primary care physician recommended ibuprofen; pain and swelling improved for a while After 6 months, both knees were involved Symptoms worsened and he could no longer work a full shift Primary care physician referred him to a rheumatologist

9 CASE: JEREMY Discussion Patient-specific treatment considerations Next steps

10 CASE, CONT D: JEREMY Rheumatologist obtains full history, conducts physical examination, orders laboratory studies (RF, ACPA, ESR/CRP) Jeremy is diagnosed with seronegative PsA with evidence of erosive disease on plain radiography Rheumatologist estimates moderate disease activity and prescribes methotrexate A biologic is added after 6 months based on persistent disease activity Joint symptoms resolve after 3 months However, skin lesions worsen during this time to 4% BSA, with increased itching and scaling RF = rheumatoid factor, ACPA = anti-citrullinated protein antibodies, ESR/CRP = erythrocyte sedimentation rate/c-reactive protein

11 CASE, CONT D: JEREMY Most important prognostic finding at initial diagnosis Evidence of erosive disease on plain radiography Implications for therapy Was initial regimen appropriate/sufficient? How should worsening skin symptoms be addressed?

12 CASE, CONT D: JEREMY Considerations for worsening skin symptoms Severity? Maintain current therapy and observe? Optimize topical therapy? Light therapy? Modify dose of methotrexate to target skin disease? Switch biologic to target skin disease?

13 CASE, CONT D: JEREMY Optimal strategy Consult with a dermatologist to help identify a strategy that could manage both skin and joint symptoms Dermatologist may modify topical treatment, consider phototherapy, or recommend changing biologic agent to one with greater efficacy for skin lesions Rheumatologist should maintain open communication and consult on any changes to therapy to ensure joint symptoms remain in remission (or low disease activity)

14 CASE, CONT D: JEREMY LATE DIAGNOSIS = EROSIVE DISEASE Jeremy had joint symptoms for over a year before seeing a rheumatologist and receiving effective treatment One important reason for frequent screening for PsA is the hypothesis that early intervention can limit progression of disease This concept underlies the T2T approach established in the treatment of RA and translated now to PsA T2T involves intensifying treatment until the target of remission or low disease activity is achieved Early diagnosis and routine assessment of disease activity are key components of this approach Coates LC, et al. BMC Musculoskelet Disord. 2013;14:101.

15 CONSIDERATIONS FOR T2T IN PSA How aggressively should PsA be treated? What is the target? Patient-specific factors/patient preferences must be considered

Rheumatology and Internal Diseases Clinic of the Central Clinical Hospital in Warsaw 137 Woloska St. WARSAW POLAND prof. Małgorzata Wisłowska

Rheumatology and Internal Diseases Clinic of the Central Clinical Hospital in Warsaw 137 Woloska St. WARSAW POLAND prof. Małgorzata Wisłowska Rheumatology and Internal Diseases Clinic of the Central Clinical Hospital in Warsaw 137 Woloska St. WARSAW 02-507 POLAND prof. Małgorzata Wisłowska MD, PhD 1 Klinika Chorób Wewnętrznych i Reumatologii

More information

Psoriasis. Jessica Kaffenberger, M.D. Assistant Professor of Dermatology Division of Dermatology The Ohio State University Wexner Medical Center

Psoriasis. Jessica Kaffenberger, M.D. Assistant Professor of Dermatology Division of Dermatology The Ohio State University Wexner Medical Center Psoriasis Jessica Kaffenberger, M.D. Assistant Professor of Dermatology Division of Dermatology The Ohio State University Wexner Medical Center Learning objectives Recognize the different types of psoriasis

More information

Update on Psoriatic Arthritis: Best Practices in Rheumatology

Update on Psoriatic Arthritis: Best Practices in Rheumatology Transcript Details This is a transcript of a continuing medical education (CME) activity accessible on the ReachMD network. Additional media formats for the activity and full activity details (including

More information

CLOSER LOOK AT SpA. Dr. Mohamed Bedaiwi. Consultant Rheumatologist Rheumatology Unit - KKUH

CLOSER LOOK AT SpA. Dr. Mohamed Bedaiwi. Consultant Rheumatologist Rheumatology Unit - KKUH CLOSER LOOK AT SpA Dr. Mohamed Bedaiwi Consultant Rheumatologist Rheumatology Unit - KKUH Closer look at SpA I. Categories II. SIGN & SYMPTOMS III. X-RAY IV. MRI V. MANAGMENT Spondyloarthritis (SpA)

More information

Jurnal Medical Aradean (Arad Medical Journal) Vol. XVIII, issue 1, 2015, pp Vasile Goldis University Press (www.jmedar.

Jurnal Medical Aradean (Arad Medical Journal) Vol. XVIII, issue 1, 2015, pp Vasile Goldis University Press (www.jmedar. Vol. XVIII, issue 1, 15, pp. 4-45 15 Vasile Goldis University Press (www.jmedar.ro) DEMOGRAPHIC AND CLINICAL PARAMETERS EVALUATION FOR PATIRNTS WITH PSORIATIC VERSUS RHEUMATOID ARTHRITIS Camelia Ciacli

More information

2018 ReachMD Page 1 of 10

2018 ReachMD Page 1 of 10 Transcript Details This is a transcript of a continuing medical education (CME) activity accessible on the ReachMD network. Additional media formats for the activity and full activity details (including

More information

Comparison of comorbidities between rheumatoid and psoriatic arthritis in a tertiary care rheumatic center

Comparison of comorbidities between rheumatoid and psoriatic arthritis in a tertiary care rheumatic center Original Research Article Comparison of comorbidities between rheumatoid and psoriatic arthritis in a tertiary care rheumatic center T.N. Tamil Selvam 1, V.A. Sowndhariya 2*, N.K. Senthil Nathan 3 1 Associate

More information

Seronegative Arthritis. Dr Mary Gayed 25 th April 2018

Seronegative Arthritis. Dr Mary Gayed 25 th April 2018 Seronegative Arthritis Dr Mary Gayed 25 th April 2018 Overview Description of the conditions Discussion of symptoms & investigations that may be required Discussion of management and treatment Questions

More information

1. Joining the Dots in Psoriatic Arthritis; 2. Reaching for a Cure for Hep C

1. Joining the Dots in Psoriatic Arthritis; 2. Reaching for a Cure for Hep C Dr Daniel Ching Consultant Rheumatologist Timaru Hospital Dr Catherine Stedman Gastroenterologist Hepatologist, Christchurch Hospital, Clinical Senior Lecturer, University Otago 7:00-8:00 Abbvie Breakfast

More information

Training on the Modular Approach on the assessment and management of psoriatic arthritis (PsA) for dermatology units

Training on the Modular Approach on the assessment and management of psoriatic arthritis (PsA) for dermatology units Training on the Modular Approach on the assessment and management of psoriatic arthritis (PsA) for dermatology units This PsA assessment initiative is led by the UK PsA Assessment Academy and funded by

More information

Identification of Psoriatic Arthritis and Ankylosing Spondylitis Early Detection to Facilitate Appropriate Care

Identification of Psoriatic Arthritis and Ankylosing Spondylitis Early Detection to Facilitate Appropriate Care Identification of Psoriatic Arthritis and Ankylosing Spondylitis Early Detection to Facilitate Appropriate Care Joy Schechtman D.O. Professor Midwestern University 64C-1876207 Disclosures None 3 64C-1876207

More information

Patient Reported Quality of Life in an Early Psoriatic Arthritis Cohort

Patient Reported Quality of Life in an Early Psoriatic Arthritis Cohort 26 Patient Reported Quality of Life in an Early Psoriatic Arthritis Cohort Majed Khraishi 1 2, Jennifer Hulburt, Sarah Khraishi and Courtney Youden 2 1 Memorial University of Newfoundland, St. John s,

More information

Understanding Rheumatoid Arthritis

Understanding Rheumatoid Arthritis Understanding Rheumatoid Arthritis Understanding Rheumatoid Arthritis What Is Rheumatoid Arthritis? 1,2 Rheumatoid arthritis (RA) is a chronic autoimmune disease. It causes joints to swell and can result

More information

A Patient s Guide to Psoriatic Arthritis

A Patient s Guide to Psoriatic Arthritis A Patient s Guide to Psoriatic Arthritis Glendale Adventist Medical Center 1509 Wilson Terrace Glendale, CA 91206 Phone: (818) 409-8000 DISCLAIMER: The information in this booklet is compiled from a variety

More information

8/29/2012. Outline Juvenile idiopathic arthritis. 1. Classification-ILAR. 1. Classification-clinical diagnosis. 1. JIA classification

8/29/2012. Outline Juvenile idiopathic arthritis. 1. Classification-ILAR. 1. Classification-clinical diagnosis. 1. JIA classification Outline Juvenile idiopathic arthritis 1. Classification and symptoms (ILAR-International league of Associations for Rheumatology) 2. Imaging J. Herman Kan, M.D. Section chief, musculoskeletal imaging Edward

More information

Clinical Practice Guideline. Psoriatic Arthritis (PsA) Version

Clinical Practice Guideline. Psoriatic Arthritis (PsA) Version Clinical Practice Guideline Psoriatic Arthritis (PsA) Version 1.1.2016 August 2016 Table of Contents Introduction...5 Diagnosis...6 Patient Assessment... 7 Management of Patients with PsA...8 Peripheral

More information

Psoriasis, Incidence, Quality of Life, Psoriatic Arthritis, Prevalence

Psoriasis, Incidence, Quality of Life, Psoriatic Arthritis, Prevalence 1.0 Abstract Title Prevalence and Incidence of Articular Symptoms and Signs Related to Psoriatic Arthritis in Patients with Psoriasis Severe or Moderate with Adalimumab Treatment (TOGETHER). Keywords Psoriasis,

More information

A Patient s Guide to. Treatments for Psoriatic Arthritis

A Patient s Guide to. Treatments for Psoriatic Arthritis A Patient s Guide to Treatments for Psoriatic Arthritis Who should read this guide? This guide is aimed at people with psoriatic arthritis (abbreviated as PsA), or those who care for a person with this

More information

Clinical Policy: Etanercept (Enbrel) Reference Number: PA.CP.PHAR.250 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid

Clinical Policy: Etanercept (Enbrel) Reference Number: PA.CP.PHAR.250 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid Clinical Policy: (Enbrel) Reference Number: PA.CP.PHAR.250 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid Coding Implications Revision Log Description (Enbrel ) is tumor necrosis

More information

Arthritis Rheumatism Psoriasis

Arthritis Rheumatism Psoriasis Arthritis Rheumatism Psoriasis 1 / 6 2 / 6 3 / 6 Arthritis Rheumatism Psoriasis You may think that arthritis is a single condition, but there are many forms of arthritis. Each type can be caused by different

More information

Psoriasis and Psoriatic Arthritis Combined Clinic Electronic Medical Records Form

Psoriasis and Psoriatic Arthritis Combined Clinic Electronic Medical Records Form Psoriasis and Psoriatic Arthritis Combined Clinic Electronic Medical Records Form NAME: AGE: SEX: CHIEF COMPLAINT: HISTORY OF PRESENT ILLNESS: The patient presents for the initial evaluation of [psoriasis

More information

Psoriasis and PsA Epidemiology and Classification

Psoriasis and PsA Epidemiology and Classification 5/15/15 Learning Objectives Psoriasis and PsA Epidemiology and Classification Describe epidemiology of psoriasis Examine impact of psoriasis on quality of life, work productivity, and under-treatment patterns.

More information

This is a repository copy of Psoriasis flare with corticosteroid use in psoriatic arthritis.

This is a repository copy of Psoriasis flare with corticosteroid use in psoriatic arthritis. This is a repository copy of Psoriasis flare with corticosteroid use in psoriatic arthritis. White Rose Research Online URL for this paper: http://eprints.whiterose.ac.uk/98736/ Version: Accepted Version

More information

Subject: Remicade (Page 1 of 5)

Subject: Remicade (Page 1 of 5) Subject: Remicade (Page 1 of 5) Objective: I. To ensure that Health Share/Tuality Health Alliance (THA) has a process by which the appropriate utilization of Remicade (Infliximab) for members whose diagnosis

More information

EARLY INFLAMMATORY ARTHRITIS. Cristina Tacu Consultant Rheumatologist Brighton and Sussex University Hospital

EARLY INFLAMMATORY ARTHRITIS. Cristina Tacu Consultant Rheumatologist Brighton and Sussex University Hospital EARLY INFLAMMATORY ARTHRITIS Cristina Tacu Consultant Rheumatologist Brighton and Sussex University Hospital EIA: Introduction National priority Preventable cause of disability Very common condition High

More information

Rheumatoid Arthritis. Marge Beckman FALU, FLMI Vice President RGA Underwriting Quarterly Underwriting Meeting March 24, 2011

Rheumatoid Arthritis. Marge Beckman FALU, FLMI Vice President RGA Underwriting Quarterly Underwriting Meeting March 24, 2011 Rheumatoid Arthritis Marge Beckman FALU, FLMI Vice President RGA Underwriting Quarterly Underwriting Meeting March 24, 2011 The security of experience. The power of innovation. www.rgare.com Case Study

More information

Mr. OA: Case Presentation

Mr. OA: Case Presentation CLINICAL CASES Case 1: Mr. OA OA Mr. OA: Case Presentation 62-year-old lawyer Mild left knee pain for 3 month, but became worse 1 week ago No swelling 1 week earlier: 2-hour walk in the countryside 2 days

More information

International DErmatology Outcomes Measures. Modeled after OMERACT: Outcomes Measures in Rheumatology

International DErmatology Outcomes Measures. Modeled after OMERACT: Outcomes Measures in Rheumatology International DErmatology Outcomes Measures Modeled after OMERACT: Outcomes Measures in Rheumatology 1992 original intent: obtain agreement on the minimum number of outcome measures to be included in all

More information

Clinical application of the CASPAR criteria for psoriatic arthritis compared to other existing criteria

Clinical application of the CASPAR criteria for psoriatic arthritis compared to other existing criteria Clinical application of the CASPAR criteria for psoriatic arthritis compared to other existing criteria L. Congi 1 and E. Roussou 2 1 Rheumatology Department, Whittington Hospital, London, United Kingdom;

More information

A. Kopchev, S.Monov, D. Kyurkchiev, I.Ivanova, T. Georgiev (UMHAT St. Ivan Rilski, Medical University - Sofia, Bulgaria)

A. Kopchev, S.Monov, D. Kyurkchiev, I.Ivanova, T. Georgiev (UMHAT St. Ivan Rilski, Medical University - Sofia, Bulgaria) International Journal of Pharmaceutical Science Invention ISSN (Online): 2319 6718, ISSN (Print): 2319 670X Volume 6 Issue 7 July 2017 PP. 08-12 Vascular endothelial growth factor (VEGF), cartilage oligomeric

More information

Examining the prevalence of rheumatoid arthritis in data from the Clinical Practice Research Datalink

Examining the prevalence of rheumatoid arthritis in data from the Clinical Practice Research Datalink Examining the prevalence of rheumatoid arthritis in data from the Clinical Practice Research Datalink Julian Gardiner, Michael Soljak, Department of Primary Care & Public Health Benjamin Ellis, Arthritis

More information

Appendix 1: Frequently Asked Questions

Appendix 1: Frequently Asked Questions Appendix 1: Frequently Asked Questions 1. What is the funding status of Inflectra (infliximab)? Effective February 25 2016, Inflectra (infliximab) will be added to the Ontario Drug Benefit (ODB) Formulary

More information

Approximately 3% of the US adult population,

Approximately 3% of the US adult population, Disease Burden and Quality of Life in Psoriasis Patients With and Without Comorbid Psoriatic Arthritis: Results From National Psoriasis Foundation Panel Surveys Emily Edson-Heredia, MPH; Baojin Zhu, PhD;

More information

Hands On PSORIATIC ARTHRITIS ITS PRESENTATION AND MANAGEMENT IN PRIMARY CARE. Introduction EDITORIAL. How common is psoriatic arthritis?

Hands On PSORIATIC ARTHRITIS ITS PRESENTATION AND MANAGEMENT IN PRIMARY CARE. Introduction EDITORIAL. How common is psoriatic arthritis? REPORTS ON THE RHEUMATIC DISEASES SERIES 6 Hands On Practical advice on management of rheumatic disease PSORIATIC ARTHRITIS ITS PRESENTATION AND MANAGEMENT IN PRIMARY CARE Philip S Helliwell Senior Lecturer

More information

Validation and Field Performance of the Italian Version of the Psoriatic Arthritis Screening and Evaluation (PASE) Questionnaire

Validation and Field Performance of the Italian Version of the Psoriatic Arthritis Screening and Evaluation (PASE) Questionnaire Acta Derm Venereol 2016; Suppl 217: 96 101 INVESTIGATIVE REPORT Validation and Field Performance of the Italian Version of the Psoriatic Arthritis Screening and Evaluation (PASE) Questionnaire Stefano

More information

NEW EFFECTIVE TREATMENTS FOR PSORIATIC ARTHRITIS PATIENTS Promising data to support two new drug classes

NEW EFFECTIVE TREATMENTS FOR PSORIATIC ARTHRITIS PATIENTS Promising data to support two new drug classes Annual European Congress of Rheumatology (EULAR) 2017 Madrid, Spain, 14-17 June 2017 NEW EFFECTIVE TREATMENTS FOR PSORIATIC ARTHRITIS PATIENTS Promising data to support two new drug classes Madrid, Spain,

More information

Juvenile Idiopathic Arthritis (JIA)

Juvenile Idiopathic Arthritis (JIA) Juvenile Idiopathic Arthritis (JIA) Kaveh Ardalan, MD, MS Division of Rheumatology Ann & Robert H. Lurie Children s Hospital of Chicago Assistant Professor, Pediatrics and Medical Social Sciences Northwestern

More information

Ontario Public Drug Programs. Inflectra (infliximab) Frequently Asked Questions

Ontario Public Drug Programs. Inflectra (infliximab) Frequently Asked Questions Ontario Public Drug Programs Inflectra (infliximab) Frequently Asked Questions 1. What is the funding status of Inflectra (infliximab)? Effective February 25 2016, Inflectra (infliximab) will be added

More information

Seronegative spondyloarthropathies : A Pictorial Review

Seronegative spondyloarthropathies : A Pictorial Review Seronegative spondyloarthropathies : A Pictorial Review Poster No.: P-0008 Congress: ESSR 2012 Type: Scientific Exhibit Authors: J. Acosta Batlle, B. Palomino Aguado, M. D. Lopez Parra, S. 1 2 3 2 4 1

More information

Health Technology Appraisal: etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis (rev 104, 125)

Health Technology Appraisal: etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis (rev 104, 125) Health Technology Appraisal: etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis (rev 104, 125) Personal view of etanercept, infliximab and adalimumab for psoriatic arthritis

More information

RHEUMATOLOGY OVERVIEW. Carmelita J. Colbert, MD Assistant Professor of Medicine Division of Rheumatology Loyola University Medical Center

RHEUMATOLOGY OVERVIEW. Carmelita J. Colbert, MD Assistant Professor of Medicine Division of Rheumatology Loyola University Medical Center RHEUMATOLOGY OVERVIEW Carmelita J. Colbert, MD Assistant Professor of Medicine Division of Rheumatology Loyola University Medical Center What is Rheumatology? Medical science devoted to the rheumatic diseases

More information

Clinical Policy: Certolizumab (Cimzia) Reference Number: PA.CP.PHAR.247 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid

Clinical Policy: Certolizumab (Cimzia) Reference Number: PA.CP.PHAR.247 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid Clinical Policy: (Cimzia) Reference Number: PA.CP.PHAR.247 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid Coding Implications Revision Log Description (Cimzia ) is a tumor necrosis

More information

Psoriasis and systemic inflammation: underdiagnosed enthesopathy

Psoriasis and systemic inflammation: underdiagnosed enthesopathy DOI: 10.1111/j.1468-3083.2009.03361.x JEADV Blackwell Publishing Ltd REVIEW ARTICLE Psoriasis and systemic inflammation: underdiagnosed enthesopathy G Girolomoni*, P Gisondi Section of Dermatology and

More information

What is Axial Spondyloarthritis?

What is Axial Spondyloarthritis? Physiotherapist Module 2 What is Axial Spondyloarthritis? How does it apply to physiotherapists? Claire Harris, Senior Physiotherapist, London North West Healthcare NHS Trust Susan Gurden, Advanced Physiotherapy

More information

Seronegative Spondyloarthropathies (SpA)

Seronegative Spondyloarthropathies (SpA) Seronegative Spondyloarthropathies (SpA) Objectives: Introduction SpA disease information Pathogenesis Clinical features Team Members: Ameera Niazi - Lulwah AlShiha - Qaiss Almuhaideb - Abdullah Hashem

More information

Pharmacy Management Drug Policy

Pharmacy Management Drug Policy SUBJECT: Cimzia (Certolizumab pegol) - for Ankylosing Spondylitis, Crohn s Disease, Psoriatic Arthritis and Rheumatoid Arthritis POLICY NUMBER: PHARMACY-07 EFFECTIVE DATE: 5/2009 LAST REVIEW DATE: 6/13/2018

More information

Training on the modular approach on the assessment and management of psoriatic arthritis (PsA) for rheumatology units

Training on the modular approach on the assessment and management of psoriatic arthritis (PsA) for rheumatology units Training on the modular approach on the assessment and management of psoriatic arthritis (PsA) for rheumatology units This PsA assessment initiative is led by the UK PsA Assessment Academy and funded by

More information

PHARMACY POLICY STATEMENT Ohio Medicaid

PHARMACY POLICY STATEMENT Ohio Medicaid DRUG NAME BILLING CODE BENEFIT TYPE SITE OF SERVICE ALLOWED COVERAGE REQUIREMENTS LIST OF DIAGNOSES CONSIDERED NOT MEDICALLY NECESSARY PHARMACY POLICY STATEMENT Ohio Medicaid Enbrel (etanercept) Must use

More information

OVERVIEW OF PSORIATIC ARTHRITIS: CLINICAL CONSIDERATIONS FOR HEALTHCARE PROFESSIONALS JAMIE L. MCCONAHA, PHARMD, NCTTP, BCACP, CDE

OVERVIEW OF PSORIATIC ARTHRITIS: CLINICAL CONSIDERATIONS FOR HEALTHCARE PROFESSIONALS JAMIE L. MCCONAHA, PHARMD, NCTTP, BCACP, CDE OVERVIEW OF PSORIATIC ARTHRITIS: CLINICAL CONSIDERATIONS FOR HEALTHCARE PROFESSIONALS JAMIE L. MCCONAHA, PHARMD, NCTTP, BCACP, CDE FACULTY DISCLOSURES I have no conflicts of interest to disclose. I do

More information

Cigna Drug and Biologic Coverage Policy

Cigna Drug and Biologic Coverage Policy Cigna Drug and Biologic Coverage Policy Subject Apremilast Table of Contents Coverage Policy... 1 General Background... 2 Coding/Billing Information... 4 References... 4 Effective Date... 1/1/2018 Next

More information

Objectives. Joint Pain. Case 1. Rheumatology for the Primary MD (Not just your grandmother s disease) 12/4/2010

Objectives. Joint Pain. Case 1. Rheumatology for the Primary MD (Not just your grandmother s disease) 12/4/2010 Objectives Rheumatology for the Primary MD (Not just your grandmother s disease) Identify when it is appropriate to refer for rheumatologic evaluation Autoimmune/ Inflammatory v. noninflammatory disease

More information

Update - Imaging of the Spondyloarthropathies. Spondyloarthropathies. Spondyloarthropathies

Update - Imaging of the Spondyloarthropathies. Spondyloarthropathies. Spondyloarthropathies Update - Imaging of the Spondyloarthropathies Donald J. Flemming, M.D. Dept of Radiology Penn State Hershey Medical Center Spondyloarthropathies Family of inflammatory arthritides of synovium and entheses

More information

37 year old male with several year history of back pain

37 year old male with several year history of back pain 37 year old male with several year history of back pain Inflammatory Low Back Pain Clues onset before the age of 40 years insidious onset, chronic (>3 months) pain morning stiffness for longer than 30

More information

Drug Therapy Guidelines

Drug Therapy Guidelines Simponi, Simponi Aria Applicable Medical Benefit x Effective: 2/13/18 Pharmacy- Formulary 1 x Next Review: 12/18 Pharmacy- Formulary 2 x Date of Origin: 7/2010 Pharmacy- Formulary 3/Exclusive x Review

More information

Psoriasis and Psoriatic Arthritis Overview

Psoriasis and Psoriatic Arthritis Overview n REPORT n Psoriasis and Psoriatic Arthritis Overview Alan Menter, MD PSORIASIS OVERVIEW Psoriasis is a chronic, multifactorial, immune-mediated skin disease. The characteristic erythematous plaques of

More information

www.fisiokinesiterapia.biz Peak onset between 20 and 30 years Form of spondyloarthritis (cause inflammation around site of ligament insertion into bone) and association with HLA-B27 Prevalence as high

More information

KEY MESSAGES. Psoriasis patients are more prone to cardiovascular diseases, stroke, lymphoma and non-melanoma skin cancers, and increased mortality.

KEY MESSAGES. Psoriasis patients are more prone to cardiovascular diseases, stroke, lymphoma and non-melanoma skin cancers, and increased mortality. KEY MESSAGES Psoriasis is a genetically determined, systemic immune-mediated chronic inflammatory disease that affects primarily the skin and joints. Psoriasis Vulgaris is characterised by well-demarcated

More information

Psoriatic Arthritis Shared Decision Making

Psoriatic Arthritis Shared Decision Making Psoriatic Arthritis Shared Decision Making Disease Modifying Drug Therapy DMARDs Therapy El Miedany et al. Ann Rheum Dis 74(Suppl2): 1002 DOI: 10.1136/annrheumdis-2015-eular.1410 www.rheumatology4u.com

More information

Golimumab: a novel anti-tumor necrosis factor

Golimumab: a novel anti-tumor necrosis factor Golimumab: a novel anti-tumor necrosis factor Rossini M, De Vita S, Ferri C, et al. Biol Ther. 2013. This slide deck represents the opinions of the authors, and not necessarily the opinions of the publisher

More information

Impact of Chronic Conditions on Health-Related Quality of Life

Impact of Chronic Conditions on Health-Related Quality of Life BURDEN OF ILLNESS Overview Impact of Chronic Conditions on Health-Related Quality of Life Chronic joint pain conditions have an important impact on health-related quality of life Note: a larger negative

More information

From Psoriasis to Psoriatic Arthritis: Incorporating Advances to Individualize Treatment

From Psoriasis to Psoriatic Arthritis: Incorporating Advances to Individualize Treatment From Psoriasis to Psoriatic Arthritis: Incorporating Advances to Individualize Treatment Final Enduring Outcomes Report Celgene Grant #20502 Janssen Grant #CE15843 Novartis Grant #NGC29612 Reflective of

More information

Proper treatment of psoriatic arthritis (PsA) requires. Update on Treatment of Psoriatic Arthritis. Philip Mease, M.D.

Proper treatment of psoriatic arthritis (PsA) requires. Update on Treatment of Psoriatic Arthritis. Philip Mease, M.D. 167 Update on Treatment of Psoriatic Arthritis Philip Mease, M.D. Abstract Some of this past year s key papers or abstracts on psoriatic arthritis (PsA) assessment and treatment are reviewed in this paper.

More information

Relation between psoriasis and psoriatic arthritis: A study of 40 patients

Relation between psoriasis and psoriatic arthritis: A study of 40 patients 2018; 2(4): 43-47 ISSN (P): 2521-3466 ISSN (E): 2521-3474 Clinical Orthopaedics www.orthoresearchjournal.com 2018; 2(4): 43-47 Received: 19-08-2018 Accepted: 23-09-2018 Dr. Hardik Sethi Orthopaedics, Govt.

More information

C. Assess clinical response after the first three months of treatment.

C. Assess clinical response after the first three months of treatment. Government Health Plan (GHP) of Puerto Rico Authorization Criteria Tumor Necrosis Factor Alpha (TNFα) Adalimumab (Humira ) Managed by MCO Section I. Prior Authorization Criteria A. Physician must submit

More information

Seronegative Spondyloarthropathies: A Radiological Persepctive

Seronegative Spondyloarthropathies: A Radiological Persepctive Seronegative Spondyloarthropathies: A Radiological Persepctive Poster No.: C-1816 Congress: ECR 2016 Type: Educational Exhibit Authors: K. Shindi, H. Nejadhamzeeigilani, P. Nagtode, C. Nel ; 1 1 2 2 3

More information

This is a repository copy of New GRAPPA and EULAR recommendations for the management of psoriatic arthritis: process and challenges faced.

This is a repository copy of New GRAPPA and EULAR recommendations for the management of psoriatic arthritis: process and challenges faced. This is a repository copy of New GRAPPA and EULAR recommendations for the management of psoriatic arthritis: process and challenges faced. White Rose Research Online URL for this paper: http://eprints.whiterose.ac.uk/102808/

More information

Remicade (Infliximab)

Remicade (Infliximab) Remicade (Infliximab) Policy Number: Original Effective Date: MM.04.016 11/18/2003 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 07/26/2013 Section: Prescription Drugs Place(s)

More information

Pediatric Psoriasis Comorbidities. Kelly M. Cordoro, M.D. Associate Professor of Dermatology and Pediatrics University of California, San Francisco

Pediatric Psoriasis Comorbidities. Kelly M. Cordoro, M.D. Associate Professor of Dermatology and Pediatrics University of California, San Francisco Pediatric Psoriasis Comorbidities Kelly M. Cordoro, M.D. Associate Professor of Dermatology and Pediatrics University of California, San Francisco log2 (Expression/hARP) Th1 CXCL10 Disclosures * *** **

More information

JuvenileIdiopathicArthritis. Dr Johan Siebert

JuvenileIdiopathicArthritis. Dr Johan Siebert JuvenileIdiopathicArthritis Dr Johan Siebert 1 NORMAL DIARTHRODIAL JOINT Synovial is a thin membrane enclosing the joint space The joint space contains fluid that bathes the joint and reduces friction

More information

Optimisation of rheumatology indices: dactylitis and enthesitis in psoriatic arthritis

Optimisation of rheumatology indices: dactylitis and enthesitis in psoriatic arthritis Optimisation of rheumatology indices: dactylitis and enthesitis in psoriatic arthritis E.G. Ferguson, L.C. Coates Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel

More information

Clinical Policy: Ixekizumab (Taltz) Reference Number: ERX.SPA.122 Effective Date:

Clinical Policy: Ixekizumab (Taltz) Reference Number: ERX.SPA.122 Effective Date: Clinical Policy: (Taltz) Reference Number: ERX.SPA.122 Effective Date: 10.01.16 Last Review Date: 11.18 Revision Log See Important Reminder at the end of this policy for important regulatory and legal

More information

Newer classification criteria 2010:How adequate is this to classify Rheumatoid Arthritis?

Newer classification criteria 2010:How adequate is this to classify Rheumatoid Arthritis? Newer classification criteria 2010:How adequate is this to classify Rheumatoid Arthritis? DR MD MATIUR RAHMAN MBBS, MD, FCPS, FACR, Fellow APLAR Associate Professor, Medicine SSMC & Mitford Hospital New

More information

What is Cosentyx (secukinumab)?

What is Cosentyx (secukinumab)? What is Cosentyx (secukinumab)? Cosentyx is the first of a new class of medicines called interleukin- 17A (IL- 17A) inhibitors to be approved for the treatment of moderate- to- severe plaque psoriasis,

More information

9 Lecture. Spondyloarthropathy แพทย หญ งน นทนา กส ตานนท คณะแพทยศาสตร มหาว ทยาล ยเช ยงใหม

9 Lecture. Spondyloarthropathy แพทย หญ งน นทนา กส ตานนท คณะแพทยศาสตร มหาว ทยาล ยเช ยงใหม 9 Lecture Spondyloarthropathy แพทย หญ งน นทนา กส ตานนท คณะแพทยศาสตร มหาว ทยาล ยเช ยงใหม Spondyloarthritis: SpA Nuntana Kasitanon Division of Rheumatology Department of Medicine Spondyloarthritis: SpA

More information

NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE. Proposed Health Technology Appraisal

NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE. Proposed Health Technology Appraisal NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Proposed Health Technology Appraisal Secukinumab for treating ankylosing spondylitis after inadequate response to non-steroidal anti-inflammatory drugs

More information

Primary Results Citation 2

Primary Results Citation 2 Table S1. Adalimumab clinical trials 1 ClinicalTrials.gov Rheumatoid Arthritis 3 NCT00195663 Breedveld FC, Weisman MH, Kavanaugh AF, et al. The PREMIER study. A multicenter, randomized, double-blind clinical

More information

Ultrasound in Rheumatology

Ultrasound in Rheumatology Arthritis Research UK Primary Care Centre Winner of a Queen s Anniversary Prize For Higher and Further Education 2009 Ultrasound in Rheumatology Alison Hall Consultant MSK Sonographer/Research Fellow Primary

More information

APPLICATION FOR SUBSIDY BY SPECIAL AUTHORITY

APPLICATION FOR SUBSIDY BY SPECIAL AUTHORITY APPLICANT (stamp sticker acceptable) Page 1 Fm SA1620 Etanercept INITIAL APPLICATION - juvenile idiopathic arthritis Applications only from a named specialist rheumatologist. Approvals valid f 6 months.

More information

Assessment of Inflammatory Back Pain: New Concepts in Diagnosis

Assessment of Inflammatory Back Pain: New Concepts in Diagnosis Assessment of Inflammatory Back Pain: New Concepts in Diagnosis March 2 nd, 2018 Spine Therapy Network Interprofessional Synposium Sheraton Toronto Airport Hotel, Toronto, CANADA Laura Passalent PT, BScPT,

More information

Pre-Activity Question 1. Psoriasis and PsA Clinical Features, Associated Conditions, Screening, and Assessment. Pre-Activity Question 2

Pre-Activity Question 1. Psoriasis and PsA Clinical Features, Associated Conditions, Screening, and Assessment. Pre-Activity Question 2 Pre-Activity Question 1 Psoriasis and PsA Clinical Features, Associated Conditions, Screening, and Assessment How confident are you in your ability to establish a clinical framework to diagnose and screen

More information

INFLIXIMAB Remicade (infliximab), Inflectra (infliximab-dyyb), Renflexis (infliximab-abda)

INFLIXIMAB Remicade (infliximab), Inflectra (infliximab-dyyb), Renflexis (infliximab-abda) RATIONALE FOR INCLUSION IN PA PROGRAM Background Remicade, Renflexis and Inflectra are tumor necrosis factor (TNFα) blockers. Tumor necrosis factor is an endogenous protein that regulates a number of physiologic

More information

Clinical Policy: Etanercept (Enbrel) Reference Number: CP.PHAR.250 Effective Date: 08/16 Last Review Date: 08/17 Line of Business: Medicaid

Clinical Policy: Etanercept (Enbrel) Reference Number: CP.PHAR.250 Effective Date: 08/16 Last Review Date: 08/17 Line of Business: Medicaid Clinical Policy: (Enbrel) Reference Number: CP.PHAR.250 Effective Date: 08/16 Last Review Date: 08/17 Line of Business: Medicaid Coding Implications Revision Log See Important Reminder at the end of this

More information

Juvenile Idiopathic Arthritis in Adults: Long-Term Observation of Ukrainian Patients

Juvenile Idiopathic Arthritis in Adults: Long-Term Observation of Ukrainian Patients Archive of Clinical Medicine 2017 Vol. 23, Issue 1, E201715 DOI: 10.21802/acm.2017.1.5 Research Article Juvenile Idiopathic Arthritis in Adults: Long-Term Observation of Ukrainian Patients Marta Dzhus

More information

Title: The ideal target for psoriatic arthritis? Comparison of remission and low

Title: The ideal target for psoriatic arthritis? Comparison of remission and low Title: The ideal target for psoriatic arthritis? Comparison of remission and low disease activity states in a real life cohort. Leonieke J.J. van Mens, MD 1, Marleen G.H. van de Sande, MD 1, PhD 1, Arno

More information

Review of the Psoriatic Arthritis working group at OMERACT 12: a report from the. GRAPPA 2014 annual meeting

Review of the Psoriatic Arthritis working group at OMERACT 12: a report from the. GRAPPA 2014 annual meeting Review of the Psoriatic Arthritis working group at OMERACT 12: a report from the GRAPPA 2014 annual meeting W. Tillett L. Eder N. Goel M. dewit A. Ogdie AM Orbai W. Campbell O. FitzGerald N. McHugh D.

More information

THE PATIENT S PERSPECTIVE ON PSORIATIC ARTHRITIS: WHAT MORE CAN RHEUMATOLOGISTS DO TO OPTIMISE DISEASE MANAGEMENT?

THE PATIENT S PERSPECTIVE ON PSORIATIC ARTHRITIS: WHAT MORE CAN RHEUMATOLOGISTS DO TO OPTIMISE DISEASE MANAGEMENT? THE PATIENT S PERSPECTIVE ON PSORIATIC ARTHRITIS: WHAT MORE CAN RHEUMATOLOGISTS DO TO OPTIMISE DISEASE MANAGEMENT? This symposium took place on 16 th June 2017 as a part of the European League Against

More information

CLINICAL MONOGRAPH FOR SIMPONI ARIA (golimumab)

CLINICAL MONOGRAPH FOR SIMPONI ARIA (golimumab) CLINICAL MONOGRAPH FOR SIMPONI ARIA (golimumab) INDICATIONS SIMPONI ARIA is indicated for the treatment of adult patients with: Moderately to severely active rheumatoid arthritis (RA), in combination with

More information

A validation study of the Simple Psoriatic Arthritis Screening (SiPAS) questionnaire to screen psoriasis patients for psoriatic arthritis

A validation study of the Simple Psoriatic Arthritis Screening (SiPAS) questionnaire to screen psoriasis patients for psoriatic arthritis A validation study of the Simple Psoriatic Arthritis Screening (SiPAS) questionnaire to screen psoriasis patients for psoriatic arthritis F. Salaffi 1, M. Di Carlo 1, M.M. Luchetti 2, E. Di Donato 1, A.

More information

Psoriatic arthritis: early ultrasound findings

Psoriatic arthritis: early ultrasound findings Psoriatic arthritis: early ultrasound findings Poster No.: C-0399 Congress: ECR 2014 Type: Educational Exhibit Authors: R. Persechino 1, L. Cristiano 1, A. Bartoloni 1, C. Cantone 2, A. Keywords: DOI:

More information

axial spondyloarthritis including ankylosing spondylitis

axial spondyloarthritis including ankylosing spondylitis 1 What is spondyloarthritis? Spondyloarthritis is a general term that describes a number of types of inflammatory arthritis which share many articular and extra-articular features. Conditions which fall

More information

Case reports CASE 1. A 67-year-old white man had back pain since the age. our clinic several years later with progressive symptoms.

Case reports CASE 1. A 67-year-old white man had back pain since the age. our clinic several years later with progressive symptoms. Annals of the Rheumatic Diseases, 1982, 41, 574-578 Late-onset peripheral joint disease in ankylosing spondylitis MARC D. COHEN AND WILLIAM W. GINSBURG From the Division ofrheumatology and Internal Medicine,

More information

Clinical Policy: Secukinumab (Cosentyx) Reference Number: ERX.SPA.165 Effective Date:

Clinical Policy: Secukinumab (Cosentyx) Reference Number: ERX.SPA.165 Effective Date: Clinical Policy: (Cosentyx) Reference Number: ERX.SPA.165 Effective Date: 10.01.16 Last Review Date: 11.18 Revision Log See Important Reminder at the end of this policy for important regulatory and legal

More information

Effective management of arthritis. Gail Dolan Victoria ACH Liz McIvor Stobhill ACH

Effective management of arthritis. Gail Dolan Victoria ACH Liz McIvor Stobhill ACH Effective management of arthritis Gail Dolan Victoria ACH Liz McIvor Stobhill ACH Role Types of arthritis Drugs Self Management Role Of CNS Advanced level nurses offering specialist care in a specific

More information

Concept of Spondyloarthritis (SpA)

Concept of Spondyloarthritis (SpA) Concept of Spondyloarthritis (SpA) Spondyloarthritis: Characteristic Parameters Used for Diagnosis I Symptoms Inflammatory back pain Imaging Lab ESR/CRP Patient s history Good response to NSAIDs Spondyloarthritis-Characteristic

More information

Medical Policy An independent licensee of the Blue Cross Blue Shield Association

Medical Policy An independent licensee of the Blue Cross Blue Shield Association Otezla (apremilast) Page 1 of 7 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Otezla (apremilast) Prime Therapeutics will review Prior Authorization requests Prior

More information

Oligoarticular Psoriatic Arthritis: Addressing Clinical Challenges in an Intriguing Phenotype

Oligoarticular Psoriatic Arthritis: Addressing Clinical Challenges in an Intriguing Phenotype https://doi.org/10.1007/s40744-018-0115-5 COMMENTARY Oligoarticular Psoriatic Arthritis: Addressing Clinical Challenges in an Intriguing Phenotype Antonio Marchesoni Received: May 8, 2018 Ó The Author(s)

More information

Clinical Policy: Certolizumab (Cimzia) Reference Number: ERX.SPA.167 Effective Date:

Clinical Policy: Certolizumab (Cimzia) Reference Number: ERX.SPA.167 Effective Date: Clinical Policy: (Cimzia) Reference Number: ERX.SPA.167 Effective Date: 10.01.16 Last Review Date: 11.17 Revision Log See Important Reminder at the end of this policy for important regulatory and legal

More information

Clinical Policy: Certolizumab (Cimzia) Reference Number: ERX.SPA.167 Effective Date:

Clinical Policy: Certolizumab (Cimzia) Reference Number: ERX.SPA.167 Effective Date: Clinical Policy: (Cimzia) Reference Number: ERX.SPA.167 Effective Date: 1.1.16 Last Review Date: 11.17 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information.

More information