Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: Systematic review and meta-analysis

• Published in: Journal of the American Academy of Dermatology Vol. 73; no. 2; pp. 242 - 248
• Main Authors: Villani, Axel Patrice, MD, Rouzaud, Marie, MD, Sevrain, Morgane, MD, Barnetche, Thomas, PhD, Paul, Carle, MD, PhD, Richard, Marie-Aleth, MD, PhD, Beylot-Barry, Marie, MD, PhD, Misery, Laurent, MD, PhD, Joly, Pascal, MD, PhD, Le Maitre, Michel, MD, Aractingi, Selim, MD, PhD, Aubin, François, MD, PhD, Cantagrel, Alain, MD, PhD, Ortonne, Jean-Paul, MD, PhD, Jullien, Denis, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2015; Elsevier
• Subjects: Arthritis, Psoriatic - diagnosis; Arthritis, Psoriatic - epidemiology; Comorbidity; cutaneous psoriasis; Delayed Diagnosis; dermatologists; Dermatology; early detection; Female; France - epidemiology; Human health and pathology; Humans; Life Sciences; Male; Needs Assessment; Prevalence; Psoriasis - epidemiology; psoriatic arthritis; Risk Assessment; systematic review; France; prevalence; PASI; early detection; psoriatic arthritis; cutaneous psoriasis; systematic review; dermatologists; Psoriasis Area and Severity Index; PsA
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2015.05.001

Background Skin psoriasis precedes the onset of psoriatic arthritis (PsA) in 84% of patients with psoriasis. Dermatologists have an important role to screen psoriasis patients for PsA. The efficiency of PsA screening remains unknown. Objective We sought to determine the point prevalence of undiagnosed PsA in patients with psoriasis using a systematic search of the literature and meta-analysis. Methods PubMed, Cochrane, and Embase database searches yielded 394 studies for review. No study aimed to determine the prevalence of undiagnosed PsA in patients with psoriasis. We assumed that the prevalence of newly diagnosed PsA in patients with psoriasis at the time they seek medical care could be a sound estimate of this value. Seven epidemiological studies and 5 studies on PsA screening questionnaires allowed us to clearly identify patients with newly diagnosed PsA and were selected for review. Results The prevalence of undiagnosed PsA was 15.5% when all studies were considered and 10.1% when only epidemiological studies were considered. Limitations Data were obtained from studies not designed to address the question at hand. Heterogeneity was high ( I2  = 96.86%), and therefore a random effects model was used. Conclusion The high prevalence of undiagnosed PsA in patients with psoriasis adds to the recommendation that dermatologists need to screen all patients with psoriasis for PsA.