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Subclinical psoriatic arthritis: concepts, dilemmas, and research needs - PubMed

4 hours ago
  • #Psoriatic Arthritis
  • #Subclinical Disease
  • #Rheumatology
  • Psoriatic arthritis (PsA) affects up to one-third of psoriasis patients, with growing interest in a subclinical phase before overt arthritis.
  • Subclinical PsA is defined as arthralgia and/or imaging abnormalities without clinical synovitis, but lacks validated biomarkers, leading to risk stratification challenges and potential overtreatment.
  • Lessons from rheumatoid arthritis show both potential and pitfalls in applying prevention paradigms to subclinical disease.
  • Key research priorities include longitudinal psoriasis cohorts, advanced imaging, and multiomic biomarker discovery to improve risk-stratification models.
  • Caution is needed against overexpanding the 'subclinical' concept to avoid overdiagnosis and ensure focus on early, accurate identification of clinically meaningful PsA.