Functional impairment measurement in psoriatic arthritis: Importance and challenges

Seminars in Arthritis and Rheumatism
Philip MeaseDafna D Gladman

Abstract

Patients with psoriatic arthritis (PsA) experience substantial physical impairment. This is commonly assessed using the patient-reported Health Assessment Questionnaire-Disability Index (HAQ-DI), which was originally developed in rheumatoid arthritis. The purpose of this review is to examine the value and challenges of using the HAQ-DI in patients with PsA, and to discuss alternative measures of functional impairment in this condition. A literature search was performed in the MEDLINE, BIOSIS Previews, Embase, Derwent Drug File, and SciSearch databases using relevant terms and key words. Additional references from personal libraries were identified by the authors. Although validated in PsA, the HAQ-DI has limitations, including marked floor effects, lack of responsiveness to treatment effects in later disease stages, and underestimation of physical impairment in patients whose symptoms are predominantly skin related. Nonetheless, it has been widely used in clinical trials of PsA treatment and is generally responsive to change with effective therapy, discriminating between active and placebo treatments. Other generic or arthritis-specific patient-reported questionnaires with a focus on physical impairment include the Medical Outc...Continue Reading

Citations

Apr 7, 2020·Expert Review of Clinical Immunology·Vinod Chandran
Oct 23, 2020·Arthritis Care & Research·Alexis OgdiePhilip Mease
Jan 22, 2020·Arthritis Care & Research·Ying Ying LeungUNKNOWN Remission/Flare in PsA Study Group

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