For a study, researchers sought to determine how the clinical specialty environment affected the therapy of psoriatic arthritis (PsA), as well as disease activity and burden. It was a post-hoc examination of the population in a cross-sectional, observational survey that took place in 17 nations. Patients with suspected or confirmed PsA who attended regular appointments at participating locations were 18 years or older. The time from the onset of symptoms to the diagnosis of PsA, the time from the diagnosis to the first conventional systemic disease-modifying antirheumatic drug (DMARD) or first biologic DMARD, and the time from the first conventional systemic DMARD to the first biologic DMARD were the primary end points. The Student t test or the Mann-Whitney U nonparametric test were used to explore potential relationships. The Shapiro-Wilk and Kolmogorov-Smirnov tests were used to determine normality.

Patients (n=130) were sent to dermatology (n=75) or rheumatology (n=55) clinics. All primary endpoints were similar between the two groups; however, dermatology patients had significantly higher enthesitis counts (2.1 vs. 0.6; P=0.002), work absenteeism (Work Productivity and Activity Impairment, 19.7% vs. 5.2%; P=0.03), and pain (Health Assessment Questionnaire–Disability Index pain scale, 1.39 vs. 1.01; P=0.032), as well as a worse quality of life related to psoriasis (Dermatology Life Quality Index total score, 8.5 vs 5.0; P=0.019) and mental health (12-item Short-Form Health Survey, version 2.0 subscale, 42.4 vs 47.4; P=0.029). 

PsA disease load and activity were impacted by clinical speciality. Patients were diagnosed with PsA with a delay regardless of setting, highlighting the importance of coordinated care of PsA by rheumatologists and dermatologists for improved results in the patients.

Reference:journals.lww.com/jclinrheum/Fulltext/2022/04000/Clinical_Specialty_Setting_as_Determinant_of.2.aspx