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Consensus-based recommendations on the diagnosis, referral and clinical management of patients with psoriatic arthritis

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Abstract

Psoriatic arthritis (PsA) is a highly heterogeneous disease with complex manifestations. Limited understanding of the disease and non-availability of local guidelines pose challenges in the management of PsA in Saudi Arabia. Therefore, this expert consensus is aimed to provide recommendations on the management of patients with PsA, including referral pathway, definition of remission and treat-to-target (T2T) approach. A Delphi technique of consensus development was used involving an expert panel comprised of 10 rheumatologists, one dermatologist and one family physician. Based on the review of available published evidence and the opinions of clinical experts, key recommendations were developed. A consensus was achieved in defining the following: management guideline adaptable for Saudi Arabia, most useful screening tool, laboratory investigations, imaging tests and criteria for referring suspected PsA patients to a rheumatologist. In addition, an agreement was achieved in defining the T2T strategy and remission for the clinical management of PsA. Overall, these recommendations provide an evidence-based framework for the management of PsA patients in Saudi Arabia.

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Availability of data and material

The datasets of the current study are available from the corresponding author on reasonable request (Dr. Hanan Al Rayes, E-mail: alrayesh@hotmail.com). This research work was recently presented at the Annual European Congress of Rheumatology—EULAR 2021.

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Acknowledgements

The authors extend their appreciation to the Saudi Society for Rheumatology for their continuous support and to the Saudi experts for their participation in the Delphi process. The authors are grateful to Dr. Xenofon Baraliakos (Ruhr-University Bochum, Germany) for his independent review of the manuscript. The authors also acknowledge Nancy Zakaria (Novartis Saudi Ltd., Saudi Arabia) for facilitating the online survey and meeting, and Mihir Pujara and Ramakrishna GS (Novartis Healthcare Pvt. Ltd., India) for supporting in the literature review process. Our acknowledgment is also extended to Amit Pagada and Ramakrishna GS (Novartis Healthcare Pvt. Ltd., India) for medical writing and editorial assistance in preparing the manuscript, based on the authors’ input and direction.

Funding

This work was supported by Novartis Saudi Limited, Saudi Arabia.

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Authors and Affiliations

  1. Department of Medicine, Prince Sultan Military Medical City, Riyadh, 21577, Saudi Arabia

    Hanan Al Rayes

  2. Department of Rheumatology, Prince Mohammed Medical City, Al Jouf, Saudi Arabia

    Mansour Alazmi

  3. Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

    Suzan Attar

  4. Department of Rheumatology, King Fahad Specialist Hospital, Dammam, Saudi Arabia

    Khaled Alderaan

  5. Department of Rheumatology, University of Bisha, Bisha, Saudi Arabia

    Mushabab Alghamdi

  6. Department of Rheumatology, King Saud Medical City, Riyadh, Saudi Arabia

    Nayef Alghanim

  7. Department of Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia

    Ahmed Alhazmi

  8. Department of Family Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia

    Nadeer Alkhadhrawi

  9. Department of Dermatology, King Saud Bin Abdulaziz University for Health Sciences and King Abdulaziz Medical City, Riyadh, Saudi Arabia

    Mohammad Almohideb

  10. Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia

    Zeyad Alzahrani

  11. Department of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia

    Mohamed Bedaiwi

  12. Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia

    Hussein Halabi

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  1. Hanan Al Rayes
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  2. Mansour Alazmi
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  3. Suzan Attar
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Contributions

HAR, MA, SA, KA, MAG, NA, AA, NAK, MAM, ZA, MB and HH contributed to the study conception, design, acquisition, interpretation or analysis of the data. All authors critically revised the manuscript for important intellectual content. All authors approved the final version to be published and agreed to be accountable for all aspects of the work.

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Correspondence to Hanan Al Rayes.

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Al Rayes, H., Alazmi, M., Attar, S. et al. Consensus-based recommendations on the diagnosis, referral and clinical management of patients with psoriatic arthritis. Rheumatol Int 42, 391–401 (2022). https://doi.org/10.1007/s00296-021-05029-5

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