Variability of Psoriatic Arthritis Impact of Disease questionnaire (PsAID12) thresholds in psoriatic arthritis: data from the ReFlaP study

Clementina López-Medina^{1

2}, Clémence Gorlier^{2

3}, Ana-Maria Orbai⁴, Laura C Coates⁵, Uta Kiltz^{6

7}, Ying-Ying Leung⁸, Penelope Palominos⁹, Juan D Cañete¹⁰, Rossana Scrivo¹¹, Andra Balanescu¹², Emmanuelle Dernis¹³, Sandra Meisalu¹⁴, Adeline Ruyssen-Witrand¹⁵, Martin Soubrier¹⁶, Sibel Zehra Aydin¹⁷, Lihi Eder¹⁸, Inna Gaydukova¹⁹, Ennio Lubrano²⁰, Umut Kalyoncu²¹, Pascal Richette^{22

23}, M Elaine Husni²⁴, Josef S Smolen²⁵, Maarten de Wit²⁶, Laure Gossec^{2

3}

Affiliations

¹ Medical and Surgical Sciences Department, University of Cordoba, Reina Sofia Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.
² Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
³ Rheumatology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
⁴ Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁵ Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
⁶ Rheumazentrum Ruhrgebiet, Herne, Germany.
⁷ Ruhr-Universität Bochum, Bochum, Germany.
⁸ Singapore General Hospital, Duke-NUS Medical School, Singapore, Singapore.
⁹ Rheumatology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
¹⁰ Rheumatology Department, Hospital Clínic and IDIBAPS, Barcelona, Spain.
¹¹ Rheumatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza Università di Roma, Rome, Italy.
¹² Internal Medicine and Rheumatology Departments, Sf Maria Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
¹³ Rheumatology Department, Le Mans Central Hospital, Le Mans, France.
¹⁴ Rheumatology Department, East-Tallinn Central Hospital, Tallinn, Estonia.
¹⁵ Rheumatology Unit, Toulouse University Hospital, CIC1463, Inserm, Université Paul Sabatier Toulouse III, Toulouse, France.
¹⁶ Rheumatology Department, Gabriel Montpied Hospital, Clermont Ferrand, France.
¹⁷ Division of Rheumatology, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.
¹⁸ Division of Rheumatology, Women's College Hospital, University of Toronto, Toronto, ON, Canada.
¹⁹ Rheumatology Department, North-Western State Medical University, St Petersburg, Russia.
²⁰ Academic Rheumatology Unit, Dipartimento di Medicina e Scienze della Salute 'Vincenzo Tiberio', University of Molise, Campobasso, Italy.
²¹ Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
²² Service de Rhumatologie, Hopital Lariboisiere Centre Viggo Petersen, Paris, France.
²³ Université Paris Diderot UFR de Medicine, Inserm UMR1132 Bioscar, Paris, France.
²⁴ Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, OH, USA.
²⁵ Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria.
²⁶ Patient Research Partner, Amsterdam, Netherlands.

PMID: 39752329
PMCID: PMC12048079
DOI: 10.1093/rheumatology/keaf002

Observational Study

Variability of Psoriatic Arthritis Impact of Disease questionnaire (PsAID12) thresholds in psoriatic arthritis: data from the ReFlaP study

Clementina López-Medina et al. Rheumatology (Oxford). 2025.

. 2025 May 1;64(5):3090-3094.

doi: 10.1093/rheumatology/keaf002.

Authors

Affiliations

¹ Medical and Surgical Sciences Department, University of Cordoba, Reina Sofia Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.
² Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
³ Rheumatology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
⁴ Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁵ Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
⁶ Rheumazentrum Ruhrgebiet, Herne, Germany.
⁷ Ruhr-Universität Bochum, Bochum, Germany.
⁸ Singapore General Hospital, Duke-NUS Medical School, Singapore, Singapore.
⁹ Rheumatology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
¹⁰ Rheumatology Department, Hospital Clínic and IDIBAPS, Barcelona, Spain.
¹¹ Rheumatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza Università di Roma, Rome, Italy.
¹² Internal Medicine and Rheumatology Departments, Sf Maria Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
¹³ Rheumatology Department, Le Mans Central Hospital, Le Mans, France.
¹⁴ Rheumatology Department, East-Tallinn Central Hospital, Tallinn, Estonia.
¹⁵ Rheumatology Unit, Toulouse University Hospital, CIC1463, Inserm, Université Paul Sabatier Toulouse III, Toulouse, France.
¹⁶ Rheumatology Department, Gabriel Montpied Hospital, Clermont Ferrand, France.
¹⁷ Division of Rheumatology, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.
¹⁸ Division of Rheumatology, Women's College Hospital, University of Toronto, Toronto, ON, Canada.
¹⁹ Rheumatology Department, North-Western State Medical University, St Petersburg, Russia.
²⁰ Academic Rheumatology Unit, Dipartimento di Medicina e Scienze della Salute 'Vincenzo Tiberio', University of Molise, Campobasso, Italy.
²¹ Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
²² Service de Rhumatologie, Hopital Lariboisiere Centre Viggo Petersen, Paris, France.
²³ Université Paris Diderot UFR de Medicine, Inserm UMR1132 Bioscar, Paris, France.
²⁴ Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, OH, USA.
²⁵ Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria.
²⁶ Patient Research Partner, Amsterdam, Netherlands.

PMID: 39752329
PMCID: PMC12048079
DOI: 10.1093/rheumatology/keaf002

Abstract

Objective: To explore thresholds for the Psoriatic Arthritis (PsA) Impact of Disease questionnaire (PsAID12) score against disease activity measures in an observational setting, in patients with PsA.

Methods: The baseline data from the ReFlaP observational, prospective, multicentre and international study were used (NCT03119805). Cutoffs for PsAID12 were determined against disease activity scores, defining disease impact states (i.e. remission, low impact, moderate impact and high impact). Statistics used to assess the optimal cutoff point included Youden's index and the 75th percentile method, with external anchors (i.e. Disease Activity index for Psoriatic Arthritis [DAPSA], very low disease activity [VLDA]/minimal disease activity [MDA] and single questions for both patients and physicians) serving as gold standards. The diagnostic performance of these cutoffs was evaluated using receiver operating characteristic (ROC) curve analyses.

Results: A total of 410 patients were analysed. Mean (s.d.) PsAID12 score was 3.4 (2.5). The prevalence of remission varied between 12.4% and 36.1%, while low disease activity ranged from 37.8% to 59.8%. PsAID12 performed well against external anchors, with high areas under the ROC curves ranging from 0.75 to 0.94. Using the DAPSA as external anchor, the proposed PsAID12 cutoffs were <1.7 for remission, ≥1.7 to ≤3.1 for low impact, >3.1 to <4.8 for moderate impact and ≥4.8 for high impact. Compared with composite scores, patient and physician opinions performed less stringently.

Conclusion: This study established cutoffs for PsAID12 in a clinical practice observational population, corresponding to remission and varying levels of disease impact. However, these proposed cutoffs need further validation, and an expert consensus is essential to confirm the most accurate thresholds for future use.

Keywords: PsAID12; disease activity; patient reported outcomes; psoriatic arthritis; remission.

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References

1. Gudu T, Gossec L. Quality of life in psoriatic arthritis. Expert Rev Clin Immunol 2018;14:405–17. - PubMed
1. Gossec L, de Wit M, Kiltz U et al. ; EULAR PsAID Taskforce. A patient-derived and patient-reported outcome measure for assessing psoriatic arthritis: elaboration and preliminary validation of the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire, a 13-country EULAR initiative. Ann Rheum Dis 2014;73:1012–9. - PubMed
1. Orbai AM, Holland R, Leung YY et al. PsAID12 provisionally endorsed at OMERACT 2018 as core outcome measure to assess psoriatic arthritis-specified health-related quality of life in clinical trials. J Rheumatol 2019;46:990–5. - PMC - PubMed
1. Leung YY, Tillet W, de Wit M et al. Initiating evaluation of composite outcome measures for psoriatic arthritis: 2022 updates from the GRAPPA-OMERACT working group. J Rheumatol 2023;50:53–7. - PubMed
1. Lubrano E, Scriffignano S, Azuaga AB et al. Assessment of the patient acceptable symptom state (PASS) in psoriatic arthritis: association with disease activity and quality of life indices. RMD Open 2020;6:e001170. - PMC - PubMed

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Variability of Psoriatic Arthritis Impact of Disease questionnaire (PsAID12) thresholds in psoriatic arthritis: data from the ReFlaP study

Affiliations

Variability of Psoriatic Arthritis Impact of Disease questionnaire (PsAID12) thresholds in psoriatic arthritis: data from the ReFlaP study

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Miscellaneous