Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jun 30, 2021
Date Accepted: Sep 7, 2021
Discovery of Arthritis in Psoriasis Patients for Early Rheumatological referral (DAPPER): Protocol for a Longitudinal Observational Study
ABSTRACT
Background:
One in three patients with psoriasis (Pso) will develop psoriatic arthritis (PsA). If left untreated, this can lead to pain, impaired function and irreversible joint damage. Timely recognition and referral to a rheumatologist is therefore key. However, current methods used to screen psoriasis patients for those who might benefit from referral to a rheumatologist, are not performing well enough.
Objective:
DAPPER is designed to determine the prevalence of PsA in a Pso population, and to find parameters which can be used to develop a new, or enhance an existing instrument for, rheumatological referral.
Methods:
DAPPER is a longitudinal observational study with a 1 year follow-up. Patients with psoriasis (n = 300) who are treated at an outpatient dermatological clinic will be screened extensively for signs and symptoms of psoriatic arthritis by a trained rheumatologist. If there is clinical suspicion of PsA, and the patient is not yet treated by a rheumatologist, referral to the department of rheumatology will follow for confirmation of the diagnosis and further care. After 1 year, data on changes in quality of life (QoL), and PsA and Pso disease activity will be collected. Screening visit will be used to gather demographical and medical data, which can later be used to develop the above-mentioned screening instrument.
Results:
Inclusion started at June 2019, and finished in June 2021. Follow-up of newly-discovered PsA patients is ongoing.
Conclusions:
The DAPPER study is specifically designed to improve the detection of existing PsA in a dermatologic outpatient setting. While internal validity will be tested, external validity will have to be checked using a second validation cohort. To predict the development of PsA in the future, longitudinal/prospective data collection is required, and will be performed in a follow up study (DAPPER-i). Clinical Trial: Dutch Trial Register NTR7604 (November 17th 2018) (www.trialregister.nl), Medical Ethical Committee NL68137.091.18 (April 29th 2019).
Citation
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