Table 1.

PsA risk framework

Disease-related risks (including functional concerns)

• Assessment of symptoms (pain, stiffness, swelling, rash)   ○ Physical examination   ○ Joint examination   ○ PASI  • Functional assessment   ○ Imaging (X-rays, MRI)  • Quality of life (social interaction, sexual health, body image)   ○ SF-36 subscales   ○ EuroQoL-5 dimension   ○ PsAQoL   ○ Pain Disability Index   ○ PsAID   ○ Work ability  • Documentation of extra-articular manifestations and/or comorbidities  • Poor balance/risk of falls   ○ Fractures

Treatment-related risks

• Contraindications   ○ NSAIDs in patients with IBD, CV disease  • Adverse events   ○ Liver damage with methotrexate (obese patients particularly at risk)  • Poor compliance/persistence   ○ Reduced efficacy of biologics  • Routine laboratory monitoring with biologics  • Immunogenicity with biologics

Psychosocial risks

• Mental health (particularly depression, but also anxiety)   ○ SF-36 subscales   ○ PsAID   ○ DASS-21  • Alcohol abuse  • Self-esteem issues (especially in younger patients)  • Social participation   ○ PsAID

CV cardiovascular, DASS-21 Depression and Anxiety Stress Scale, IBD inflammatory bowel disease, MRI magnetic resonance imaging, NSAIDs nonsteroidal anti-inflammatory drugs, PASI Psoriasis Area and Severity Index, PsAID Psoriatic Arthritis Impact of Disease, PsAQoL Psoriatic Arthritis Quality of Life Questionnaire, SF-36 Short-form 36