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Phenotype Submission - Psoriatic arthritis

Cohort Definition Name: “Psoriatic arthritis”
Contributor name: Joel N. Swerdel
Contributor OrcId: 0000-0001-9491-2737
Logic Description: First occurrence of Psoriatic arthritis.
Recommended study application: outcome, indication
Assertion statement: This cohort definition was executed on at least one real person-level observational health data source and resulted in a cohort with at least 1 person.
Submitted cohort definition:
Psoriatic arthritis.txt (9.6 KB)

Target Clinical Description

Overview: Psoriatic Arthritis (PsA) ia a type of inflammatory autoimmune condition that can cause chronic pain in and around joints. If left untreated, PSA can lead to permanent joint damage and if untreated is disabling. Some patients with psoriasis develop psoriatic arthritis.
Presentation: Psoriatic arthritis presents as painful, stiff, and swollen joints.
Assessment: Symptoms of PsA include painful, stiff, and swollen joints, which may flare and subside. Joints may be swollen and tender, and fingernails may have be abnormal (e.g., pitting and flaking), in addition to tenderness of the soles of the feet. X-ray imaging may help to identify joint changes that are specific to PsA over other types of arthritis. Rheumatoid factor and joint fluid laboratory tests may help to rule out other types of conditions (rheumatoid arthritis and gout, respectively).

Plan: There is no cure for PsA. Treatment may include steroid injections, disease modifying antirheumatic drugs (DMARDs), biologic treatments, and newer oral medications (apremilast). Joint replacement surgery may also be an intervention.

Prognosis: PsA may be mild to severe, is chronic, and joint damage that has occurred does not improve. Early diagnosis and intervention with treatment is important to limit progression of joint damage. If untreated, PsA will progress to disabling joint disease.

imported id 748

Thanks @jswerdel for this submission. I plan to use this definition as a nesting indication for TNF inhibitors as part of the HowOften workshop for OHDSI2023.

Two interesting tidbits to capture here that I noted in my review: 1- in SNOMED, ‘psoriasis with arthropathy’ and ‘psoriatic arthritis’ are both children of ‘psoriasis’ but not related to each other. Most of the data in our OHDSI community appears to load on ‘psoriasis with arthropathy’ based on ICD source mappings. 2- this definition has a conceptset named ‘Arthropathy’ to look for co-occurrent Psoriasis, as another means of identifying patients, but it does not include the broad ‘Arthropathy’ concept + descendants. (~2/3 of ‘arthopathy’ records appear to be from ‘osteoarthritis’, ‘disorder of joint of spine’ and ‘joint injury’ , so perhaps those aren’t what we are specifically interested in here?)