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Abstract: To assess the prevalence and factors associated with mild cognitive impairment (MCI) in patients suffering from psoriatic arthritis (PsA).A cross-sectional evaluation was conducted in consecutive PsA patients. Sociodemographic data and the clinimetric variables related to PsA and psoriasis were collected for each patient. MCI was assessed through the Montreal Cognitive Assessment (MoCA). The cognitive performance of PsA patients was compared to healthy subjects using one-way analysis of variance (ANOVA). The correlations among variables were studied by the Spearman rank correlation coefficient. A multivariate logistic regression analysis was carried out to establish the predictors of MCI.The study involved 96 PsA patients and 48 healthy subjects. MCI (defined as a MoCA score < 26/30) was detected in 47 (48.9%) PsA patients. Compared to healthy subjects, the MoCA score resulted significantly lower in PsA patients (P = .015). The main differences involved the denomination and language domains. MoCA was negatively correlated with age (r = -0.354; P < .0001), HAQ-DI (r = -0.227; P = .026), and fatigue (r = -0.222; P = .029), and positively correlated with psoriasis duration (r = 0.316; P = .001) and DLQI (r = 0.226; P = .008).The multivariate logistic regression analysis revealed the duration of psoriasis (P = .0005), age (P = .0038), PASI (P = .0050), and HAQ-DI (P = .0193) as predictors of the MoCA score.MCI is present in a significant proportion of PsA patients, and is mainly determined by age, cutaneous variables, and disability., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: To establish the weight of the subjective components of the Disease Activity index for Psoriatic Arthritis (DAPSA) in psoriatic arthritis (PsA) patients and comorbid fibromyalgia syndrome (FM)., Methods: In PsA patients not fulfilling the DAPSA remission, it has been calculated the DAPSA-patient (DAPSA-P), an index represented by the ratio between the sum of the subjective components (tender joint count+patient global assessment of disease activity+visual analogue scale pain) and DAPSA in its entirety (swollen joint count+tender joint count+patient global assessment of disease activity+visual analogue scale pain+C-reactive protein [in mg/ dl]). The DAPSA-P ranges from 0 to 1, and values closer to 1 suggest a major weight of the subjective components, while values closer to 0 indicate a greater contribution of the swollen joint count and C-reactive protein, the two factors more closely related to inflammation. It was also defined as the presence of a comorbid FM, and it was established the DAPSA-P cut-off point distinguishing for the presence of a comorbid FM through the receiver operating characteristic (ROC) curve analysis., Results: DAPSA-P was higher in all PsA+FM patients. Analysing the receiver operating characteristic curve, the DAPSA-P cut-off distinguishing a comorbid FM was 0.775., Conclusions: DAPSA-P can help to measure how comorbid FM inflates DAPSA.

Objective: To develop a preliminary power Doppler (PD) US composite score for global assessment of PsA patients., Methods: Sixteen PsA patients receiving anti-TNF-α therapy were enrolled. All patients were involved in multiple psoriatic targets, including joints, tendon, enthesis, skin and nail. The target with the highest PD signal, one for each target area, was selected to be scanned at baseline and at follow-up visit 8 weeks after. For each target, PD was graded according to semi-quantitative scoring systems. Inter- and intra-observer reliability and feasibility was also investigated. The new PD composite score for PsA was called Five Targets PD for Psoriatic Disease (5TPD)., Results: Sixty targets (16 joints, 9 tendons, 11 enthesis, 16 psoriatic plaques and 8 psoriatic onychopathies) were assessed. A significant improvement of the clinical scores was found at follow-up with respect to the baseline: HAQ modified for SpA (HAQ-S) (P = 0.0001); Psoriasis Area and Severity Index (P = 0.0001) and Nail Psoriasis Severity Index (P = 0.35). The 5TPD showed a significant change between baseline and follow-up (P = 0.0001). There was no significant correlation between HAQ-S and 5TPD findings. The inter- and intra-observer κ-values varied from good to excellent at baseline and follow-up. The time spent on baseline US examinations was mean (s.d.) 10.5 (2.0) min and no more than 7 min for follow-up assessment., Conclusion: The present study provides a new working hypothesis that the sonographic core set may be useful to construct a PDUS composite score for the assessment of PsA. The 5TPD formula provides a feasible and reliable approach for multi-target monitoring of psoriatic disease.