Spondyloarthritis & psoriatic arthritis
Using ultrasound to define inflammatory and non-inflammatory phenotypes in difficult-to-treat psoriatic arthritis
Authors' conclusion
The classification into PIPsA and NIPsA based on easily detectable clinical features can support a tailored therapeutic management of patients with D2T-PsA.
Study context
- Population
- PsA patients treated with b/tsDMARDs; Difficult-to-treat psoriatic arthritis (D2T-PsA) defined as inadequate response to ≥2 classes of b/tsDMARDs and persistent active disease (DAPSA >14)PsA patients on b/tsDMARDs
- Participants
- 517 patients
- Exposure
- Persistent inflammatory PsA vs non-inflammatory PsA among patients with D2T-PsA
- PIPsAn = 30
- Non-inflammatory PsA (NIPsA)n = 23reference
- Outcome
- Prevalence of D2T-PsA
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Met D2T-PsA criteria: 53 of 517
10.3%
D2T-PsA classified as PIPsA: 30
57%
D2T-PsA classified as NIPsA: 23
43%
Observational data: associations, not effects.
Further findings
Dactylitis
P = 0.030
Nail psoriasis
P = 0.027
| Outcome | PIPsA | NIPsA | P value |
|---|---|---|---|
| Swollen joint count | 2.5 (IQR 1.0–7.0) | 0.0 (IQR 0.0–1.0) | P < 0.001 |
| ΔPtGA-PhGA | 0.0 (IQR 0.0–1.5) | 4.0 (IQR 2.5–5.0) | P < 0.001 |
| Tender points | 0.0 (IQR 0.0–8.0) | 16.0 (IQR 0.0–18.0) | P = 0.009 |
| SPARCC enthesitis index | 2.0 (IQR 0.0–5.0) | 5.0 (IQR 2.0–8.0) | P = 0.023 |
| MSUS activity score | 3.81 ± 2.0 | 0.91 ± 0.5 | P < 0.001 |
| MSUS structural damage score | 4.12 ± 1.0 | 2.38 ± 2.1 | P < 0.001 |
Original publication
Using ultrasound to define inflammatory and non-inflammatory phenotypes in difficult-to-treat psoriatic arthritis. RMD Open. Published 14 August 2025. doi:10.
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