Serum bone-turnover biomarkers in Psoriatic Arthritis v1

  • Research type

    Research Study

  • Full title

    Specificity and Sensitivity of Serum Bone-Turnover Biomarkers in Psoriatic Arthritis (SPECTRUM-PsA) study

  • IRAS ID

    276581

  • Contact name

    Deepak R Jadon

  • Contact email

    deepak.jadon@addenbrookes.nhs.uk

  • Sponsor organisation

    Cambridge University Hospitals NHS Foundation Trust & the University of Cambridge

  • Duration of Study in the UK

    1 years, 2 months, 29 days

  • Research summary

    Psoriasis is a chronic, inflammatory skin condition affecting up to 2% of the population. Up to 20% of patients with psoriasis develop a type of inflammatory arthritis (psoriatic arthritis). Various blood tests are available to aid with the diagnosis of other forms of inflammatory arthritis (such as rheumatoid arthritis) however, to date, the lack of specific antibodies in patients with psoriatic arthritis contributes to the often delayed diagnosis; other contributory factors include the complexity of clinical features, late reporting of symptoms to clinicians, and the absence of elevated inflammatory markers in up to 50% of patients at first presentation. Various screening questionnaires have been developed to identify possible psoriatic arthritis occurrence in patients with psoriasis, with a view to trigger early referral to specialist rheumatology clinics for further assessment and diagnosis, for example the Psoriasis Epidemiology Screening Tool (PEST). It has been demonstrated, however, that a large proportion of patients referred to rheumatology departments for further assessment based on the results of these questionnaires are diagnosed with non-inflammatory joint pathology, in particular osteoarthritis. There is currently much interest in both clinical and research communities regarding the presence of biomarkers in psoriasis to aid the diagnosis of psoriatic arthritis, predict and monitor treatment response. In terms of diagnostic biomarkers, a large cross-sectional study has shown that serum concentrations of bone-turnover markers (MMP-3 and M-CSF) differ in subjects with psoriasis, psoriatic arthritis and healthy controls. Furthermore various genetic differences have shown an association with psoriatic arthritis, independently of psoriasis. In this study we aim to determine whether the addition of biomarker analysis improves the sensitivity and specificity of the PEST questionnaire. We also aim to review whether genetic analysis and inflammatory marker assessment (C-reactive protein (CRP) and high-sensitivity CRP (hsCRP)) are beneficial for diagnostic purposes.

  • REC name

    HSC REC A

  • REC reference

    21/NI/0187

  • Date of REC Opinion

    6 Dec 2021

  • REC opinion

    Further Information Favourable Opinion