Introduction
Psoriasis is a common skin condition that affects approximately 3.2% of adults in the United States.1 Psoriasis is associated with a number of coexisting conditions, the most prevalent of which is psoriatic arthritis (PsA). Among people with psoriasis, the prevalence of PsA is estimated to be between 6% and 41%.2 PsA and other comorbidities are associated with a decreased life span.3
PsA has a heterogeneous presentation, with symptoms that span multiple clinical specialties.4 In addition to the nail and skin symptoms that are also present in psoriasis, PsA affects peripheral joints, axial joints, entheses, and other organs.5 As such, the diagnosis and management of PsA can be complex and time-consuming, benefitting from a multidisciplinary approach. Traditional single-specialty management paradigms can result in fragmented care, delaying the diagnosis and treatment of PsA and leading to worse clinical outcomes for patients.6 An estimated 15% of PsA cases are undiagnosed, and more than half of patients with PsA are undertreated.7,8
Because of the diverse and multi-organ presentation of PsA, rheumatologists and dermatologists often share management responsibilities.9 As such, established guidelines for the management of PsA include recommendations for communication and referral between rheumatologists and dermatologists.10,11 To prevent disjointed care and improve outcomes of patients, combined dermatology-rheumatology clinics have emerged to provide patients with concurrent care that holistically addresses their multiple disease manifestations.12 In this review, we will discuss the diagnosis and management of PsA. We will also review the importance and implementation of interdisciplinary care and describe the roles of the dermatologist and rheumatologist within the co-management paradigm.
ALIGN PsA: Advancing a Multidisciplinary Approach in PsA
This activity has been designed to meet the educational needs of physicians, physician assistants, medical assistants, and nurse practitioners involved in the care of patients with psoriatic disease.
Supported by educational grants from:
Celgene Corporation,
Janssen Biotech Inc., and Pfizer, Inc.
Activity Information
Original Release Date: December 1, 2018
Expiration Date: December 1, 2019
Estimated Time to Complete Activity: 1.0 hour
Faculty
 | Eric W. Baum, MD, MS |
 | Sergio Schwartzman, MD |
Claim Credit:
To claim your CME credit for this activity go to: http://www.focusmeded.com/eval-alignpsa/
Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the Annenberg Center for Health Sciences at Eisenhower and Focus Medical Communications. The Annenberg Center for Health Sciences at Eisenhower is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation
The Annenberg Center for Health Sciences at Eisenhower designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Educational Needs
Psoriasis is a common skin condition that affects approximately 3.2% of adults in the United States. Psoriasis is associated with a number of coexisting conditions, the most prevalent of which is psoriatic arthritis (PsA). Among people with psoriasis, the prevalence of PsA is estimated to be between 6% and 41%. According to expert KOL opinion, interdisciplinary cooperation between dermatologists and rheumatologists remains a significant practice gap in the management of psoriasis/psoriatic arthritis (PsA). Combined clinics offer a promising care model because they increase collaborative care for patients with complex diseases, enhance professional development, provide unique training opportunities for medical students, residents, and fellows in a setting where they can learn the importance of communication between patients and provider and allow the opportunity to study long-term outcomes and outcome measurements in patients with complex diseases.
Educational Objectives
- Analyze the roles of the dermatologist and rheumatologist in the treatment of psoriatic disease (PD), including both psoriasis (PsO) and psoriatic arthritis (PsA)
- Discuss how to integrate interdisciplinary collaboration into daily clinical practice
- Define PsA under the spondyloarthritis umbrella and discuss CASPAR criteria
- Describe the detrimental effects and comorbidities of untreated PD
- Discuss comorbidities associated with PD
- Define the patient-centric effects of PD, including aspects that affect quality of life, and recommend techniques to treat the “whole” patient
- Review data on new and emerging therapies for PD
- Demonstrate strategies to incorporate diagnostic and treatment updates into clinical practice and how to tailor treatment to individual cases
Disclosure of Conflicts of Interest
All faculty and staff involved in the planning or presentation of continuing education activities provided by the Annenberg Center for Health Sciences at Eisenhower (ACHS) are required to disclose to the audience any real or apparent commercial financial affiliations related to the content of the presentation or enduring material. Full disclosure of all commercial relationships must be made in writing to the audience prior to the activity. Charles Willis, Director of Continuing Education, consults for Pfizer, Inc., all other staff at the Annenberg Center for Health Sciences at Eisenhower have no relationships to disclose.
Learner Assurance Statement
The Annenberg Center for Health Sciences at Eisenhower is committed to resolving all conflicts of interest issues that could arise as a result of prospective faculty members’ significant relationships with drug or device manufacturer(s). The Annenberg Center for Health Sciences at Eisenhower is committed to retaining only those speakers with financial interests that can be reconciled with the goals and educational integrity of the CME activity.
Additional Planners/Reviewers Affiliation and Disclosure Statements
Anne Michaels: Planning Committee, has no relationships to disclose.
Emma Patten: Medical Writer, has no relationships to disclose.
Faculty Disclosures
Eric W. Baum, MD, MS: Dr. Baum has served on an advisory board for Janssen. He has also been on a speakers’ bureau for Aclaris, Celgene Corporation, Encore, Dermira, Pfizer, PruGen, Novartis, Sanofi-Regeneron, and UCB Inc.
Sergio Schwartzman, MD: Dr. Schwartzman has been a consultant for AbbVie Inc.; Crescendo Bioscience; Genentech, Inc.; Hospira; Janssen Biotech Inc.; Novartis; and Regeneron. He has served on a speakers’ bureau for AbbVie Inc.; Crescendo Bioscience; Janssen Biotech Inc.; Genentech, Inc.; Pfizer; and UCB Inc.