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Psoriasis: HELP
Articles by Gavin Shaddick
Based on 13 articles published since 2010
(Why 13 articles?)
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Between 2010 and 2020, G. Shaddick wrote the following 13 articles about Psoriasis.
 
+ Citations + Abstracts
1 Article Trajectory of radiographic change over a decade: the effect of transition from conventional synthetic disease-modifying antirheumatic drugs to anti-tumour necrosis factor in patients with psoriatic arthritis. 2019

Allard, Andrew / Antony, Anna / Shaddick, Gavin / Jadon, Deepak R / Cavill, Charlotte / Robinson, Graham / Korendowych, Eleanor / McHugh, Neil / Tillett, William. ·Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK. · Mathematical Sciences, University of Exeter, Exeter, UK. · Rheumatology, Cambridge University Hospitals NHSFT, Cambridge, UK. · Radiology, Royal United Hospitals Bath, Bath, UK. · Pharmacy and Pharmacology, University of Bath, Bath, UK. ·Rheumatology (Oxford) · Pubmed #30247726.

ABSTRACT: Objectives: To describe the trajectory of radiographic progression among patients with PsA who transitioned from conventional synthetic DMARDs to anti-TNF-α inhibitors in routine care. Methods: A retrospective sample of patients with PsA (ClASsification criteria for Psoriatic ARthritis) was taken from the Bath longitudinal cohort. All patients had radiographs of the hands and feet taken: 5 years before (T0), at the time of (T1) and 5 years after (T2) commencing anti-TNF treatment. Radiographs were scored blinded using the PsA-modified Sharp-van der Heijde score (mSvdHS) and for osteoproliferation (Psoriatic Arthritis Ratingen Score) by A.Allard, A.Antony and W.T. This sample size was calculated to ensure 90% power to determine the smallest detectable difference of the mSvdHS to a 5% significance level. Cumulative probability plots were used to determine the probability of radiographic progression pre- (T0-T1) and post- (T1-T2) anti-TNF treatment. Results: Eighty-four radiographs from 28 patients were selected for inclusion. The median [interquartile range (IQR)] disease duration at baseline (T0) was 8.5 (0-19.5) years. The interval between T0-T1 and T1-T2 was 4.2 years (3.34-6.65) and 4.9 years (4.25-5.87), respectively. The median mSvdHS at baseline (T0) was 8.5 (IQR 1.75-27.5). The median (IQR) rate of change in mSvdHS per year reduced after commencing anti-TNF, from 2.1 (0.88-3.92) between T0-T1 to 1.0 (IQR 0.05-2.35) between T1-T2 (P = 0.012). Conclusion: The trajectory of damage accumulation over a 10-year period in this observational clinical cohort is low overall. The rate of radiographic damage as measured by the mSvdHS slows following commencement of anti-TNF.

2 Article Risk of type 2 diabetes and cardiovascular disease in an incident cohort of people with psoriatic arthritis: a population-based cohort study. 2019

Charlton, Rachel / Green, Amelia / Shaddick, Gavin / Snowball, Julia / Nightingale, Alison / Tillett, William / Smith, Catherine / McHugh, Neil / Anonymous2570961. ·Department of Pharmacy and Pharmacology, Bath, UK. · Department of Mathematical Sciences, University of Bath, Bath, UK. · Department of Mathematics, University of Exeter, Exeter, UK. · Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath, UK. · St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK. ·Rheumatology (Oxford) · Pubmed #30202906.

ABSTRACT: Objectives: To determine the risk of type 2 diabetes (T2D) and cardiovascular diseases in PsA patients compared with the general population and patients with psoriasis. Methods: Incident PsA patients aged 18-89 years were identified in the UK Clinical Practice Research Datalink between 1998 and 2014 and were matched (1:4 ratio) to a general population cohort and psoriasis cohort. The incidence of T2D, cerebrovascular disease, ischaemic heart disease and peripheral vascular disease (PVD) was calculated for each study cohort. Conditional Poisson regression was used to calculate adjusted relative risks. Results: We identified 6783 incident cases of PsA. The risk of T2D was significantly higher in the PsA cohort than in the general population and the psoriasis cohorts [adjusted relative risk 1.40 (CI95 1.15, 1.70) and adjusted relative risk 1.53 (CI95 1.19, 1.97), respectively]. The incidence of ischaemic heart disease, peripheral vascular disease and the three cardiovascular outcomes combined in the PsA cohort was significantly higher than in the general population. No significant differences in risk were observed between the PsA and psoriasis cohorts for any cardiovascular outcome. Conclusion: The development of T2D in an incident population of PsA is significantly higher than in psoriasis alone or in a general population, whereas the increased risk of cardiovascular disease in PsA and psoriasis is similar.

3 Article Value of the Routine Assessment of Patient Index Data 3 in Patients With Psoriatic Arthritis: Results From a Tight-Control Clinical Trial and an Observational Cohort. 2018

Coates, Laura C / Tillett, William / Shaddick, Gavin / Pincus, Theodore / Kavanaugh, Arthur / Helliwell, Philip S. ·Leeds Institute of Rheumatic and Musculoskeletal Medicine and Leeds Teaching Hospitals NHS Trust, Leeds, and University of Oxford, Oxford, UK. · Royal National Hospital for Rheumatic Diseases and University of Bath, Bath, UK. · University of Bath, Bath, UK. · Rush University School of Medicine, Chicago, Illinois. · University of California at San Diego School of Medicine, San Diego. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Teaching Hospitals NHS Trust, Leeds, UK. ·Arthritis Care Res (Hoboken) · Pubmed #29112801.

ABSTRACT: OBJECTIVE: To analyze the Routine Assessment of Patient Index Data 3 (RAPID3), a patient-reported, composite index, designed initially for feasibility in clinical care. RAPID3 was developed in rheumatoid arthritis, but has been found useful in many rheumatic diseases. We analyzed RAPID3 in patients with psoriatic arthritis (PsA). METHODS: Post hoc analyses were performed on 2 independent data sets, the Tight Control of Psoriatic Arthritis (TICOPA) clinical trial, and the Long-Term Outcome in Psoriatic Arthritis Study (LOPAS II), an observational cohort. RAPID3 (range 0-30) is the total of three 0-10 scores for the Health Assessment Questionnaire disability index (recalculated from 0-3), pain visual analog scale (VAS), and global VAS. RAPID3 scores were compared to the Psoriatic Arthritis Disease Activity Score (PASDAS), the Disease Activity in Psoriatic Arthritis (DAPSA), and other available clinical measures, according to Spearman's correlation coefficients, standardized response mean, SEM, smallest detectible difference, minimally important difference (in patients who improved), and receiver operating characteristic curves. RAPID3 remission was compared to criteria for both standard minimal disease activity (MDA) and very low disease activity (VLDA). RESULTS: RAPID3 was correlated significantly with PASDAS in TICOPA (r = 0.79, P < 0.01) and with DAPSA in LOPAS II (ρ = 0.59, P < 0.01), and with most other measures in both data sets. RAPID3 discriminated between tight control and standard care in TICOPA at 48 weeks at levels comparable to DAPSA and the PASDAS (P < 0.01). RAPID3 remission discriminated treatment groups in TICOPA intermediate between MDA and VLDA criteria. CONCLUSION: RAPID3 appears comparably informative to PASDAS and DAPSA in PsA, with greater feasibility for routine clinical care.

4 Article Risk of uveitis and inflammatory bowel disease in people with psoriatic arthritis: a population-based cohort study. 2018

Charlton, Rachel / Green, Amelia / Shaddick, Gavin / Snowball, Julia / Nightingale, Alison / Tillett, William / Smith, Catherine H / McHugh, Neil / Anonymous3500925. ·Department of Pharmacy and Pharmacology, University of Bath, Bath, UK. · Department of Mathematical Sciences, University of Bath, Bath, UK. · Department of Mathematics, University of Exeter, Exeter, Devon, UK. · Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK. · Guy's and St Thomas' Foundation Trust, St John's Institute of Dermatology, London, UK. ·Ann Rheum Dis · Pubmed #29092855.

ABSTRACT: OBJECTIVES: To determine the risk of uveitis and inflammatory bowel disease (IBD) in patients with psoriatic arthritis (PsA) compared with the general population and patients with psoriasis. METHODS: A cohort study using data from the UK Clinical Practice Research Datalink between 1998 and 2014. Patients with incident PsA aged 18-89 years were identified and matched to a cohort of patients with psoriasis and a general population cohort. The incidence of uveitis, all IBD, Crohn's disease and ulcerative colitis was calculated for each study cohort and adjusted relative risks (RR RESULTS: 6783 incident cases of PsA were identified with a median age of 49 years. The risk of uveitis was significantly higher in the PsA cohort than in the general population and psoriasis cohorts (RR CONCLUSIONS: In a primary care-based incidence cohort of patients with PsA, there were substantial risks of developing uveitis and/or Crohn's disease, but not ulcerative colitis, when compared with the general population and psoriasis controls.

5 Article Interval between onset of psoriasis and psoriatic arthritis comparing the UK Clinical Practice Research Datalink with a hospital-based cohort. 2017

Tillett, William / Charlton, Rachel / Nightingale, Alison / Snowball, Julia / Green, Amelia / Smith, Catherine / Shaddick, Gavin / McHugh, Neil. ·Department of Rheumatology, Royal National Hospital for Rheumatic Diseases. · Department of Pharmacy and Pharmacology. · Department of Mathematical Sciences, University of Bath, Bath. · St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London. · Department of Mathematics, University of Exeter, Exeter, UK. ·Rheumatology (Oxford) · Pubmed #28968790.

ABSTRACT: Objectives: To describe the time interval between the onset of psoriasis and PsA in the UK primary care setting and compare with a large, well-classified secondary care cohort. Methods: Patients with PsA and/or psoriasis were identified in the UK Clinical Practice Research Datalink (CPRD). The secondary care cohort comprised patients from the Bath PsA longitudinal observational cohort study. For incident PsA patients in the CPRD who also had a record of psoriasis, the time interval between PsA diagnosis and first psoriasis record was calculated. Comparisons were made with the time interval between diagnoses in the Bath cohort. Results: There were 5272 eligible PsA patients in the CPRD and 815 in the Bath cohort. In both cohorts, the majority of patients (82.3 and 61.3%, respectively) had psoriasis before their PsA diagnosis or within the same calendar year (10.5 and 23.8%), with only a minority receiving their PsA diagnosis first (7.1 and 14.8%). Excluding those who presented with arthritis before psoriasis, the median time between diagnoses was 8 years [interquartile range (IQR) 2-15] in the CPRD and 7 years (IQR 0-20) in the Bath cohort. In the CPRD, 60.1 and 75.1% received their PsA diagnosis within 10 and 15 years of their psoriasis diagnosis, respectively; this was comparable with 57.2 and 67.7% in the Bath cohort. Conclusion: A similar distribution for the time interval between psoriasis and arthritis was observed in the CPRD and secondary care cohort. These data can inform screening strategies and support the validity of data from each cohort.

6 Article Effect of anti-TNF and conventional synthetic disease-modifying anti-rheumatic drug treatment on work disability and clinical outcome in a multicentre observational cohort study of psoriatic arthritis. 2017

Tillett, William / Shaddick, Gavin / Jobling, Amelia / Askari, Ayman / Cooper, Annie / Creamer, Paul / Clunie, Gavin / Helliwell, Philip S / James, Jana / Kay, Lesley / Korendowych, Eleanor / Lane, Suzanne / Packham, Jonathon / Shaban, Ragai / Thomas, Matthew L / Williamson, Lyn / McHugh, Neil. ·Department of Rheumatology, Royal National Hospital for Rheumatic Diseases. · Department of Pharmacy and Pharmacology. · Department of Mathematics, University of Bath, Bath. · Department of Rheumatology, Robert Jones and Agnes Hunt Hospital, Shropshire. · Department of Rheumatology, Queen Alexandra Hospital, Portsmouth. · Department of Rheumatology, North Bristol NHS Foundation Trust, Bristol. · Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge. · Department of Rheumatology, NIHR Leeds Biomedical Research Unit, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds. · Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne. · Department of Rheumatology, Ipswich Hospital NHS Trust, Ipswich. · Department of Rheumatology, Haywood Rheumatology Centre, Stoke-on-Trentand. · Department of Rheumatology, Great Western Hospitals NHS Foundation Trust, Swindon, UK. ·Rheumatology (Oxford) · Pubmed #28013211.

ABSTRACT: Objectives: To determine the effect of medical treatment on work disability in patients with active PsA in a real-world setting. Methods: Four hundred patients with active PsA commencing or switching to anti-TNF or conventional synthetic DMARD (csDMARD) were recruited to a multicentre UK prospective observational cohort study. Work disability was measured using the work productivity and activity-specific health problem instrument and peripheral joint activity was measured with the disease activity in PsA composite measure. Results: Four hundred patients were recruited, of whom 229 (57.25%) were working (of any age). Sixty-two patients of working age (24%) were unemployed. At 6 months there was a 10% improvement in presenteeism ( P = 0.007) and a 15% improvement in work productivity ( P = 0.001) among working patients commenced on csDMARDs ( n = 164) vs a larger and more rapid 30% improvement in presenteeism ( P < 0.001) and 40% improvement in work productivity ( P < 0.001) among those commenced on anti-TNF therapy ( n = 65). Clinical response was poor among patients commenced on a csDMARD ( n = 272), with an 8.4 point improvement in disease activity in PsA ( P < 0.001) vs those commenced on anti-TNF therapy ( n = 121), who had a 36.8 point improvement ( P < 0.001). Conclusion: We report significant and clinically meaningful improvements in both work disability and clinical outcomes after commencement of anti-TNF therapy in a real-world setting. Improvements in all outcomes among those commencing csDMARDs were slower and of a smaller magnitude.

7 Article Axial Disease in Psoriatic Arthritis study: defining the clinical and radiographic phenotype of psoriatic spondyloarthritis. 2017

Jadon, Deepak R / Sengupta, Raj / Nightingale, Alison / Lindsay, Mark / Korendowych, Eleanor / Robinson, Graham / Jobling, Amelia / Shaddick, Gavin / Bi, Jing / Winchester, Robert / Giles, Jon T / McHugh, Neil J. ·Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK. · Department of Rheumatology, Addenbrooke's Hospital, Cambridge, UK. · Department of Pharmacy & Pharmacology, University of Bath, Bath, UK. · Department of Mathematical Sciences, University of Bath, Bath, UK. · Columbia College of Physicians & Surgeons, New York, New York, USA. ·Ann Rheum Dis · Pubmed #27913376.

ABSTRACT: OBJECTIVES: To compare the prevalence, clinical and radiographic characteristics of psoriatic spondyloarthritis (PsSpA) in psoriatic arthritis (PsA), with ankylosing spondylitis (AS). METHODS: A prospective single-centre cross-sectional observational study recruited consecutive PsA and AS cases. Participants completed outcome measures, and underwent clinical examination, axial radiographic scoring and RESULTS: The 402 enrolled cases (201 PsA, 201 AS; fulfilling classification criteria for respective conditions) were reclassified based upon radiographic axial disease and psoriasis, as: 118 PsSpA, 127 peripheral-only PsA (pPsA), and 157 AS without psoriasis (AS) cases. A significant proportion of patients with radiographic axial disease had PsSpA (118/275; 42.91%), and often had symptomatically silent axial disease (30/118; 25.42%). Modified New York criteria for AS were fulfilled by 48/201 (23.88%) PsA cases, and Classification of Psoriatic Arthritis criteria by 49/201 (24.38%) AS cases. pPsA compared with PsSpA cases had a lower frequency of CONCLUSIONS: In a combined cohort of patients with either PsA or AS from a single centre, 24% fulfilled classification criteria for both conditions. The pattern of axial disease was influenced significantly by the presence of skin psoriasis and

8 Article Novel Composite Radiographic Score for Longitudinal Observational Studies of Psoriatic Arthritis: A Proof-of-concept Study. 2016

Tillett, William / Shaddick, Gavin / Jadon, Deepak / Robinson, Graham / Korendowych, Eleanor / McHugh, Neil. ·From the Royal National Hospital for Rheumatic Diseases; Department of Mathematics, University of Bath; Department of Pharmacy and Pharmacology, University of Bath; Department of Radiology, Royal United Hospital, Bath, UK.W. Tillett, BSc, MBChB, PhD, MRCP, Royal National Hospital for Rheumatic Diseases; G. Shaddick, MSc, PhD, Department of Mathematics, University of Bath; D. Jadon, MBBCh, MRCP, Royal National Hospital for Rheumatic Diseases; G. Robinson, MBBS, FRCR, Department of Radiology, Royal United Hospital; E. Korendowych, PhD, MRCP, Royal National Hospital for Rheumatic Diseases; N. McHugh, MB, ChB, MD, FRCP, Department of Pharmacy and Pharmacology, University of Bath. ·J Rheumatol · Pubmed #26773116.

ABSTRACT: OBJECTIVE: To devise a feasible composite radiographic score for use in observational studies of psoriatic arthritis (PsA). METHODS: Radiographs from 50 patients with PsA were evaluated with the PsA-modified Sharp, Sharp/van der Heijde (SvdH), and Ratingen scores. Data reductions were made to devise a concise score. RESULTS: The Reductive X-ray Score for Psoriatic Arthritis (ReXSPA) required the assessment of only 22 joints (117 points), including erosion, joint space narrowing, and osteoproliferation in the hands and feet. The ReXSPA accounted for 80% of change detected with the SvdH score. CONCLUSION: We report a proof-of-concept radiographic score for observational studies derived though data reduction.

9 Article Psoriatic Arthritis Mutilans: Characteristics and Natural Radiographic History. 2015

Jadon, Deepak R / Shaddick, Gavin / Tillett, William / Korendowych, Eleanor / Robinson, Graham / Waldron, Nicola / Cavill, Charlotte / McHugh, Neil J. ·From the Rheumatology Department, Royal National Hospital for Rheumatic Diseases, Bath, UK.D.R. Jadon, MRCP, Research Fellow - Rheumatology, Rheumatology Department, Royal National Hospital for Rheumatic Diseases; G. Shaddick, PhD, Reader of Mathematics, Mathematics Department, University of Bath; W. Tillett, MRCP, Consultant Rheumatologist; E. Korendowych, FRCP, Consultant Rheumatologist; G. Robinson, FRCR, Consultant Radiologist; N. Waldron, MSc, Research Nurse; C. Cavill, MSc, Database Manager; N.J. McHugh, FRCP, Consultant Rheumatologist, Rheumatology Department, Royal National Hospital for Rheumatic Diseases. ·J Rheumatol · Pubmed #25979723.

ABSTRACT: OBJECTIVE: (1) To compare clinical characteristics of patients with psoriatic arthritis (PsA) with PsA mutilans (PAM) and without PAM, and (2) to determine the rate of PAM radiographic progression. METHODS: A retrospective cohort study was conducted of all patients with PsA attending a teaching hospital. The most recent hand and feet radiographs were screened for PAM. Serial radiographs (earliest to most recent) were quantitatively scored for osteolysis, erosion, joint space narrowing, and osteoproliferation. RESULTS: Out of the 610 cases, 36 PsA cases had PAM (5.9%). PAM cases were younger at diagnosis of PsA than non-PAM cases (p = 0.04), had more prevalent psoriatic nail dystrophy (OR 5.43, p < 0.001), and worse health assessment questionnaire score (1.25 vs 0.63, p < 0.04). Radiographic axial disease (OR 2.31, adjusted p = 0.03) and especially radiographic sacroiliitis (OR 2.99, adjusted p = 0.01) were more prevalent in PAM. PAM were more likely than non-PAM cases to have used a disease-modifying antirheumatic drug (DMARD; OR 16.36, p < 0.001). Out of 33 cases, 29 PAM cases had initiated a synthetic DMARD and 4/13 had initiated anti-tumor necrosis factor (anti-TNF) prior to first demonstration of PAM. A median 5 radiographs were scored for each PAM case (interquartile range 3-7). PAM progressed from monoarticular (60%) to polyarticular (80%) involvement. Osteolysis was initially rapid and progressive in the hands and feet, tapering later during disease course. Nail dystrophy predicted more severe osteolysis (p = 0.03). CONCLUSION: Compared with non-PAM cases, PAM cases have earlier age at PsA diagnosis, poorer function, more prevalent nail dystrophy, and more radiographic axial disease/sacroiliitis. The rate of osteolysis is higher in earlier disease, and more severe in those with nail dystrophy. DMARD and anti-TNF therapy appear not to prevent PAM occurrence.

10 Article Factors influencing work disability in psoriatic arthritis: first results from a large UK multicentre study. 2015

Tillett, William / Shaddick, Gavin / Askari, Ayman / Cooper, Annie / Creamer, Paul / Clunie, Gavin / Helliwell, Philip S / Kay, Lesley / Korendowych, Eleanor / Lane, Suzanne / Packham, Jonathan / Shaban, Ragai / Williamson, Lyn / McHugh, Neil. ·Royal National Hospital for Rheumatic Diseases, Department of Mathematics, University of Bath, Bath, Department of Rheumatology, Robert Jones and Agnes Hunt Hospital, Shropshire, Department of Rheumatology, Royal Hampshire County Hospital, Winchester, Department of Rheumatology, North Bristol NHS Foundation Trust, Bristol, Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, NIHR Leeds Biomedical Research Unit, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Department of Rheumatology, Ipswich Hospital NHS Trust, Ipswich, Haywood Rheumatology Centre, Stoke-on-Trent, Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, Department of Rheumatology, Great Western Hospitals NHS Foundation Trust, Swindon and University of Bath, Department of Pharmacy and Pharmacology, Bath, UK. w.tillett@nhs.net. · Royal National Hospital for Rheumatic Diseases, Department of Mathematics, University of Bath, Bath, Department of Rheumatology, Robert Jones and Agnes Hunt Hospital, Shropshire, Department of Rheumatology, Royal Hampshire County Hospital, Winchester, Department of Rheumatology, North Bristol NHS Foundation Trust, Bristol, Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, NIHR Leeds Biomedical Research Unit, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Department of Rheumatology, Ipswich Hospital NHS Trust, Ipswich, Haywood Rheumatology Centre, Stoke-on-Trent, Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, Department of Rheumatology, Great Western Hospitals NHS Foundation Trust, Swindon and University of Bath, Department of Pharmacy and Pharmacology, Bath, UK. · Royal National Hospital for Rheumatic Diseases, Department of Mathematics, University of Bath, Bath, Department of Rheumatology, Robert Jones and Agnes Hunt Hospital, Shropshire, Department of Rheumatology, Royal Hampshire County Hospital, Winchester, Department of Rheumatology, North Bristol NHS Foundation Trust, Bristol, Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, NIHR Leeds Biomedical Research Unit, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Department of Rheumatology, Ipswich Hospital NHS Trust, Ipswich, Haywood Rheumatology Centre, Stoke-on-Trent, Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, Department of Rheumatology, Great Western Hospitals NHS Foundation Trust, Swindon and University of Bath, Department of Pharmacy and Pharmacology, Bath, UK. Royal National Hospital for Rheumatic Diseases, Department of Mathematics, University of Bath, Bath, Department of Rheumatology, Robert Jones and Agnes Hunt Hospital, Shropshire, Department of Rheumatology, Royal Hampshire County Hospital, Winchester, Department of Rheumatology, North Bristol NHS Foundation Trust, Bristol, Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, NIHR Leeds Biomedical Research Unit, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Department of Rheumatology, Ipswich Hospital NHS Trust, Ipswich, Haywood Rheumatology Centre, Stoke-on-Trent, Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, Department of Rheumatology, Great Western Hospitals NHS Foundation Trust, Swindon and University of Bath, Department of Pharmacy and Pharmacology, Bath, UK. ·Rheumatology (Oxford) · Pubmed #25125591.

ABSTRACT: OBJECTIVE: The aim of this study was to determine the extent to which structural damage, clinical disease activity, demographic and social factors are associated with work disability (WD) in PsA. METHODS: Four hundred patients fulfilling CASPAR (Classification Criteria for Psoriatic Arthritis) criteria for PsA were recruited from 23 hospitals across the UK. Demographic, socio-economic, work, clinical and radiographic data were collected. WD was assessed with the Work Productivity and Activity Impairment Specific Health Problem (WPAI-SHP) questionnaire reporting WD as a percentage of absenteeism (work time missed), presenteeism (impairment at work/reduced effectiveness) and work productivity loss (overall work impairment/absenteeism plus presenteeism). Logistic and linear regressions were conducted to investigate associations with WD. RESULTS: Two hundred and thirty-six participants of any age were in work. Absenteeism, presenteeism and productivity loss rates were 14% (s.d. 29.0), 39% (s.d. 27.2) and 46% (s.d. 30.4), respectively. Ninety-two (26%) participants of working age were unemployed. Greater age, disease duration of 2-5 years and worse physical function were associated with unemployment. Patients reported that employer awareness and helpfulness exerted a strongly positive influence on remaining in employment. Higher levels of global and joint-specific disease activity and worse physical function were associated with greater levels of presenteeism and productivity loss among those who remained in work. CONCLUSION: Reduced effectiveness at work was associated with measures of disease activity, whereas unemployment, considered the endpoint of WD, was associated with employer factors, age and disease duration. A longitudinal study is under way to determine whether treatment to reduce disease activity ameliorates WD in the real-world setting.

11 Article Feasibility, reliability, and sensitivity to change of four radiographic scoring methods in patients with psoriatic arthritis. 2014

Tillett, W / Jadon, D / Shaddick, G / Robinson, G / Sengupta, R / Korendowych, E / de Vries, C S / McHugh, N J. ·Royal National Hospital for Rheumatic Diseases, Bath, UK. ·Arthritis Care Res (Hoboken) · Pubmed #23925955.

ABSTRACT: OBJECTIVE: We set out to assess the feasibility, reliability, and sensitivity to change of 4 radiographic scoring methods in psoriatic arthritis (PsA). METHODS: Hand and feet radiographs from 50 patients with PsA were scored at 2 time points by 2 assessors with each of the following methods: modified Steinbrocker score, modified Sharp score (MSS), modified Sharp/van der Heijde score (SHS), and the Ratingen score for PsA. The radiographs of 10 patients were scored by both assessors to assess reliability using intraclass correlation coefficients (ICCs). Sensitivity to change was estimated using a standardized response mean (SRM) and smallest detectable change (SDC). RESULTS: The patients' mean ± SD age at baseline was 50 ± 12.1 years, the mean ± SD disease duration was 10 ± 8.4 years, and the mean ± SD followup period was 25 ± 9.6 months. Intrarater reliability was excellent for all methods (ICC >0.97). Interrater reliability was highest for the SHS (ICC 0.95-0.99). The percentage SDC for the Steinbrocker method, the Ratingen method, the MSS, and the SHS was 2.9%, 2.1%, 1.4%, and 1.2%, respectively, and the SRMs were 0.46, 0.44, 0.77, and 0.79, respectively. The mean time to score each of the Steinbrocker method, the Ratingen method, the MSS, and the SHS was 6.2, 10.5, 14.6, and 14.4 minutes, respectively. CONCLUSION: The SHS method was the most reliable and sensitive to change but took longer to perform. The Steinbrocker method is the most feasible but lacks the sensitivity of the SHS. The SDC of the Ratingen method is close to that of the SHS and MSS, but is quicker to perform.

12 Article Smoking and delay to diagnosis are associated with poorer functional outcome in psoriatic arthritis. 2013

Tillett, William / Jadon, Deepak / Shaddick, Gavin / Cavill, Charlotte / Korendowych, Eleanor / de Vries, Corinne S / McHugh, Neil. ·Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK. w.tillett@nhs.net ·Ann Rheum Dis · Pubmed #23291384.

ABSTRACT: OBJECTIVE: To identify predictors of poorer physical function in established psoriatic arthritis (PsA). METHODS: PsA patients with disease duration of ≥10 years were identified from the Bath longitudinal cohort. Physical function was assessed using the Stanford Health Assessment Questionnaire (HAQ). Sex, age at diagnosis, duration of symptoms prior to diagnosis, smoking, treatment and year of diagnosis were included in a multivariable regression analysis to identify associations with HAQ. RESULTS: 267 patients were identified for inclusion. The median age was 56 years (IQR 45-63), median disease duration was 13 years (IQR 10-18) and median HAQ score was 0.63 (IQR 0.13-1.25). The model predicted significant increases in HAQ related to smoking (0.23, 95% CI 0.04 to 0.42), age >50 years at diagnosis (0.27, 95% CI 0.03 to 0.51), symptom duration of ≥1 year before diagnosis (0.22, 95% CI 0.02 to 0.42), female sex (0.39, 95% CI 0.20 to 0.57) and history of treatment with an anti-TNF agent (0.63, 95% CI 0.32 to 0.93) at follow-up. CONCLUSIONS: Smoking, delay to diagnosis, older age at diagnosis, female sex and a history of anti-TNF treatment are associated with worse physical function in established PsA.

13 Minor Joint count reliability in psoriatic arthritis observational trials--an unreported problem. 2012

Tillett, William / Shaddick, Gavin / Korendowych, Eleanor / de Vries, Corinne S / McHugh, Neil. · ·Rheumatology (Oxford) · Pubmed #22562935.

ABSTRACT: -- No abstract --