A recent, large, real-world study compared early diagnostic and treatment outcomes for patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA) using data from the UK’s National Early Inflammatory Arthritis Audit. Patients with PsA experienced longer delays in diagnosis—both before presenting to their general practitioner (GP) and after referral to secondary care—compared with matched patients with RA. Despite similar levels of disease activity at diagnosis, patients with PsA were significantly less likely to receive early or combination disease-modifying antirheumatic drug (DMARD) therapy and had smaller improvements in disease activity over 3 months. This delay and undertreatment led to worse short-term outcomes, even though most patients were enrolled in treat-to-target care pathways.

The study found that nearly 60% of PsA cases had polyarticular involvement, with fewer patients receiving corticosteroids and combination DMARD therapy compared to RA. Patient-reported outcome measures showed smaller improvements in musculoskeletal health and work productivity among patients with PsA. The findings underscore the critical need to improve awareness and early detection of PsA among patients and providers. Despite limitations—including underrepresentation of non-polyarticular PsA and the use of RA-centric outcome measures—the data suggest patients with PsA are systematically underdiagnosed and undertreated, reinforcing the need for more aggressive early management to improve long-term outcomes.

Reference: Charlton RA, Gates E, Coates LC, et al. Diagnostic delay and less intensive therapy for people with psoriatic arthritis compared with rheumatoid arthritis: a study nested within an English and Welsh audit data set. Ann Rheum Dis. 2025 Jun;84(6):970-978. doi: 10.1016/j.ard.2025.02.020. Epub 2025 Mar 29. PMID: 40158947.