This study analyzed data from more than 700 newly diagnosed, DMARD-naïve patients with psoriatic arthritis (PsA) to evaluate the impact of diagnostic delay on clinical and patient-reported outcomes. Nearly half of patients had a delay of more than one year. Those with delays over 12 months were significantly less likely to achieve Minimal Disease Activity (MDA) or DAPSA remission over a three-year period. Patients diagnosed earlier (<12 weeks) reported better pain control, general health, and functional outcomes. Importantly, the physician delay (median 4.5 months) was substantially longer than patient delay (median 1.0 month), especially in patients with enthesitis or back pain—presentations less easily recognized by primary care providers.

These findings support the existence of a “window of opportunity” in PsA, where earlier diagnosis and treatment initiation—ideally within one year—can improve long-term outcomes. Although this window may be broader than that in rheumatoid arthritis, the impact of delay remains clinically significant. The study suggests physician awareness and referral practices are critical modifiable factors. While residual confounding cannot be fully excluded, the large, prospective design and consistent alignment between clinical and PRO measures strengthen the results. Ultimately, early recognition and personalized management—accounting for phenotypic variability and comorbidities—are key to optimizing PsA care.

Reference: Snoeck Henkemans SVJ, de Jong PHP, Luime JJ, et al. Window of opportunity in psoriatic arthritis: the earlier the better? RMD Open. 2024 Feb 27;10(1):e004062. doi: 10.1136/rmdopen-2023-004062. PMID: 38413172; PMCID: PMC10900390.