Chapter 65 - Psoriatic Arthritis and Reactive Arthritis Flashcards

1
Q

TABLE 65-1
The Classification Criteria for PsA (CASPAR)

ENTRY CRITERIA?

A

ENTRY CRITERIA: INFLAMMATORY ARTICULAR DISEASE OF THE JOINTS, SPINE, OR ENTHESES

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2
Q

TABLE 65-1
The Classification Criteria for PsA (CASPAR)

Point/s

Classification Criteria
1. Psoriasis (mutually exclusive categories for scoring)
- Current
- Personal history
- Family history (first- or second-degree relative)

A
  • 2 points
  • 1 point
  • 1 point
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3
Q

TABLE 65-1
The Classification Criteria for PsA (CASPAR)

Point/s

Classification Criteria
2. Nail dystrophy typical of psoriasis (onycholysis, pitting, hyperkeratosis), must be current

A

1 point

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4
Q

TABLE 65-1
The Classification Criteria for PsA (CASPAR)

Point/s

Classification Criteria
3. Negative rheumatoid factor (any method except latex)

A

1 point

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5
Q

TABLE 65-1
The Classification Criteria for PsA (CASPAR)

Point/s

Classification Criteria
4. Dactylitis (current, or historical if recorded by a rheumatologist)

A

1 point

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6
Q

TABLE 65-1
The Classification Criteria for PsA (CASPAR)

Point/s

Classification Criteria
5. Juxtaarticular new bone formation (ill-defined ossification near joint margins excluding osteophytes) on plain hand/feet radiographs

A

1 point

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7
Q

TABLE 65-1
The Classification Criteria for PsA (CASPAR)

A classification of PsA is met if the final score is equal to or more than ___ points.

A

A classification of PsA is met if the final score is equal to or more than 3 points.

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8
Q

TABLE 65 2
Psoriatic Arthritis Phenotypes

Percent

Oligoarthritis

A

> 70%

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9
Q

TABLE 65 2
Psoriatic Arthritis Phenotypes

Percent

Polyarthritis/symmetric

A

15%

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10
Q

TABLE 65 2
Psoriatic Arthritis Phenotypes

Percent

Distal interphalangeal joint predominant

A

5%

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11
Q

TABLE 65 2
Psoriatic Arthritis Phenotypes

Percent

Spondyloarthritis

A

5%

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12
Q

TABLE 65 2
Psoriatic Arthritis Phenotypes

Percent

Arthritis mutilans

A

5%

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13
Q

TABLE 65-4
Medications

DRUG (2)

PSORIATIC DISEASE SPECIFIC INDICATIONS
- SKIN
- ARTHRITIS

A
  1. Methotrexate
  2. Leflunomide
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14
Q

TABLE 65-4
Medications

DRUG (2)

PSORIATIC DISEASE SPECIFIC INDICATIONS
- ARTHRITIS

A
  1. Sulfasalazine
  2. Abatacept
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15
Q

TABLE 65-4
Medications

DRUG (1)

PSORIATIC DISEASE SPECIFIC INDICATIONS
- SKIN
- NAIL
- ARTHRITIS
- AXIAL SPONDYLOARTHRITIS

A

Etanercept

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16
Q

TABLE 65-4
Medications

DRUG (2)

PSORIATIC DISEASE SPECIFIC INDICATIONS
- SKIN
- NAIL
- ARTHRITIS
- DACTYLITIS
- ENTHESITIS
- AXIAL SPONDYLOARTHRITIS
- Uveitis
- IBD

A
  1. Infliximab
  2. Adalimumab
17
Q

TABLE 65-4
Medications

DRUG (1)

PSORIATIC DISEASE SPECIFIC INDICATIONS
- SKIN
- NAIL
- ARTHRITIS
- DACTYLITIS
- ENTHESITIS
- AXIAL SPONDYLOARTHRITIS
- IBD [Crohn disease]

A

Certolizumab

18
Q

TABLE 65-4
Medications

DRUG (1)

PSORIATIC DISEASE SPECIFIC INDICATIONS
- SKIN
- NAIL
- ARTHRITIS
- DACTYLITIS
- ENTHESITIS
- AXIAL SPONDYLOARTHRITIS
- IBD [Ulcerative colitis]

19
Q

TABLE 65-4
Medications

DRUG (2)

PSORIATIC DISEASE SPECIFIC INDICATIONS
- SKIN
- NAIL
- ARTHRITIS
- DACTYLITIS
- ENTHESITIS

A
  1. Apremilast
  2. Ixekizumab
20
Q

TABLE 65-4
Medications

DRUG (1)

PSORIATIC DISEASE SPECIFIC INDICATIONS
- SKIN
- NAIL
- ARTHRITIS
- DACTYLITIS
- ENTHESITIS
- IBD [Crohn disease]

A

Ustekinumab

21
Q

TABLE 65-4
Medications

DRUG (1)

PSORIATIC DISEASE SPECIFIC INDICATIONS
- SKIN
- NAIL
- ARTHRITIS
- DACTYLITIS
- ENTHESITIS
- AXIAL SPONDYLOARTHRITIS

A

Secukinumab

22
Q

TABLE 65-4
Medications

DRUG (1)

PSORIATIC DISEASE SPECIFIC INDICATIONS
- SKIN
- NAIL
- ARTHRITIS
- DACTYLITIS
- ENTHESITIS
- IBD [Ulcerative colitis]

A

Tofacitinib

23
Q

TABLE 65-4
Medications

DRUG

SIDE EFFECTS AND SPECIAL CONSIDERATIONS
Risk of mucosal ulcerations, hepatotoxicity, teratogenic.
Liver function tests, blood counts and renal function need to be monitored
Folic acid 1 mg daily mandatory for the duration of therapy

A

Methotrexate

24
Q

TABLE 65-4
Medications

DRUG

SIDE EFFECTS AND SPECIAL CONSIDERATIONS
Monitor liver function, blood counts
Reversible azoorspermia
Folic acid supplementation indicated

A

Sulfasalazine

25
Q

TABLE 65-4
Medications

DRUG

SIDE EFFECTS AND SPECIAL CONSIDERATIONS
Risk of hepatotoxicity, teratogenic.
Monitor liver function, blood counts.
Long half-life, stores in adipose tissue.

A

Leflunomide

26
Q

TABLE 65-4
Medications

DRUG (5)

SIDE EFFECTS AND SPECIAL CONSIDERATIONS
Drug induced SLE, Demyelinating disease, CHF, cancer

A
  1. Etanercept
  2. Infliximab
  3. Adalimumab
  4. Certolizumab
  5. Golimumab
27
Q

TABLE 65-4
Medications

DRUG

SIDE EFFECTS AND SPECIAL CONSIDERATIONS
Weight loss (10%)
Depression (1%)

A

Apremilast

28
Q

TABLE 65-4
Medications

DRUG

SIDE EFFECTS AND SPECIAL CONSIDERATIONS
Increased risk of eosinophilic pneumonia, cancer

A

Ustekinumab

29
Q

TABLE 65-4
Medications

DRUG

SIDE EFFECTS AND SPECIAL CONSIDERATIONS
Increased risk of candidiasis, exacerbation of IBD

A

Secukinumab

30
Q

TABLE 65-4
Medications

DRUG

SIDE EFFECTS AND SPECIAL CONSIDERATIONS
Increased risk of candidiasis, exacerbation of IBD, neutropenia

A

Ixekizumab

31
Q

TABLE 65-4
Medications

DRUG

SIDE EFFECTS AND SPECIAL CONSIDERATIONS
Increased risk of elevated LDL and HDL (10-19%), pulmonary embolism, herpes zoster, neutropenia, lymphopenia, GI perforation, cancer

A

Tofacitinib

32
Q

TABLE 65-4
Medications

DRUG

SIDE EFFECTS AND SPECIAL CONSIDERATIONS
Chronic obstructive pulmonary disease exacerbation, cancer