Enhanced surveillance for the detection of psoriatic arthritis in a UK primary care psoriasis population: results from the TUDOR trial
<p><strong>Background</strong> Our objective was to determine whether early detection of undiagnosed PsA in a primary care psoriasis population improves outcome in physical function at 24 months post-registration.</p> <p><strong>Methods</strong> A multicent...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Oxford University Press
2024
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| _version_ | 1826315319921082368 |
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| author | McHugh, N Tillett, W Helliwell, P Packham, J Collier, H Davies, C Ransom, M Coates, L Brown, ST |
| author_facet | McHugh, N Tillett, W Helliwell, P Packham, J Collier, H Davies, C Ransom, M Coates, L Brown, ST |
| author_sort | McHugh, N |
| collection | OXFORD |
| description | <p><strong>Background</strong>
Our objective was to determine whether early detection of undiagnosed PsA in a primary care psoriasis population improves outcome in physical function at 24 months post-registration.</p>
<p><strong>Methods</strong>
A multicentre, prospective, parallel group cluster randomized controlled trial in patients with psoriasis was conducted. Participants with suspected inflammatory arthritis on screening were referred for an assessment of PsA [enhanced surveillance (ES) arm: at baseline, and 12 and 24 months; standard care (SC) arm: at 24 months]. The primary outcome measure was the HAQ Disability Index (HAQ-DI) at 24 months post-registration in participants diagnosed with PsA.</p>
<p><strong>Results</strong>
A total of 2225 participants across 135 general practitioner practices registered: 1123 allocated to ES and 1102 to SC. The primary analysis population consisted of 87 participants with a positive diagnosis of PsA: 64 in ES, 23 in SC. The adjusted odds ratio (OR) for achieving a HAQ-DI score of 0 at 24 months post-registration in ES compared with SC was 0.64 [95% CI (0.17, 2.38)], and the adjusted OR of achieving a higher (non-zero) HAQ-DI score at 24 months post-registration in ES relative to SC arm was 1.12 (95% CI 0.67, 1.86), indicating no evidence of a difference between the two treatment groups (P = 0.66).</p>
<p><strong>Conclusion</strong>
The trial was underpowered for demonstrating the prespecified treatment effect; in patients with psoriasis there was no evidence that early diagnosis of PsA by ES in primary care changes physical function at 24 months compared with SC.</p>
<p><strong>Clinical trial registration</strong>
The TUDOR trial is registered as ISRCTN38877516.</p>
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| first_indexed | 2024-09-25T04:34:39Z |
| format | Journal article |
| id | oxford-uuid:2fe0dab1-231e-4a38-ac18-6804907c7c9c |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-12-09T03:23:36Z |
| publishDate | 2024 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:2fe0dab1-231e-4a38-ac18-6804907c7c9c2024-11-22T12:24:07ZEnhanced surveillance for the detection of psoriatic arthritis in a UK primary care psoriasis population: results from the TUDOR trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:2fe0dab1-231e-4a38-ac18-6804907c7c9cEnglishSymplectic ElementsOxford University Press2024McHugh, NTillett, WHelliwell, PPackham, JCollier, HDavies, CRansom, MCoates, LBrown, ST<p><strong>Background</strong> Our objective was to determine whether early detection of undiagnosed PsA in a primary care psoriasis population improves outcome in physical function at 24 months post-registration.</p> <p><strong>Methods</strong> A multicentre, prospective, parallel group cluster randomized controlled trial in patients with psoriasis was conducted. Participants with suspected inflammatory arthritis on screening were referred for an assessment of PsA [enhanced surveillance (ES) arm: at baseline, and 12 and 24 months; standard care (SC) arm: at 24 months]. The primary outcome measure was the HAQ Disability Index (HAQ-DI) at 24 months post-registration in participants diagnosed with PsA.</p> <p><strong>Results</strong> A total of 2225 participants across 135 general practitioner practices registered: 1123 allocated to ES and 1102 to SC. The primary analysis population consisted of 87 participants with a positive diagnosis of PsA: 64 in ES, 23 in SC. The adjusted odds ratio (OR) for achieving a HAQ-DI score of 0 at 24 months post-registration in ES compared with SC was 0.64 [95% CI (0.17, 2.38)], and the adjusted OR of achieving a higher (non-zero) HAQ-DI score at 24 months post-registration in ES relative to SC arm was 1.12 (95% CI 0.67, 1.86), indicating no evidence of a difference between the two treatment groups (P = 0.66).</p> <p><strong>Conclusion</strong> The trial was underpowered for demonstrating the prespecified treatment effect; in patients with psoriasis there was no evidence that early diagnosis of PsA by ES in primary care changes physical function at 24 months compared with SC.</p> <p><strong>Clinical trial registration</strong> The TUDOR trial is registered as ISRCTN38877516.</p> |
| spellingShingle | McHugh, N Tillett, W Helliwell, P Packham, J Collier, H Davies, C Ransom, M Coates, L Brown, ST Enhanced surveillance for the detection of psoriatic arthritis in a UK primary care psoriasis population: results from the TUDOR trial |
| title | Enhanced surveillance for the detection of psoriatic arthritis in a UK primary care psoriasis population: results from the TUDOR trial |
| title_full | Enhanced surveillance for the detection of psoriatic arthritis in a UK primary care psoriasis population: results from the TUDOR trial |
| title_fullStr | Enhanced surveillance for the detection of psoriatic arthritis in a UK primary care psoriasis population: results from the TUDOR trial |
| title_full_unstemmed | Enhanced surveillance for the detection of psoriatic arthritis in a UK primary care psoriasis population: results from the TUDOR trial |
| title_short | Enhanced surveillance for the detection of psoriatic arthritis in a UK primary care psoriasis population: results from the TUDOR trial |
| title_sort | enhanced surveillance for the detection of psoriatic arthritis in a uk primary care psoriasis population results from the tudor trial |
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