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28 February 2017

Guidance Published for Spondyloarthritis (Including Psoriatic Arthritis)

The National Institute for Health and Care Excellence (NICE) has published guidance on spondyloarthritis.

The National Institute for Health and Care Excellence (NICE) has today published its guidance on Spondyloarthritis in over 16s: diagnosis and management. The term ‘spondyloarthritis’ encompasses a number of types of inflammatory arthritis with some shared features, including psoriatic arthritis.

The ‘spondyloarthritides’ are different from rheumatoid arthritis but are just as important to recognise and manage early, to improve outlook. At the Psoriasis Association, we regularly hear from people whose diagnosis of psoriatic arthritis was delayed due to confusion over the symptoms, the fact that it behaves differently to more common forms of arthritis, or due to a single ‘negative’ test or sign. Of the numerous useful recommendations in this guidance, perhaps the most welcome for people who have been through the journey of difficult diagnosis is:

Do not rule out the possibility that a person has spondyloarthritis solely on the presence or absence of any individual sign, symptom or test result.

It is important to remember that, under the term ‘spondyloarthritis’, this guidance encompasses a number of different conditions. Not all of the recommendations are relevant to psoriatic arthritis, and some of those that are there refer to guidance that already exists (for example, identifying and referring spondyloarthritis in people with psoriasis refers to the established NICE guidance on the assessment and management of psoriasis. Similarly, detail on when it is appropriate to offer biologic treatment for psoriatic arthritis refers to the biologics’ own individual Technology Appraisal guidance). However, it is useful to have a step-by-step pathway for these conditions, particularly in the early stages when diagnoses may be confused, and tests inconclusive.

You can read the full guidance, as well as the key recommendations here.