ASSESSMENT OF COMORBIDITY IN PSORIATIC DISEASE: HOW OFTEN SHOULD BE PERFORMED?

Background: Psoriatic disease (PsD) is associated with multiple comorbidities. When establishing management protocols, the periodicity for detection and evaluation of such comorbid conditions needs to be specified. Objectives: To establish guidelines for the follow-up of selected comorbidities in patients with PsD. Methods: An expert panel with specialists in Rheumatology, Internal Medicine, Dermatology and General Practitioners defined the comorbidities with higher impact on PsD based on the existing literature and their experience. The periodicity for detection and monitoring of comorbidities in the Rheumatology setting was established by consensus after iterations and systematic review. Results: The expert panel agreed to evaluate comorbidities as part of routine clinical practice at the time of diagnosis, upon changes in systemic treatment and at follow-up visits (evidence level 5, level of agreement 8.8). In any case, monitoring must be customized depending on the risk profile, morbidity, comorbidities and patient preferences. The following table shows the proposed periodicity for detection, assessment, and monitoring of the most important comorbidities in PsD. Table 1 At first visitAt all visitsAnnuallyEvery 2 yearsBefore any change in treatment Personal and family history Allergies List of treatments CV assessment and CV risk score. Screening of: Obesity and metabolic syndrome (waist circumference, BMI) Diabetes (blood glucose and HbA1c) HTN Dyslipidemia Smoking Cancer Alcoholism Depression Liver or kidney problemsInterrogation of new onset symptoms and corresponding examinations. Liver and kidney function.CV risk SCORE: Total cholesterol, LDL and triglycerides Glucemia Smoking Blood pressure BMI Waist circumference lymphadenopathy screening Evaluation of the psycho-emotional state Questioning for addictions (alcohol/smoking)Dermatology and Rheumatology recommendation: Dietary Exercise Check for lipid-lowering antihypertensive treatment if altered (by Dermatology, Rheumatology and GPT).CV risk Infection risk Latent Tuberculosis Vaccinations Working and living conditions CV: Cardiovascular; HbA1c: Glycated hemoglobin; BMI: Body Mass Index; HTN: arterial hypertension; GP: General Practitioner. Conclusions: This proposal for a periodic assessment of comorbidities in patients with PD allows systematic clinical monitoring of the patient by the Rheumatologist and Dermatologist, and can contribute to the early detection and management of these comorbidities Acknowledgement: The GECOAP project was funded by Merck Sharp & Dohme of Spain Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2016-eular.3484Citation: Annals of the Rheumatic Diseases, volume 75, supplement 2, year 2016, page 602Session: Psoriatic arthritis (Poster Presentations )