Comparative analysis of disease outcomes: Early vs. late transition from psoriasis to psoriatic arthritis
Bibliographic record
Abstract
• The median transition time from psoriasis to PsA in our cohort was 9 years. • After the advent of biologics, in the year 2000, the transition interval increased significantly. • Clinical phenotype at baseline was not significantly different between early and late transition groups. • With early transition, there was a trend for higher cumulative disease activity but not in radiographic progression. Psoriasis typically precedes psoriatic arthritis (PsA). We explored whether the interval between the two diagnoses is associated with PsA phenotype and outcomes. We constructed an inception (PsA duration ≤2 years) cohort of patients who developed PsA after psoriasis from a prospective observational cohort. All patients were diagnosed with PsA prior to or at their presentation to the clinic (baseline). We divided the cohort into early and late transition groups based on the median transition period between the diagnoses of psoriasis and PsA of nine years. Features associated with early and late transition at baseline were studied using logistic regression. The impact of early versus late transition on disease activity was assessed using multivariate linear regression, with the 5-year adjusted mean swollen joint count (SJC) as the outcome. The influence on damage was evaluated using Cox regression, with time to radiographic progression as the outcome. We included 702 patients. Late transition patients were observed to have a younger age at diagnosis of psoriasis and older age at diagnosis of PsA. At baseline, they had higher BMI and PASI and less frequent use of conventional synthetic DMARDs. There was a trend for lower disease activity over time in the late transition group. Radiographic progression was not significantly different. There were no significant differences in the PsA features at baseline between the two groups. However, on follow-up, there was a trend for lower cumulative disease activity but not in the rate of radiographic progression in the late transition group.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".