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This is intended to be completed by patients who have already been diagnosed with psoriatic arthritis by a medical professional.

Six Domains: What's Your Combination?

Psoriatic arthritis affects each person differently.1  There are six different manifestations through which the disease can present itself10 – sometimes called ‘domains’ by healthcare professionals.  Each person will have their own unique combination of domains, with varying levels of involvement. This questionnaire is intended to help you better understand which of the six manifestations you experience and the impact they have on your day-to-day activities.

Once you have completed the questionnaire, you will be provided with a summary of your results to help inform discussions with your rheumatologist.

 

This is not a diagnostic tool or a guide for selecting treatment options. For advice on treating your psoriatic arthritis, please speak with your doctor.

The questionnaire will take around 5 minutes to finish.

About Yourself

Gender:
Were you aware that psoriatic arthritis can affect other parts of your body beyond the joints?
Which of the six different domains of psoriatic arthritis were you not aware of (tick all that apply)?

Identifying the unique combination of your disease

This section will ask some questions related to each of the six domains of psoriatic arthritis, to help you identify the combination you are experiencing or have previously experienced.

1. Peripheral arthritis

Peripheral arthritis causes pain, swelling, tenderness or morning stiffness in the joints that are not in the spine or buttock region.11

Based on the description above, do you believe you experience peripheral arthritis?
If no/don't know, scroll down to next question.
If yes, please select any areas in which you experience pain, stiffness, tenderness or swelling.

Right

Human image

Left

How much of an impact does the discomfort you experience in these areas have on your day-to-day activities?
1 2 3 4 5 6 7 8 9 10
Low impact
(does not stop me carrying out my day-to-day activities)
High impact
(prevents me carrying out my day-to-day activities)

2. Enthesitis

Enthesitis can present as swelling, pain and stiffness at the point where tendons connect to a bone.12 A way to differentiate enthesitis from general arthritis is that pain is often felt either next to a joint or spread out over a wider area.

Based on the description above, do you believe you experience enthesitis?
If no/don't know, scroll down to next question.
If yes, please select any areas in which you experience pain and stiffness, possibly accompanied by swelling.
How much of an impact does this have on your day-to-day activities?
1 2 3 4 5 6 7 8 9 10
Low impact
(does not stop me carrying out my day-to-day activities)
High impact
(prevents me carrying out my day-to-day activities)

3. Dactylitis

Dactylitis is the swelling of an entire finger or toe. It can also be called ‘sausage fingers/toes’.13,14,15

Based on the description above, do you believe you experience sausage fingers?
If no/don't know, scroll down to next question.
Based on the description above, do you believe you experience sausage toes?
If no/don't know, scroll down to next question.
How much of an impact does this have on your day-to-day activities?
1 2 3 4 5 6 7 8 9 10
Low impact
(does not stop me carrying out my day-to-day activities)
High impact
(prevents me carrying out my day-to-day activities)

4. Axial disease

Axial disease may cause pain, stiffness and reduced movement in the spine and buttock area.11 People with axial disease often report feeling morning stiffness or pain in the back and pelvis.15

Based on the description above, do you believe you experience axial disease?
If no/don't know, scroll down to next question.
If yes, please select any areas in which you experience pain in the morning.
How much of an impact does this have on your day-to-day activities?
1 2 3 4 5 6 7 8 9 10
Low impact
(does not stop me carrying out my day-to-day activities)
High impact
(prevents me carrying out my day-to-day activities)

Please note, back pain is common and is not always related to psoriatic arthritis. It will be important to work with your doctor to understand the source of any pain you might be experiencing.

5. Psoriasis

Psoriasis can present as dry red patches of skin, known as plaques or lesions19, which can be covered in silver scales16,20. These will most often appear on the elbow, knee, scalp, genital and lower back regions, but can appear anywhere on your body. The plaques/lesions can be itchy, sore or both. In some cases, the skin around your joints may crack and bleed.16,20

Based on the description above, do you believe you experience psoriasis?
If no/don't know, scroll down to next question.
If yes, please select any areas which you believe are affected:
How much of an impact does this have on your day-to-day activities?
1 2 3 4 5 6 7 8 9 10
Low impact
(does not stop me carrying out my day-to-day activities)
High impact
(prevents me carrying out my day-to-day activities)

6. Nail disease

Nail disease can affect both fingernails and toenails. The most common changes are tiny dents or pits, discolouration, or abnormal growth on the nail.17 Nails can become loose and separate from your nail bed.17

Based on the above, do you believe you experience nail disease in your fingernails?
If no/don't know, scroll down to next question.
Based on the above, do you believe you experience nail disease in your toenails?
If no/don't know, scroll down to next question.
How much of an impact does this have on your day-to-day activities?
1 2 3 4 5 6 7 8 9 10
Low impact
(does not stop me carrying out my day-to-day activities)
High impact
(prevents me carrying out my day-to-day activities)

Co-morbidities and associated conditions

People with psoriatic arthritis are at greater risk of developing other health conditions, known as ‘co-morbidities’ and ‘associated conditions’. This can also contribute to your experience of living with psoriatic arthritis.

I have been informed by a medical professional I have the following co-morbidities of psoriatic arthritis:
I have been informed by a medical professional I have the following conditions associated with psoriatic arthritis:
Have you completed this questionnaire before?

We hope that you have found this questionnaire helpful in understanding the combination of psoriatic arthritis domains that impact your day-to-day activities. Once you click submit, you will be able to download a personalised summary, which has been prepared for you based on your answers. You may wish to share this summary with your rheumatologist.

This will include questions and suggested discussion points, which we hope you find useful in your consultations with them.

This has been developed by Celgene as a part of the Six Domains educational campaign. It is not intended for a US or UK audience. To report an adverse event concerning a Celgene product, please contact:

Celgene Drug Safety Europe.
Phone: 0041 32 729 84 76
Fax: 0041 32 729 84 09
Email: drugsafetyeurope@celgene.com

References

1. Kavanaugh A, et al. Rheumatol Ther 2016;3:91–102.
2. Aletaha D, et al. The many faces of psoriatic arthritis – a challenge to treatment to target? Reumatologia. 2016; 54(1): 1–2.
3. Mayo Clinic, Psoriatic Arthritis, Available at: https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076. Accessed August 2018
4. Al Hammadi, et al., Psoriatic Arthritis – Overview, MedScape. Available at: https://emedicine.medscape.com/article/2196539-overview#a1. Accessed August 2018
5. Arthritis Research UK, What causes psoriatic arthritis?, Available at: https://www.arthritisresearchuk.org/arthritis-information/conditions/psoriatic-arthritis/causes.aspx, Accessed Septemebr 2018
6. Al Hammadi, et al., Psoriatic Arthritis – Pathophysiology and Etiology, MedScape. Available at: https://emedicine.medscape.com/article/2196539-overview#a4. Accessed August 2018
7. International Federation of Psoriasis Associations, World Psoriasis Day 2013, available at: https://ifpa-pso.com/wp-content/uploads/2017/01/WPD-2013-General-Summary.pdf. Accessed August 2018.
8. PAPAA, About Psoriatic Arthritis, Available at: http://www.papaa.org/resources/about-psoriatic-arthritis

9. NHS Choices, Psoriatic Arthritis, Available at: https://www.nhs.uk/conditions/psoriatic-arthritis/. Accessed July 2018
10. Coates LC, et al. Arthritis Rheumatol 2016;68:1060–71
11. Husted JA, et al. Arthritis Care Res (Hoboken) 2011;63:1729–35.
12. Edson-Heredia E, et al. J Eur Acad Dermatol Venereol 2015;29:955–63.
13. Ogdie A, et al. J Rheumatol 2014;41:2315–22
14. Ogdie A, et al. J Invest Dermatol 2017 [Epub].
15. Mayo Clinic, Caregiver stress: Tips for taking care of yourself, Available at: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/caregiver-stress/art-20044784. Accessed August 2018.
16. Lebwohl MD, et al. J Am Acad Derm 2014;70:871–81.

17. Arthritis UK (2013). Caring for a person with arthritis. Published April 2013 2005/CARER/13-1
18. Carers UK (2018). Looking after someone (2018). Available at: https://www.carersuk.org/images/publications/Carers_UK_LAS2018_Digital_40pp_WEB_reduced_1.pdf. Accessed August 2018.
19. Armstrong, A., Quality of Life and Work Productivity Impairment among Psoriasis Patients: Findings from the National Psoriasis Foundation Survey Data 2003–2011, PLOS ONE, 7(12)
20. Thompson A et al (2013). Building confidence in social situations: A guide for people living with a skin condition, including scars. http://skinsupport.org.uk/sites/default/files/Social%20Confidence%20Self-help%20Leaflet_0.pdf. Accessed August 2018.
21. PAPPA. Psychological Aspects Of Psoriasis. (2012). Available at: http://www.papaa.org/sites/default/files/Psychological%20aspects%20of%20psoriasis%20final%20June%202012.pdf. Accessed August 2018.

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