collaboration is key to unlock new innovation — and challenge the status quo — in psoriatic arthritis
how new canadian partnerships are improving the diagnostic journey for inflammatory arthritis
5 minute read
historically, diagnosing psoriatic arthritis sometimes required the assistance of a rheumatologist with access to a specialized ultrasound. getty
this story is sponsored by
novartis canada
this story was created by content works, postmedia’s commercial content division, on behalf of a client.
you’ve heard the myths before — arthritis is an old persons’ disease and cracking your knuckles can lead to arthritis . these are common misconceptions that surround the condition, but the truth is that arthritis is a complex disease with over 100 different types.
while osteoarthritis and rheumatoid arthritis are the best-known forms of the disease, the number of people affected by other forms of arthritis might surprise you. in fact, a lot of arthritis is caused by inflammatory diseases that are immune-mediated and often affect people when they are young. living with lesser-known forms of arthritis can present a set of challenges beyond the symptoms of the disease alone.
understanding what psoriatic arthritis is
psoriatic arthritis (psa) is associated with psoriasis, a skin condition that affects one million canadians. a chronic condition characterized by red or purple patches and flaking scales, data suggests up to 30 per cent of people with psoriasis develop psa.
people living with psa often experience joint stiffness, painful swelling, and tenderness in areas like the heel and sole of the foot, where tendons attach to bone — also known as enthesitis.
among the most frustrating aspects is the difficulty in getting a diagnosis — which is necessary for beginning treatment. “when we see lots of inflammation around joints, there might be inflammatory proteins present that can accelerate damage to cartilage and destruction of bone,” says dr. jonathan chan, a vancouver-based adult rheumatologist and clinical investigator with arthritis research canada. “that’s why we want to act quickly.”
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with a clinical focus on psa, he’s seen first-hand the struggles faced by patients with the condition. dr. chan explains that in patients with ra, a blood test can typically reveal elevated levels of anti–cyclic citrullinated peptide (anti-ccp) — an antibody which can help doctors make a diagnosis. but no such diagnostic tool is available for those with psa.
“one of the challenges with psa is there’s no blood test for it. it’s largely a clinical diagnosis,” he continues.
pre-existing psoriasis can be a “yellow flag” for physicians which, when combined with joint pain, can help suggest psa. however, as the medical community has come to better understand psa, it’s also become aware of new hurdles to making the diagnosis.
“in the last 10 years or so, we’ve learned that patients with psa don’t just get the classic swollen joints,” dr. chan elaborates. “they can get swelling of the tendon sheath (tenosynovitis) or where the tendon inserts into the bone (enthesitis). that inflammation generally isn’t visible, and healthy people commonly get similar symptoms with conditions like tennis elbow or achilles tendonitis.”
depression and the struggles of getting a diagnosis
people with psoriasis are 1.5 times as likely to have depression as the general population. combined with the chronic pain of arthritis, it’s not hard to imagine the burden patients may face — especially when they don’t have a clear diagnosis.
data suggests up to 30 per cent of people with psoriasis develop psa. getty
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for those with a chronic condition, the uncertainty of searching for a diagnosis can be discouraging. and while it’s empowering for patients to finally receive a correct diagnosis and look forward to developing a treatment plan with their doctor, waiting to see a specialist can lead to further damage to the joints.
“research suggests that a delay over six months in seeing a rheumatologist and initiating therapy to treat psa may result in irreversible damage to the affected joints,” says dr. chan. “this damage may lead to chronic pain and disability.”
changing the diagnosis paradigm for psa
historically, diagnosing psa sometimes required the assistance of a rheumatologist with access to a specialized ultrasound. “there are only a few rheumatologists in all of british columbia with access to these machines,” says dr. chan, whose patients have experienced a delay of up to nine months for a referral appointment. “these rheumatologists were working 13-hour days and it was getting unmanageable.”
in fact, data from 2021 shows that referrals to rheumatologists have the longest wait time among all specialties in canada — around 62 days. to make matters worse, these patients often require ongoing specialist care.
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this is the problem novartis canada aims to solve by providing support to enable more proactive diagnosis and management of the condition. in partnership with portable ultrasound leader, clarius mobile health, novartis canada has facilitated access to a working group of rheumatologists and enabled physicians, like dr. chan, to identify key diagnostic markers sooner, right in the clinic, using ultrasound.
the clarius hd3 l15 ultrasound scanner wirelessly connects to clinicians’ apple and android smart devices. supplied
“today alone i’ve scanned three people,” says dr. chan, “and that changed our decision-making when it comes to treatment. i’ve been able to make very informed decisions on the spot. i think it’s been very helpful.”
collaboration drives progress for patients
on the other side of the partnership is clarius mobile health — pioneers in ultrasound miniaturization.
“clarius’ mission is to make medical imaging accessible everywhere by delivering affordable and easy to-use solutions with the power of ai,” says ohad arazi, ceo & president of clarius.
in addition to its handheld design, an important part of what makes the clarius hd3 l15 different is the use of ai, which is applied to both imaging technology and the clinician workflow. “clarius helps provide clinicians with the tools to provide diagnosis and monitoring patient progress over time,” explains arazi.
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authorized by health canada in 2022, the clarius hd3 l15 ultrasound scanner wirelessly connects to clinicians’ apple and android smart devices. the clarius app then provides a real-time image, generated using ai technology. this product may not be right for you. consult your health-care professional.
mark vineis, country president of novartis canada says that the partnership was driven by “a mutual desire to improve patient outcomes.”
“there is a real opportunity to modernize the approach to psa by improving the access to diagnostic imagery in a clinical setting,” says vineis. “when we do so, patients can get access to a crucial diagnosis sooner rather than later.”
“most importantly, it also supports patient conversations with their rheumatologist by unmasking a largely invisible disease.”
with new technology now in the hands of doctors, they have another way to support patients with psoriatic arthritis. “when we work together,” says vineis, “we have potential to positively impact patients across the country.”
talk to your health-care provider if you have psoriasis, you’re experiencing any other symptoms of psa or you need support in managing your physical and mental health when living with psa.
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this story was created by content works, postmedia’s commercial content division, on behalf of novartis canada.
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