Table 1 PsA risk framework

Disease-related risks (including functional concerns)

 • Assessment of symptoms (pain, stiffness, swelling, rash)

  ○ Physical examination

  ○ Joint examination

  ○ PASI

 • Functional assessment

  ○ Imaging (X-rays, MRI)

 • Quality of life (social interaction, sexual health, body image)

  ○ SF-36 subscales

  ○ EuroQoL-5 dimension

  ○ PsAQoL

  ○ Pain Disability Index

  ○ PsAID

  ○ Work ability

 • Documentation of extra-articular manifestations and/or comorbidities

 • Poor balance/risk of falls

  ○ Fractures

Treatment-related risks

 • Contraindications

  ○ NSAIDs in patients with IBD, CV disease

 • Adverse events

  ○ Liver damage with methotrexate (obese patients particularly at risk)

 • Poor compliance/persistence

  ○ Reduced efficacy of biologics

 • Routine laboratory monitoring with biologics

 • Immunogenicity with biologics

Psychosocial risks

 • Mental health (particularly depression, but also anxiety)

  ○ SF-36 subscales

  ○ PsAID

  ○ DASS-21

 • Alcohol abuse

 • Self-esteem issues (especially in younger patients)

 • Social participation

  ○ PsAID