Psoriatic arthritis (PsA) is a rheumatic disease that can involve both the skin and musculoskeletal system. This thesis focusses on three important topics regarding the improvement of care for PsA patients. The improvement of: 1) timely detection of PsA in psoriasis patients, 2) disease activity assessment in PsA and 3) early treatment of PsA. Patients with PsA could be distinguished from psoriasis patients based on a combination of machine learning and immune profiles. In addition, implementation of a new method to measure disease activity, PASDAS measurement, revealed relevant residual disease burden in a large (and treated) PsA cohort and showed that women had higher disease activity than men. Lastly, this thesis demonstrates that methotrexate and leflunomide combination therapy is more effective than methotrexate monotherapy in patients with PsA. This combination therapy appears to be a valuable option in the treatment of patients with PsA.
Michelle Mulder (1991) obtained her Master’s degree in Medicine, cum laude, at the Radboud University in 2015. After graduating, she worked at the internal medicine and rheumatology department of the CWZ hospital and Sint Maartenskliniek, respectively. In 2018 she started with her PhD research focussing on psoriatic arthritis. Currently, she is working as a resident in rheumatology.