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The iPROLEPSIS project is where psoriatic arthritis inflammation is explained through multi-source data analysis guiding a novel personalized digital care ecosystem. iPROLEPSIS is een oplossing voor artritis psoriatica Het iPROLEPSIS-project richt zich op het uitleggen van artritis psoriatica door gebruik te maken van data-analyse uit verschillende bronnen. Het project zal leiden tot een nieuw, gepersonaliseerd digitaal zorg-ecosysteem. OVER HET CONSORTIUM NEEM CONTACT MET ONS OP januari 2026 Vandaag ma di wo do vr za zo 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 Aankomende evenementen Artritis psoriatica (PsA) is een chronische progressieve ontstekings ziekte die 1-2% van de algemene bevolking treft, en zich ontwikkelt bij tot wel 30% van de mensen met psoriasis (PsO). Projectvisie en impact Het iPROLEPSIS-project, gefinancierd door Horizon Europe, heeft als doel een nieuw gepersonaliseerd digitaal zorgecosysteem te ontwikkelen voor mensen met artritis psoriatica (PsA). Het doel van iPROLEPSIS is om een nieuw ecosysteem te ontwikkelen waarin mechanismen voor het verzamelen van Real World Data (RWD) en een krachtig beslissingsondersteunend systeem geïntegreerd zijn. Dit ecosysteem zal nieuwe inzichten verschaffen in de belangrijkste factoren die de overgang van gezondheid naar PsA beïnvloeden door middel van een multiscale en multifactoriële aanpak. Door gebruik te maken van op xAI gebaseerde modellen streeft iPROLEPSIS naar een efficiënt, effectief en klinisch gevalideerd gepersonaliseerd digitaal zorgsysteem voor patiënten met PsA. ONTDEK MEER Projectdoelstellingen en werkpakketten Het iPROLEPSIS-consortium werkt aan zeven ambitieuze kerndoelstellingen op het gebied van artritis psoriatica (PsA) en omvat zes werkpakketten die de diverse en elkaar aanvullende expertises van de consortiumpartners zullen bundelen. ONTDEK MEER Over het project 15 Partners 9 Landen 48 m Projectduur € 6,4M Totale budget De kernactiviteit domeinen De basis • De onderzoeksactiviteiten van het project zijn gebaseerd op een uitgebreide verkenning van de beschikbare literatuur en data, evenals op het ontwerp van klinische dataverzamelings- en validatiestudies; • Een participatief ontwerp zal worden toegepast om de ontwikkeling van een gebruikersgericht ecosysteem van oplossingen te ondersteunen. Dit zal bijdragen aan het opzetten van een betrouwbaar kader voor AI-gebaseerd onderzoek en ontwikkeling. Validatie • Het ontwerpen en implementeren van klinische studies die onderzoeksgegevens verzamelen, digitale biomarkers voor ontstekingssymptomen valideren bij personen met een risico op PsA en patiënten met psoriasis (PSO), en de effectiviteit van digitale zorginstrumenten evalueren met betrekking tot de preventie van ontstekingsuitbarstingen. Onderzoek en ontwikkeling • Het onderzoek richt zich op multimodale gegevens om de belangrijkste oorzaken van PsA-ontsteking te identificeren, digitale biomarkers voor PsA-ontstekingssymptomen te ontwikkelen, en het effect van PsA op de gewrichten en de microvasculatuur van de huid te onderzoeken, evenals de rol van mestcellen bij de overgang naar PsA; • De uitkomsten samenbrengen in een multischaal/multifactorieel model van de transitie van gezondheid naar PsA; • Het leveren van een geïntegreerd iPROLEPSIS digitaal gezondheidszorgecosysteem, bestaande uit tools voor gepersonaliseerde preventieve PsA-zorg, om patiënten en zorgverleners te versterken. Learning Hub Explore resources to help you understand and manage psoriatic arthritis. Handbook Handbook 2 Psoriatic Arthritis Key Facts Key Facts Psoriatic Arthritis Handbook Handbook Quizzes about Psoriatic Arthritis Take a Quiz Project news Handbook Handbook 2 iPROLEPSIS Showcased at MEDICA 2025 Read More iPROLEPSIS at IEEE-EMBS BSN 2025 Read More Seasons Greetings from iPROLEPSIS Read More ONTDEK MEER Neem contact op Wij staan open voor uw opmerkingen of vragen over het iPROLEPSIS-project! NEEM CONTACT MET ONS OP

Learning how to live with psoriatic arthritis might feel like a challenge. But understanding your diagnosis can help you take control of your health. Learning hub Explore resources to help you understand and manage psoriatic arthritis. Learning hub Key Facts Handbook News Feed Quizzes Search Psoriatic Arthritis Key Facts Key Facts Quizzes about Psoriatic Arthritis Take a Quiz Search about Psoriatic Arthritis Search Psoriatic Arthritis Handbook Handbook News Feed about Psoriatic Arthritis News Feed

iProlepsis psoriatic arthritis project is a comprehensive multiscale model employing novel trustworthy AI-based analysis of multisource and heterogenous data. iPROLEPSIS- projectdoelstellingen en werkpakketten Het project streeft ernaar inzicht te verschaffen in de transitie van gezondheid naar PsA door middel van een uitgebreid multiscale en multifactorieel PsA-model . Deze zal worden bereikt door gebruik te maken van nieuwe, betrouwbare analyses op basis van kunstmatige intelligentie van diverse en heterogene gegevens uit meerdere bronnen, waaronder diepgaande gezondheids-, milieu-, genetische en gedragsgegevens. Project doelstellingen Het iPROLEPSIS-consortium werkt aan 7 ambitieuze kerndoelstellingen op het gebied van artritis psoriatica (PsA). PsA-ontstekingsdrivers Het ontdekken van PsA-ontstekings[X] door gebruik AI-gestuurde datamining in de domeinen gezondheid, milieu en omics. De rol van mestcellen Onderzoek naar de rol van mestcellen en kenmerken van niet-invasieve microvasculaire/gewrichtsbeeldvorming van de huid voor het detecteren van ontstekingssymptomen bij PsA. Gepersonaliseerde interventies Het ontwikkelen van op ICT-gebaseerde gepersonaliseerde interventies om de kwaliteit van leven bij PsA-patiënten te behouden of te verbeteren. Co-creatie ecosysteem Het co-creëren van het iPROLEPSIS-ecosysteem met belangrijke belanghebbenden, volgens ethische, inclusieve en betrouwbare AI-principes. Digitale biomarkers Het ontwikkelen en valideren van objectieve digitale biomarkers voor het monitoren van ontstekingssymptomen en ziekteactiviteit bij PsA. Betrouwbare AI-modellen Het bouwen van betrouwbare AI-modellen voor een gepersonaliseerde voorspelling van PsA-risico, vroege diagnose en prognose van ziekteactiviteit. Digitaal gezondheidsecosysteem Het ontwikkel en klinisch valideren van het iPROLEPSIS digitale gezondheidsecosysteem om mensen met PsA of risico daarop en gezondheidszorgprofessionals te ondersteunen en meer eigen regie te geven. Werkpakketten De 6 werkpakketten van het project zullen diverse en aanvullende expertise van consortiumpartners samenbrengen. WP1 WP2 WP3 WP4 WP5 WP6 Werkpakket 1: Beheer en coördinatie WP1 richt zich op projectmanagement en coördinatie om een efficiënt project verloop te waarborgen ; Het optimaliseren van contractuele, administratieve, financiële, wetenschappelijke, technische, IE- en innovatiemanagementprocessen; Het waarborgen van projectkwaliteit, ethiek, regelgeving en goed gegevensbeheer. Werkpakket 2: Kenniswinning, fundering en participatief ontwerp WP2 richt zich op het creëren van fundamentele kennis over PsA, gerelateerde aandoeningen en ontstekingen; Het identificeren, verkrijgen en beheren van datasets die relevant zijn voor R&D-activiteiten van het project; Het identificeren van gebruikersbehoeften en effectief communiceren met belangrijke belanghebbenden om onderzoeksvragen te sturen en digitale zorginstrumenten van iPROLEPSIS co-creëren; Het tot stand brengen en monitoren van praktijken die ervoor zorgen dat de AI-gestuurde componenten van iPROLEPSIS voldoen aan betrouwbare AI-principes. Werkpakket 3: Onderzoek naar PsA-ontstekingsfactoren en monitoring WP3 is gericht op het identificeren van factoren die verband houden met PsA en de bijbehorende ontstekingen, door gebruik te maken van zowel nieuwe als bestaande gezondheidsrelevante gegevens uit diverse bronnen ; Ontwikkeling van smartphone/wearable-gebaseerde digitale biomarkers (dBM’s) voor de beoordeling van PsA-ontstekingssymptomen; Onderzoek naar veranderingen in de gewrichten en de microvasculatuur van de huid in relatie tot PsA, inclusief de rol van mestcellen bij ontstekingen; Ontwikkeling van een multischaal/multifactorieel PsA-model door middel van datafusie, met een focus op het voorspellen van de transitie van hoogrisicopatiënten en patiënten met Psoriasis (PsO) naar PsA, en van PsA-patiënten naar een gevorderde ontstekingsfase. Werkpakket 4: Ontwikkeling van het iPROLEPSIS digitale gezondheidsecosysteem voor gepersonaliseerde preventieve zorg WP4 zal het iPROLEPSIS-ecosysteem technisch specificeren en een robuuste infrastructuur voor gegevensbeheer en DevOps/MLOps-platforms opzetten ; Daarnaast zal WP4 via een flexibele aanpak de iPROLEPSIS minimaal levensvatbare producten (MVP's) ontwikkelen voor gepersonaliseerde PsA-zorg, waaronder: 1) Een patiënten app met PsA-monitoring gebaseerd op digitale biomarkers (dBM), kennisoverdracht, gerichte interventies en op maat gemaakte AI-gestuurde levensstijlaanbevelingen, 2) Een serious gamingplatform voor gezondheid en welzijn, 3) Een applicatie voor zorgverleners waarmee zij patiënten op afstand kunnen monitoren en voorspellingen over hun ziekteverloop kunnen raadplegen. Werkpakket 5: Klinische studies WP5 zal de onderzoeksprotocollen ontwikkelen en het proces uitvoeren voor tijdige goedkeuring door de relevante instanties ; Er wordt een systeem opgezet voor de coördinatie van werving en het efficiënte beheer van klinische gegevens en rapportage; Het organiseren en uitvoeren van vier klinische onderzoeken: Dit omvat twee multicenter prospectieve cohortstudies voor de ontdekking en validatie van PsA-ontstekingsfactoren en digitale biomarkers, een observationeel onderzoek naar PsA en veranderingen in de gewrichten en microvasculatuur van de huid, en een multicenter proof-of-concept gerandomiseerde gecontroleerde studie (RCT) om de effectiviteit van de digitale zorginstrumenten van iPROLEPSIS te evalueren. Werkpakket 6: Verspreiding, communicatie en exploitatie WP6 richt zich op het maximaliseren van de zichtbaarheid van het project en de resultaten, en het vergemakkelijken van kennisuitwisseling door betrokkenheid van een breed netwerk van belanghebbenden ; Er zal educatieve inhoud worden ontwikkeld met betrekking tot PsA; Een routekaart zal worden opgesteld voor goedkeuring door de regelgevende instanties van de digitale hulpmiddelen van iPROLEPSIS; Er zal een grondige sociaal-economische/marktanalyse worden uitgevoerd en concrete exploitatieplannen zullen worden ontwikkeld, zowel gezamenlijk als individueel. PROJECTVISIE

Over onze consortium partners Konstantinidis Dimitrios CERTH Position Postdoctoral researcher What is your role in iPROLEPSIS? Researcher and technical developer What are your main activities in the project? I am mainly involved in the research activities of CERTH, concerning psoriatic nail detection and classification, range-of-motion assessment through the execution of active video tests and nutrition and physical activity recommendations. What is your motivation? I am deeply passionate about artificial intelligence and deep learning, with a strong interest in uncovering hidden patterns within data that can lead to highly accurate and reliable predictions. I find great satisfaction in developing advanced machine learning techniques to transform data into innovative solutions that contribute to real-world progress. Nikos Melanitis Ainigma Position Data Scientist What is your role in iPROLEPSIS? Data Scientist, Digital health and predictive modelling What are your main activities in the project? To design and implement novel approaches for improved management of PsA, through personalized models that warn patients for high risk of PsA exacerbation (flare). What is your motivation? To be part of the digital innovation in Health, enabling better disease management and personalised, precision medicine. Kosmas Dimitropoulos CERTH Position Principal Researcher (Researcher of Grade B’) What is your role in iPROLEPSIS? Principal Investigator for CERTH What are your main activities in the project? I am mainly involved in the research activities of CERTH, concerning psoriatic nail detection and classification, range-of-motion assessment through the execution of active video tests and nutrition and physical activity recommendations. What is your motivation? I am deeply motivated by the intersection of Artificial Intelligence and healthcare. I aspire to contribute to research that applies deep learning techniques to personalized medicine, enabling more accurate, data-driven, and patient-specific approaches to diagnosis and treatment. Eleni Vasileiou Signal Processing & Biomedical Technology Unit (SPBTU) – Aristotle University of Thessaloniki (AUTH) Position Research assistant working on digital health technologies and AI-enabled healthcare tools What is your role in iPROLEPSIS? AI Researcher & Data Scientist | Digital health and predictive modelling What are your main activities in the project? My main activities focus on developing digital, passively captured indicators that support risk prediction and monitoring models for psoriatic arthritis. I work on digital phenotyping of inflammatory symptoms with an emphasis on tracking motor manifestations using smart devices and wearables. This involves designing methods to analyze data from daily living activities – such as sleep, walking, and hand movements – to capture subtle physiological and behavioral changes associated with disease onset and progression. These efforts aim to identify key drivers of psoriatic arthritis and support personalized models for disease risk, progression prediction, and inflammation monitoring. What is your motivation? I am deeply motivated by the potential of digital health technologies to bring a more human and data-informed approach to healthcare. By combining AI with continuous, real-world data, we can reveal patterns often hidden in traditional clinical assessments. What drives me is the belief that these insights can empower both patients and clinicians to make earlier and more informed decisions, ultimately improving health outcomes and quality of life. My goal is to contribute to a future where technology enhances understanding, prevention, and personalized care for chronic conditions. Coordination Clinical Experts Data Science Software Development Ethics, Legal and Exploitation Dissemination and Communication

The consortium of iProlepsis project for psoriatic arthritis consists of 15 partners from 9 countries. Discover more about project by visiting our website. Over onze consortium partners iPROLEPSIS-projectcoördinator Aristoteles Universiteit van Thessaloniki Het consortium bestaat uit 15 partners uit 9 landen. De partners van het iPROLEPSIS-consortium

Learning hub Explore resources to help you understand and manage psoriatic arthritis. Learning hub Key Facts Handbook News Feed Quizzes Search Quizzes What is psoriatic arthritis? Take a Quiz What are the symptoms of psoriatic arthritis? Take a Quiz How is psoriatic arthritis treated? Drug treatments Take a Quiz How is psoriatic arthritis treated? Self-care and lifestyle Take a Quiz How will psoriatic arthritis affect me? Sleep and Fatigue Take a Quiz How will psoriatic arthritis affect me? Relationships and Family Planning Take a Quiz What causes psoriatic arthritis? Take a Quiz How is psoriatic arthritis diagnosed? Take a Quiz How is psoriatic arthritis treated? Non-pharmacological treatments Take a Quiz How will psoriatic arthritis affect me? Work Take a Quiz How will psoriatic arthritis affect me? Emotional wellbeing Take a Quiz

Learning how to live with psoriatic arthritis might feel like a challenge. But understanding your diagnosis can help you take control of your health. Learning hub Explore resources to help you understand and manage psoriatic arthritis. Handbook Learning hub Key Facts Handbook News Feed Quizzes Search Handbook 1 Psoriatic Arthritis Handbook Understanding Psoriatic Arthritis h1.1 What is psoriatic arthritis? Psoriatic arthritis is a type of arthritis linked with psoriasis, a chronic skin and nail disease. Psoriasis causes red, scaly rashes and thick, pitted fingernails. Psoriatic arthritis is characterized by joint swelling (inflammation), pain and stiffness and can affect any peripheral joint such as fingers, toes, knees and/or spine. It also affects the insertion of tendons or ligaments in bones (enthesitis). Between 20-40% of people with the skin condition psoriasis will develop psoriatic arthritis (1, 2). Symptoms affecting their joints tend to develop 5 to 10 years after psoriasis is diagnosed but it can occur at any time (3). Currently, it is not clear why some people with psoriasis develop psoriatic arthritis while others do not. The arthritis of psoriatic arthritis comes in 3 forms: oligoarticular arthritis that affects 4 or less peripheral joints (e.g., joints in the fingers, toes, knees); polyarticular arthritis that involves 5 or more peripheral joints on both sides of the body; and axial arthritis that affects the joints of the spine including the sacroiliac joint (where the spine connects to the pelvis). Some people may develop psoriasis after or at the same time as symptoms of psoriatic arthritis present themselves (4). In rare cases, people may have psoriatic arthritis and never have any noticeable symptoms of psoriasis. Psoriatic arthritis and psoriasis are chronic inflammatory conditions that are caused by a fault in the immune system. Our immune system protects us from infection and illness. See related Key Facts section What causes psoriatic arthritis? While psoriatic arthritis can occur at any age, most people present their first signs and symptoms at 30-50 years. Psoriatic arthritis is most likely to be diagnosed within the first ten years of the psoriasis diagnosis (3). Psoriatic arthritis affects both sexes equally. However, the manifestations in terms of severity and impact of the disease differ between sexes. Men are more likely to have involvement of the bones in the spine (axial arthritis) and radiographic damage in the spine and peripheral joints (e.g., fingers, knees and toes), whereas women are more likely to experience impaired quality of life and severe limitations in function (5). Researchers are not sure why some people develop psoriatic arthritis. It is thought that certain genes inherited from parents and grandparents can make a person more likely to develop psoriatic arthritis (6–8). h1.2 In people with a higher genetic predisposition to develop psoriatic arthritis, the condition can be triggered by environmental factors, such as: an infection (9); an accident or injury (10, 11); being overweight (12); smoking (13, 14). Psoriasis and psoriatic arthritis are not contagious. You cannot catch psoriasis or psoriatic arthritis from other people. See related Key Facts section What are the symptoms of psoriatic arthritis? Psoriatic arthritis symptoms usually develop slowly, that is, many people are unaware that they are developing psoriatic arthritis (Figure 1). Although symptoms can develop suddenly in rarer cases. Some of the main symptoms include (15): pain in one or more joints; swelling in one or more joints; stiffness in one or more joints that lasts for 30 minutes or longer. These symptoms are caused by inflammation and can affect any joint in the body. See Figure 2 for the most commonly affected joints. See related Key Facts section h1.3 Psoriatic arthritis can cause pain and swelling in the entheses, that is, places in the body where tendons and ligaments connect to the bones (15). When the entheses become inflamed it is known as enthesitis. Enthesitis pain can spread along a wider area than joint pain. It frequently occurs at the back of the heel or on the bottom of the foot, which can make standing or walking difficult. Affected areas feel tender to touch even when just a small amount of pressure is applied. The knees, hips, elbows and chest can also be affected by enthesitis. Many people with psoriatic arthritis have swollen fingers or toes, a condition that is known as dactylitis (15) (Figure 1). It most commonly affects one or two fingers or toes at a time. Psoriatic arthritis can also cause small round dents in fingernails and/or toenails, a condition known as pitting. The nails can change colour, become thicker, or even lift away from your finger (15). People living with psoriatic arthritis may feel very tired (fatigued) and some may have a low-grade fever. Fatigue does not get better with rest. Psoriatic arthritis symptoms may come and go. A period of increased inflammation and worsening of other symptoms is called a flare. A flare can last for days or months See related Key Facts section h1.5 How is psoriatic arthritis diagnosed? A timely and accurate diagnosis is an important step for optimising care and improve long-term health outcomes (16). If you have been diagnosed with psoriasis in the past, and symptoms of arthritis (e.g., painful or swollen joints) have started more recently, you may have developed psoriatic arthritis. However, the symptoms of psoriatic arthritis can look like other health conditions. Make sure to see your healthcare provider for a diagnosis. The doctor you see first may depend on whether you have previously been diagnosed with psoriasis. If you develop symptoms of arthritis your primary care or skin doctor should refer you to a rheumatologist – a doctor who specialises in joint conditions – for an assessment. Tell your doctor if you have a history of psoriasis and/or psoriatic arthritis in your family. CURRENTLY, NO SINGLE TEST CAN CONFIRM PSORIATIC ARTHRITIS (15). A diagnosis will be made based on your medical history, symptoms, and a physical examination by your doctor. Your doctor may order X-rays or other types of imaging, such as ultrasound scans and magnetic resonance imaging (MRI), to look for changes to your bones and joints. Imaging studies will help your doctor determine the type and pattern of joint involvement, which can also help them distinguish between arthritis types. Blood tests, such as erythrocyte sedimentation rate and C-reactive protein, can help to identify inflammation. Your doctor may also order tests for rheumatoid factor and the anti-CCP antibody to rule out rheumatoid arthritis and HLA-B types to look for your genetic predisposition to spondylarthritis. See related Key Facts section h1.4 See related Key Facts Previous page Next page

iProlepsis project for psoriatic arthritis uses multi-source data analysis for guiding to a novel personalised digital care ecosystem and maximizes the impact. iPROLEPSIS-project visie en impactmaximalisatie Data-analyse vanuit meerdere bronnen betreffende de transitie van gezondheid naar PsA als leidraad voor een nieuw gepersonaliseerd digitaal zorgecosysteem , en maximalisatie van impact door middel van openheid, zichtbaarheid, netwerken en hergebruik van resultaten. Projectvisie Gegevensanalyse, iPROLEPSIS projectdoelen, IoT-technologieën en mobiele applicatie. Over artritis psoriatica Artritis psoriatica (PsA) is een chronische inflammatoire aandoening die zowel het perifere als axiale skelet aantast, met aanzienlijke gevolgen voor de kwaliteit van leven van patiënten. Naar schatting heeft 1-2% van de algemene bevolking PsA, wat betekent dat 5 tot 10 miljoen mensen in de EU getroffen worden. PsA wordt geassocieerd met psoriasis (PsO) en naar verwachting zal tot 30% van de mensen met PsO, dat wil zeggen minstens 100 miljoen mensen wereldwijd (volgens de WHO), PsA ontwikkelen. Het doel Het doel van iPROLEPSIS is om een nieuw ecosysteem voor te stellen dat mechanismen voor het verzamelen van Real World Data (RWD) omvat, in combinatie met een krachtig beslissingsondersteunend systeem. Dit ecosysteem is gericht op het verschaffen van nieuwe kennis over de belangrijkste actiegerichte factoren die de transitie van gezondheid naar PsA beïnvloeden, door middel van een multiscale/multifactoriële benadering. Het uiteindelijke doel is om met behulp van op xAI gebaseerde modellen een efficiënt, effectief en klinisch gevalideerd en gepersonaliseerd digitaal zorgecosysteem te bieden voor PsA-patiënten. Technologieën IoT-detectie technologieën en een mobiele applicatie zullen de kern vormen van het proces voor het verzamelen van Real World Data (RWD). Deze technologieën zullen retrospectieve en prospectieve gegevens uit diverse bronnen verzamelen, waaronder databases van klinische partners en open toegankelijke databases. Door middel van analyse en visualisatie van deze gegevens met AI-voorspellende modellen en een intuïtieve visuele analysetool, zal iPROLEPSIS in staat zijn om gepersonaliseerde behandelingen voor te stellen. Deze behandelingen omvatten dieet, fysieke activiteit, en management van stress, vermoeidheid en pijn. Dit ondersteunt artsen, zorgverleners en ziekenhuizen bij het streven naar optimaal beheer van PsA. Tot slot streeft iPROLEPSIS er met behulp van xAI-technieken naar om ziekenhuizen en beleidsmakers te faciliteren bij het verkrijgen van nieuwe inzichten die kunnen bijdragen aan verbeterde klinische praktijken en het vormgeven van toekomstig beleid voor de behandeling van PsA. Invloedmaximalisatie Om ervoor te zorgen dat de succesvolle implementatie van de trajecten leidt tot impact op de lange termijn, streeft het project consortium ernaar om iPROLEPSIS een referentie te maken in de strijd tegen PsA door: 01 Het oprichten van een actieve iPROLEPSIS-gemeenschap van belanghebbenden. 02 Het informeren van belangrijke stakeholders over de resultaten en hun potentieel voor klinische innovatie. 03 Het beschikbaar stellen van vooruitgangen voor onderzoeks- en zakelijke doeleinden op de lange termijn. 04 Het vergroten van de betrokkenheid van mensen met of met risico op PsA door hun problemen aan te pakken, zorgen te adresseren, hun bewustzijn te vergroten en vertrouwen op te bouwen in nieuwe technologieën. 05 Het samenwerken met vergelijkbare/relevante R&I-projecten om netwerken en gezamenlijke activiteiten te bevorderen. 06 Het opzetten van een forum/community voor zorgverleners en autoriteiten om nieuwe richtlijnen en standaarden te ontwikkelen. 07 Het identificeren van exploitatiemechanismen en activiteiten, evalueren van de commercialisering en toepasbaarheid van concepten en ideeën. PROJECT DOELSTELLINGEN

Welcome to our collaborative initiative, a dedicated networking subpage showcasing the synergistic efforts of innovative projects. iPROLEPSIS networking activities Our shared vision is to establish a robust ecosystem of initiatives , where the combined strength of each project contributes to the overarching goal of advancing healthcare and well-being . By pooling our resources, knowledge, and expertise, we believe in the potential for significant benefits both for the collaborative cluster and the individual projects involved. Networking projects funded under the call HORIZON-HLTH-2022-STAYHLTH-02-01 CARE-IN-HEALTH Cardiovascular REsolution of INflammation to promote HEALTH WEBSITE Cardiovascular diseases (CVD) are the leading cause of mortality in Europe (1.9 million of annual deaths). CVD are significant public health challenge, accounting for €200 billion in economic burden annually in Europe. Lipid-mediated chronic inflammation and particularly the failure in the resolution of the inflammation, is a particular critical risk factor for the transition from health to CVD. CARE-IN-HEALTH addresses this by aiming to identify the pathways involved in the resolution of the lipid-mediated inflammation to prevent and reverse inflammation and therefore CVD. The interdisciplinary consortium will collect and integrate epidemiological, multi-omics, and immune data to create the CARE-IN-HEALTH Atlas, which will be openly accessible to the scientific community. Such a knowledge base will allow to systematically identify and validate individual’s critical immune pathways. A CARE-IN-HEALTH MCDSS (multi-criteria decision support system) will guide healthcare professionals to design personalised CVD prevention strategies. The CARE-IN-HEALTH BIOSENSOR will monitor inflammation resolution for citizens. CARE-IN-HEALTH will demonstrate proof-of-concept for an appropriate lipid intake as dietary intervention and specifically, for the use of vegetal omega-3 fatty acid sources as substrates for immunomodulatory lipid mediators and resolution of inflammation. All this is based on the results of a proof-of-concept clinical trial. GlycanTrigger Glycans as master triggers of health to intestinal inflammation transition WEBSITE GLYCANTRIGGER - Glycans as master triggers of health to intestinal inflammation transition. The GlycanTrigger project proposes a thorough and innovative approach to understand better the health-to-chronic inflammation transition occurring in patients with Crohn’s Disease that will be translated into improved disease prediction and prevention. The project will address how changes in glycosylation of the gut mucosa act as a primary event that dysregulates not only local mechanisms but also systemic mechanisms, involving the novel concept of glycan mimicry as an early trigger of the health-to-inflammation transition. The long-term goal of this project is to unlock a new checkpoint that regulates the transition to chronic inflammation, aiming to figure out how to turn off this process by developing novel preventive intervention strategies. halt-RONIN Discovering chronic inflammation biomarkers that define key stages in the Healthy-to-NASH (non-alcoholic steatohepatitis) transition to inform early prevention and treatment strategies. Downolad PDF to read more. WEBSITE NAFL (non-alcoholic fatty liver) is the most widespread subtype of NAFLD, a highly prevalent inflammation-related disease, characterized by steatosis, relatively benign and reversible condition, which can progress to the more serious progressive stage of non-alcoholic steatohepatitis (NASH), in which steatosis is accompained by lipotoxicity, mitochondrial dysfunction and a high state of inflammation and fibrosis. IMMEDIATE Imminent Disease Prediction and Prevention at the Environment Host Interface WEBSITE The EU-funded research project IMMEDIATE strives to identify individual biomarkers of risk and resilience against chronic inflammation by investigating the diet-microbiome-metabolite-immune axis. This complex interaction refers to how an individual's diet, gut microbiota, metabolites, and immune system can influence their health. IMMEDIATE will use cutting-edge technologies and clinical and metadata from large observational cohort studies to identify pre-disease stages and further our understanding of the mechanisms and molecular pathways underpinning non-communicable diseases. Furthermore, a proof-of-concept study on healthcare professionals will be conducted to test the effectiveness of a probiotic intervention and ultimately develop mobile apps designed to offer personalized lifestyle recommendations and empower citizens to manage their own health proactively. INITIALISE Inflammation in human early life: targeting impacts on life-course health WEBSITE INITIALISE (Inflammation in human early life: targeting impacts on life-course health) is an EU funded project that aims to elucidate how exposures and genome impact gut microbiome, host immune system and metabolism, and how the interplay of these factors impact life-course health.  INITIALISE aims to define the role of the maturation of the immune system as a mediator between exposures and life-course health. INTERCEPT-T2D Early Interception of Inflammatory-mediated Type 2 Diabetes WEBSITE Inflammatory-based interceptive medicine in type 2 diabetes Individuals with type 2 diabetes (T2D) do not use insulin efficiently and, therefore, their glucose levels rise. T2D is a heterogeneous disease, which is an obstacle to the delivery of an optimal tailored treatment. Consequently, patients’ individual trajectories of progressive hyperglycaemia and risk of chronic complications such as stroke, heart attacks, nephropathy and retinopathy are so far difficult to predict. Chronic systemic inflammation has been suggested to be a major contributor to the onset and progression of T2D complications. The EU-funded INTERCEPT-T2D project will bring a new and clinically relevant dimension in T2D care considering at diagnosis inflammatory parameters that are of importance for the transition to T2D-related complications. Moreover, the project will help deliver optimal treatments tailored to patient needs and conduct a clinical trial to evaluate the efficacy of anti-inflammatory strategies. miGut-Health Personalised blueprint intestinal health WEBSITE The miGut-Health project is an EU-funded initiative that is developing novel strategies to predict and prevent inflammatory bowel disease (IBD). miGut-Health aims to create personalised patient engagement strategies for predicting and monitoring preclinical IBD by focusing on the transitory phase from health to disease. The overarching goal is to provide strategies for early disease prediction, prevention and gut health improvement for people affected by IBD, high-risk individuals and citizens. AIDA An Artificially Intelligent Diagnostic Assistant for gastric inflammation WEBSITE Most cases of gastric cancer (GC) are detected at a late stage, when patients have a median life expectancy of about a year. Diagnosing people at risk of developing GC at the pre-symptomatic stage, typically chronic gastric inflammation, could significantly improve the outlook. Artificial intelligence (AI) can help clinicians make sense of their own data by automating much of the treatment and analysis, which require manual work and years of experience. But it can do more: it can bring together available data from various sources into a vast data lake and cross-correlate the data to derive a ‘risk score’ for gastric cancer and shed light on the mechanisms of its evolution. Aida aims to do just that. It helps researchers understand the mechanisms that trigger gastric oncogenesis, helps clinicians diagnose precancerous inflammation at the earliest possible stage, suggests personalised therapeutic strategies for treatment and follow-up, and makes personalised recommendations for monitoring patient health status, thus contributing to gastric cancer prevention. This places Aida squarely on Europe’s agenda of ‘Staying healthy in a rapidly changing society’. Aida unites some of Europe’s leading authorities in the field of gastric inflammation, gastric cancer, leading AI and machine learning experts, experts on data governance and privacy, representatives of the public administration and patient advocates. Aida also has strong ties with the industry. After the project, the results will live on in a foundation that acts as a transnational focal point for chronic gastric inflammation — and GC in general. We hope that the solid, inclusive design principles of Aida, its societal relevance and its durability will spawn a vigorous ecosystem around chronic gastric inflammation, its understanding and its treatment. And we hope that it will inspire other data collaboratives in health — for other chronic inflammations, other forms of cancer or other ailments altogether. PROTO Advanced Personalized Therapies for Osteoarthritis WEBSITE Osteoarthritis (OA) is a chronic progressive joint disorder, characterized by inflammation causing pain, stiffness, swelling and gradual loss of joint function. PROTO aims to halt and partially reverse the structural and functional changes caused by inflammatory processes in OA Our ambitious goal is to introduce: a highly innovative anti-inflammatory local placental derived cell therapy in early-stage OA patients and a personalized sensor-based training intervention intended to prevent inflammation and OA onset during a crucially important ‘window of opportunity’ by correcting pathological movement patterns in pre-stage OA patients. ENDOTARGET Sytemic Endotoxemia as the driver of chronic inflammation–Biomarkers and novel therapeutic targets for Arthritis WEBSITE ENDOTARGET explores the relationship between gut microbiota, gut permeability, and systemic endotoxemia with a special focus on the three most abundant rheumatic diseases (RDs): osteoarthritis, rheumatoid arthritis and spondylarthritis. The aim is to clarify (1) the role of the three factors gut microbiota, gut permeability and systemic endotoxemia in RD onset and pathogenesis, (2) which events and mechanisms are responsible for the origin of RDs, and (3) the influence of the gut microbiota on the joints. Based on the gained knowledge, e.g. new biomarkers for risk assessment will be identified and a Rheumatic disease risk prediction tool (RDPT) will be developed to support clinicians in the classification of patients and to treat RDs preventively. This tool will help to reduce the risk of RD onset and/or to reduce disease activity. PRAESIIDIUM Real-time prediction of the prediabetes risk WEBSITE PRAESIIDIUM will develop a tool based on artificial intelligence coupled with multi-scale, multi-organ integrated mathematical equations for the real-time prediction of the prediabetes risk of an individual. The prediction algorithm will draw on a rich set of information for training, derived from prior clinical data, the individual’s family history, and a pilot study testing wearable sensors that will provide glucose, bioimpedance, and heart rate monitoring. The PRAESIIDIUM platform will be made available to healthcare professionals and patients for an easier data entering and results query and it will be linked to common wearable sensors to monitor the physical activity. PREVALUNG EU Biomarkers affecting the transition from cardiovascular disease to lung cancer: towards stratified interception WEBSITE The project PREVALUNG EU will harness retrospective and prospective cohorts of both CVD patients and LCDT eligibles to develop actionable biomarkers and validate the four classifiers detecting high-risk individuals before or pre-symptomatic of LC, exploiting the latest advances of system biology omics (metabolomics, metagenomics, immunomics, proteomics, and aging-associated BM stem cell genomics) that correlate with uncontrolled inflammatory status of CVD patients. In particular, using four types of diagnosis tools harnessing either of the four drivers of overt inflammation (metabolism, gut dysbiosis, stem cell mutational status, innate immunity), we shall stratify the CVD patient population and leverage the PLCOm2012 risk score to better identify LC high-risk individuals. We will propose a personalized interceptive measure, whose efficacy will be monitored using PREVALUNG EU Focus Panels. We will robustly validate clinical applications, workflows, and tools for easy and broad adoption of the interceptive system across European public care centers and private stakeholders.

Learning how to live with psoriatic arthritis might feel like a challenge. But understanding your diagnosis can help you take control of your health. iPROLEPSIS networking activities Our shared vision is to establish a robust ecosystem of initiatives , where the combined strength of each project contributes to the overarching goal of advancing healthcare and well-being . By pooling our resources, knowledge, and expertise, we believe in the potential for significant benefits both for the collaborative cluster and the individual projects involved. Introduction Learning how to live with psoriatic arthritis might feel like a challenge, especially at first. But understanding your diagnosis and how to manage this chronic disease can help you take control of your health. Psoriatic arthritis patient booklet is meant to help you understand your disease and medications, and to improve your ability to communicate your symptoms and concerns to your healthcare professionals. Here, you will also find several non-pharmacological strategies that may ease your symptoms and help you to cope with this disease (e.g., physical exercise, sleeping habits, and diet). This booklet has been edited by rheumatologists, healthcare experts, and patients living with psoriatic arthritis. The information in this booklet is for educational purposes only, and it should never replace the information and advice from your treating physician(s). It is meant to inform the discussions that you have with healthcare professionals, as well as others who play a role in your care and well-being. What is psoriatic arthritis? Psoriatic arthritis is a type of arthritis linked with psoriasis, a chronic skin and nail disease. Psoriasis causes red, scaly rashes and thick, pitted fingernails. Psoriatic arthritis is characterized by joint swelling (inflammation), pain and stiffness and can affect any peripheral joint such as fingers, toes, knees and/or spine. It also affects the insertion of tendons or ligaments in bones (enthesitis). Between 20-40% of people with the skin condition psoriasis will develop psoriatic arthritis. Symptoms affecting their joints tend to develop 5 to 10 years after psoriasis is diagnosed but it can occur at any time. Currently, it is not clear why some people with psoriasis develop psoriatic arthritis while others do not. The arthritis of psoriatic arthritis comes in three forms: oligoarticular arthritis that affects four or less peripheral joints (e.g., joints in the fingers, toes, knees); polyarticular arthritis that involves five or more peripheral joints on both sides of the body; and axial arthritis that affects the joints of the spine including the sacroiliac joint (where the spine connects to the pelvis). Some people may develop psoriasis after or at the same time as symptoms of psoriatic arthritis present themselves (4). In rare cases, people may have psoriatic arthritis and never have any noticeable symptoms of psoriasis. Psoriatic arthritis and psoriasis are chronic inflammatory conditions that are caused by a fault in the immune system. Our immune system protects us from infection and illness. Learn about psoriatic arthritis Networking projects funded under the call HORIZON-HLTH-2022-STAYHLTH-02-01 The Psoriatic Arthritis Patient Handbook is now available for download. The booklet includes essential information to support your understanding of psoriatic arthritis and offers practical tips to enhance your daily life.

Over onze consortium partners Francisco Cardoso PLUX Position Software Developer What is your role in iPROLEPSIS? Monitoring Engineer What are your main activities in the project? I define SLIs/SLOs, design telemetry (metrics, logs, traces), build alerts and dashboards, run incident response/postmortems, and align data retention and security with compliance. What is your motivation? I’m motivated by making complex systems trustworthy. Turning real-time signals into fast decisions that reduce downtime and protect participants and data. Hugo Humberto Plácido da Silva PLUX Position Founder & Chief Innovation Officer What is your role in iPROLEPSIS? Principal Investigator representing PLUX. What are your main activities in the project? Internal management of the project at the board/administration level. Our team is making substantial contributions to the development of digital biomarkers (dBMs) that can be acquired using a smart belt. Furthermore, we are responsible for the iPROLEPSIS system orchestration, verification, and monitoring. What is your motivation? Psoriatic Arthritis (PsA) is a highly conditioning disease that currently affects a significant number of patients globally. Existing assessment and management methods are mostly bound to a clinical setting, involving complex protocols, therefore only of limited access to patients. For as long as I can remember, my work has been centered around purpose-driven innovations in the healthcare space; the possibility to explore novel dBMs as a way of improving the lives of PsA patients constitutes a once-in-a-lifetime opportunity and purpose like none other. Sofia Balula Dias Faculdade de Motricidade Humana Position Principal Investigator representing FMH partner What is your role in iPROLEPSIS? As Principal Investigator, I lead the design and development of a serious games-based intervention tool specifically tailored to support individuals living with Psoriatic Arthritis. What are your main activities in the project? Our multidisciplinary team is leading the development of the iPROLEPSIS serious games application to support Psoriatic Arthritis patients. Through co-creation with patients and collaboration across research, clinical, and design fields, we’re tailoring game mechanics and biofeedback features to meet real needs and preferences. Our work involves prototyping, testing, and refining therapeutic content designed to improve mobility, support pain management, reduce stress, and promote self-management, ultimately contributing to a more holistic and patient-centered approach to chronic care. What is your motivation? I am driven by the opportunity to improve the lives of PsA patients through non-pharmacological, technology-driven interventions. Serious games present an innovative and empowering method for symptom management and patient engagement. To date, there are no serious games specifically tailored to the needs of individuals with PsA, making this work both timely and impactful. Rodrigo Duarte Braga PLUX Position Research Collaborator What is your role in iPROLEPSIS? Systems Engineer What are your main activities in the project? I coordinate system orchestration, verification, and monitoring. I also lead the Smartbelt's technical development, from data acquisition and processing device data to building machine learning models. What is your motivation? Tackling complex challenges and developing innovative solutions and medical devices that create tangible value. Sérgio Lopes da Fonseca PLUX Position Project Manager What is your role in iPROLEPSIS? PLUX’s contribution to iPROLEPSIS management. What are your main activities in the project? Aligning timelines, deliverables, and resources across partners. I manage work-package commitments, budget and risks, and represent PLUX in steering and technical meetings to keep decisions action-oriented and on schedule. What is your motivation? To turn research into deployable, user-centred solutions. I’m driven by projects that measurably improve clinical workflows and patient outcomes—while creating a clear path from prototype to scalable product. iPROLEPSIS is a chance to do all three: integrate wearable biosignals seamlessly, prove value in real settings, and accelerate European med-tech competitiveness. Coordination Clinical Experts Data Science Software Development Ethics, Legal and Exploitation Dissemination and Communication

Learning how to live with psoriatic arthritis might feel like a challenge. But understanding your diagnosis can help you take control of your health. Learning hub Explore resources to help you understand and manage psoriatic arthritis. Learning hub Key Facts Handbook News Feed Quizzes Search Psoriatic Arthritis Handbook Managing Psoriatic Arthritis: Treatments and Lifestyle Handbook Handbook 2 How is psoriatic arthritis treated? While there is no cure for psoriatic arthritis, there are multiple drug treatment options that work to control the disease and its symptoms (3). Drug treatments specific for psoriatic arthritis focus on: DRUG TREATMENTS slowing down the progression of the condition; reducing inflammation; relieving pain; treating skin symptoms; keeping joints as mobile as possible. For most people, treatment for psoriatic arthritis will involve trying several different medications. Since many people with psoriatic arthritis have psoriasis, managing the condition can seem like treating two diseases. Some treatments work on both diseases, while others work mainly on the arthritis or skin problems. Every person diagnosed with psoriatic arthritis is different. Doctors recommend certain treatments depending on: how many and which parts of the body are affected; how severe the disease is; drug allergies and other health conditions; current medication use. Many times, people with psoriatic arthritis may need to take more than one drug at the same time to control the disease – this is called combination therapy. Combination therapy can allow for lower doses of each individual drug to be used. During flares, additional medications may be added temporarily or for the longer term.It is important to be involved in shared-decision making with your doctor(s) and adhere to the treatment plan. You should communicate any issues with medications, such as side effects or difficulty adhering to the treatment plan, so that effective steps can be taken to address the problem(s). TREATMENT FOR THE ARTHRITIS The over-the-counter and prescription medicines for psoriatic arthritis include: non-steroidal anti-inflammatory drugs (NSAIDs); steroid medication (corticosteroids); disease modifying anti-rheumatic drugs (DMARDs). See related Key Facts section h2.1 Non-steroidal anti-inflammatory drugs (NSAIDs) NSAIDs can help relieve pain and reduce inflammation, but they might not be enough to treat symptoms of psoriatic arthritis (9). There are two types of NSAIDs: traditional NSAIDs, such as ibuprofen, naproxen, and diclofenac; COX-2 inhibitors, such as celecoxib and etoricoxib. Like all medicines, NSAIDs can have side effects. Your doctor will take precautions to reduce the risk of side effects by prescribing the lowest dose necessary to control your symptoms for the shortest time possible. NSAIDs can sometimes affect the stomach and intestines, causing digestive problems such as indigestion and stomach ulcers (17). A medication called a proton pump inhibitor (PPI), such as omeprazole or lansoprazole, may also be prescribed to help protect the stomach. Chronic treatment with NSAIDs can also increase the risk of heart attacks, strokes, and other heart problems (17). Please, let your doctor know if there are risk factors that may increase your overall risk, for example, smoking, high blood pressure, high cholesterol, diabetes, or a family history of heart disease. Some people have found that taking NSAIDs made their psoriasis symptoms worse. Inform your doctor if this happens to you. Steroid medication (corticosteroids) Like NSAIDs, corticosteroids can help reduce inflammation and pain (18). If you have a single painful and/or swollen joint, your doctor may inject the medication directly into the joint. The effect can last from a few weeks to several months. However, having too many steroid injections in the same joint(s) can damage the surrounding tissue and, thus, your doctor will usually not recommend more than three injections per year. When lots of joints are inflamed, corticosteroids can be taken as a tablet, or as an injection into the muscle. However, doctors are cautious about this because corticosteroids can cause side effects, such as weight gain and osteoporosis, increased risk of infection and cardiovascular events, if used for long periods of time. Because of these side effects, your doctor will prescribe you the lowest dose necessary to control your symptoms for the shortest time possible. Psoriasis can flare up when you stop using oral corticosteroids. Disease modifying anti-rheumatic drugs (DMARDs) DMARDs are powerful medications that reduce inflammation and can stop psoriatic arthritis from getting worse (19). DMARDs can help prevent damage to your joints. Many DMARDs will treat both psoriasis and psoriatic arthritis. Because this type of medicine treats the cause of your condition and not the symptoms, it can take up to three months before you feel an effect. Therefore, it is important to keep taking the medication, even if it does not seem to be working at first. Like all drugs, DMARDs can have some side effects. While DMARDs can be very effective, these medications reduce the activity of the immune system (immunosuppressants) and raise the risk of an infection. However, it is important to remember that not treating psoriatic arthritis could lead to permanent bone and joint damage. There are three types of DMARDs as described in Table 1. Table 1: Types of disease modifying anti-rheumatic drugs. Traditional Traditional DMARDs (csDMARDs) have been used the longest and have a broad immune- suppressing effect. These medicines are usually taken by mouth. Example: methotrexate, sulfasalazine. Biologic Biologic DMARDs (bDMARDs) disrupt key steps in the inflammatory process and generally work more quickly than traditional DMARDs. These drugs are usually injected. Example: adalimumab, etanercept. Targeted Like biologic DMARDs, targeted DMARDs (tsDMARDs) block key steps in the inflammatory process. These medications are usually taken by mouth. Example: tofacitinib. TREATMENT FOR THE PSORIASIS The over-the-counter and prescription medicines for psoriasis include: topical medications made from vitamin D, derivatives of vitamin A, salicylic acid, coal tar or corticosteroids; phototherapy that uses ultraviolet light (UVB) may be prescribed to treat and lessen skin rashes. Only your doctor should prescribe phototherapy, do not try to use sunlight or sunlamps to treat your skin on your own; some DMARDs and biological therapies used for arthritis can also help the psoriasis. VACCINES If you have psoriatic arthritis, you may have a higher risk of infection and infections may be more severe (20). This can be due to the arthritis itself or its treatment. Psoriatic arthritis, which caused by a fault of the immune system, can make you more vulnerable to infections. In addition, some of the drugs utilised to treat psoriatic arthritis (e.g., DMARDs and/ or steroids) dampen down the immune system, that is, they act as immunosuppressants, which can also make you more prone to infection. An increased risk of infection due to a medical condition and/or drugs is called immunosuppression. Your rheumatologist can provide guidance based on your age and your risk for getting certain infectious diseases (e.g., COVID-19, flu, pneumonia, shingles, or hepatitis B). Vaccines are safe and can help you avoid serious infections. See related Key Facts section Non-pharmacological treatments NON-PHARMACOLOGICAL TREATMENTS Drugs are not the only way to treat or manage the symptoms of psoriatic arthritis. There are many things you can do, alongside taking prescribed medication, that can improve your life quality by lessening pain and inflammation, and improving your overall health. YOUR VOICE MATTERS Your experiences – how your therapies are working, what side affects you are experiencing, how your symptoms are affecting you, what challenges you are facing in your daily life due to psoriatic arthritis – are very important pieces of information. This information is called patient-reported outcomes (PROs) and it may be collected via a questionnaire prior to your rheumatology appointment. PROs can help your doctor assess the impact of your disease and better evaluate your treatment plan. These questionnaires can also help you self-manage your condition. Some of the questionnaires your rheumatologist may use are: PSAID (Psoriatic Arthritis Impact of Disease): measures the impact of your disease on your physical and psychological health; VAS (Visual Analogue Scale): a simple tool to track and measure your pain; IPAQ (International Physical Activity Questionnaire): measures the types of intensity of physical activity and sitting time that people do as part of their daily lives; HAQ (Health Assessment Questionnaire): measures your physical function and disability due to arthritis; FACIT-F (Functional Assessment of Chronic Illness Therapy - Fatigue): measures your fatigue that is caused by the arthritis; WPAI (Work Productivity and Activity Impairment): measures impairments in work and activities; HADS (Hospital Anxiety and Depression Scale): measures the levels of anxiety and depression; PsAQoL (Psoriatic Arthritis Quality of Life): measures the quality of life in people with psoriatic arthritis; EQ-5D (EuroQol-5 Dimensions): measures quality of life in relation to 5 dimensions – mobility, usual activities, self-care, pain and discomfort, and anxiety and depression; SF-36 (Short Form-36): measures quality of life and covers 8 domains of health – physical functioning, physical role, pain, general health, vitality, social function, emotional role, and mental health. So, if your doctor or nurse asks you to fill out a questionnaire, please take the time to do it and be honest! PHYSICAL AND OCCUPATIONAL THERAPY Inflammation of joints and soft tissues can often lead to extreme pain, immobility, and dysfunction. Additionally, the arthritis can lead to difficulty in daily activities in the home and workplace. Physical and occupational therapy can help you get moving safely and effectively. Physical therapy is the most impactful if you are experiencing (21): loss of motion due to inflammation in the shoulder, wrist, hand, knee, or foot; severe enthesitis or dactylitis; inflammatory back pain. Physical therapy will focus on (21): improving mobility and restore the use of affected joints; increasing muscle strength to support the joints; maintaining fitness; preserving the ability to perform daily activities. Occupational therapy can also be helpful, especially if you are experiencing difficulties with everyday activities. See related Key Facts section h2.3 Occupational therapy can help you maximise your ability to participate in daily activities. Strategies include the use of assistive devices (e.g., braces, splints), and movement modification to help people protect their joints by performing tasks in different ways than they are used to (e.g., using both hands). SURGERY Most people diagnosed with psoriatic arthritis will never need joint surgery. However, if joints are severely damaged by the arthritis, or if other treatments do not reduce pain, damaged joints can be replaced by plastic, metal, or ceramic prosthesis to reduce pain, and improve function and quality of life. COMPLEMENTARY TREATMENTS Some people with psoriatic arthritis feel that complementary therapies can be helpful. However, you should always talk to your doctor before trying complementary therapies. There is no scientific evidence to support that taking any kind of dietary supplement, such as fish body oil capsules, works in treating psoriatic arthritis. In addition, there is not enough scientific evidence to support the use of complementary therapies, such as balneotherapy or acupuncture, as treatments for psoriatic arthritis. Complementary therapies can react with other treatments, so you should talk to your doctor if you are using or thinking of using any. See related Key Facts section SELF-CARE AND LIFESTYLE Sedentary behaviour Sedentary behaviour, characterised by prolonged periods of sitting, when accumulated daily for more than 8 hours or maintained for periods longer than 30 minutes without interruption, constitutes a risk to health and well-being. h2.4 h2.5 Since mechanical stress in the case of an inflammatory crisis can promote the appearance of enthesitis, it is necessary to control inflammation before increasing the level of usual physical activity or starting an exercise programme. In any case, the beneficial effects of physical activity and exercise on disease, well-being and associated comorbidities outweigh the risk of enthesitis induced by mechanical stress, which is low (25). Diet While there is no a specific diet that can treat psoriatic arthritis, adopting a nutritious and balanced eating plan can play a vital role in managing symptoms and improving overall wellbeing. Research suggests that adopting a Mediterranean-style diet (Figure 3, left-hand side), which includes fruits, vegetables, fibre, high-quality fats, and vitamins, might lessen the impact of your psoriatic arthritis (26). This type of diet has anti-inflammatory benefits that help manage disease activity. So, trying this eating approach might help you ease your psoriatic arthritis symptoms. Incorporating omega-3 fatty acids , commonly found in oily fish (such as salmon, mackerel, or flaxseeds), can also have anti-inflammatory effects, potentially reducing joint stiffness and tenderness (27). Antioxidants found in colourful fruits and vegetables (such as berries, spinach, and kale) also offer potent anti-inflammatory properties that could alleviate joint inflammation and discomfort in people living with psoriatic arthritis. Overall, it is recommended to aim for a balanced intake of 2-5 portions of fruits and 3-5 portions of vegetables daily, as these nutrient-rich foods provide essential antioxidants that may contribute to managing joint inflammation and overall health. Figure 3: Beneficial (on the left side) and harmful (on the right side) dietary patterns. Adapted from Guilliams et al., 2023 (28). Reducing the intake of sugar, saturated fats , and sodium can help you maintain a healthy weight. Obesity is linked to a higher chance of developing psoriatic arthritis, underlining the significance of weight management, especially for psoriasis patients who often suffer from metabolic syndrome and obesity (29). In people living with psoriatic arthritis, studies suggest that sedentary behaviour may contribute to increased joint stiffness, reduced muscle strength, and compromised joint function. Additionally, a sedentary lifestyle may exacerbate symptoms such as fatigue and depression, which are common in psoriatic arthritis. While the exact mechanisms are not fully understood, maintaining an active lifestyle is generally considered beneficial for managing psoriatic arthritis symptoms. The risks of sedentary behaviour increase even more when people are inactive; that is, they do not comply with the World Health Organization’s (WHO) recommendations for physical activity, described below. Physical activity Engaging in regular physical activity has been shown to have numerous benefits for people living with psoriatic arthritis. Physical activity concerns all body movements resulting from muscle contraction regardless of the context in which they are carried out: leisure, transportation to and from places, or as part of a person’s work. Physical activity can help improve joint flexibility, reduce inflammation, and enhance overall joint function. Moreover, physical activity may contribute to better mental health, as it can help alleviate symptoms of depression and anxiety that are often associated with chronic conditions like psoriatic arthritis. Physical activity also plays a role in weight management, which is essential as excess weight can increase joint stress (22). According to the WHO, it is recommended to accumulate at least ~20 minutes per day of physical activity, such as brisk walking (23). This recommendation is also adopted by the European Alliance of Associations for Rheumatology (24). A 20-minute physical activity of moderate intensity corresponds to an accumulation of around 2000 steps. Considering a functional activity of 4500 steps per day associated with carrying out activities of daily living such as grooming, cooking, cleaning, travelling to and from work/school, the WHO recommendations, when expressed in total number of steps per day, represent the sum of the two types of activity and correspond to an accumulation of 6500 daily steps under normal living conditions. Physical exercise The most beneficial types of exercise for psoriatic arthritis focus on improving flexibility, strength, and cardiovascular fitness without causing excessive joint stress. Low-impact activities such as swimming, walking, and cycling are often recommended. Strength training exercises, including resistance training and gentle yoga, can help enhance muscle support around the joints. Water-based exercises are particularly advantageous as they provide buoyancy, reducing impact on the joints. The benefits of these exercises include increased joint mobility, reduced pain and stiffness, improved muscle tone, and better overall well-being. People living with psoriatic arthritis should adopt a tailored physical activity routine, considering their specific symptoms and limitations. The iPROLEPSIS app intends to help you limit sedentary behaviours, increase physical activity, and improve daily functional capacity with specific and safe training program recommendations (for more information see section “iPROLEPSIS”). Excess weight can increase joint discomfort and inflammation, particularly in load-bearing joints (such as the hips, knees, and spine). Thus, be mindful of your dietary choices, as these can help you manage your symptoms. Vitamin D aids in calcium absorption, which is necessary for maintaining healthy bones. Additionally, vitamin D helps boost our immune system, fight off viruses, and combat fatigue. It has even been linked to good mood, with a deficiency potentially leading to anxiety and depression. Vitamin D is a fat-soluble vitamin that our bodies produce when the skin is exposed to sunlight. It can also be obtained from certain foods or supplements. This vitamin has several forms, but the most important ones are vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D3 is the form that our skin produces naturally in response to sunlight. Research indicates that people with psoriatic arthritis often have lower vitamin D levels than others (30). Having enough vitamin D might help ease some psoriatic arthritis symptoms. The best way to ensure this is through adequate sun exposure. Spending around 10 to 30 minutes in the sun between 10 AM and 3 PM, at least twice a week, is generally sufficient for most individuals to produce enough vitamin D. The exact time needed depends on factors such as skin type, latitude, altitude, and season. The Medical Board of the National Psoriasis Foundation recommends vitamin D supplementation for psoriatic arthritis patients and encourages overweight or obese patients to explore weight reduction through a controlled diet (31). However, you must seek advice from your doctor. Hydration is another key aspect often overlooked, but crucial in managing psoriatic arthritis. Though there are no specific hydration guidelines for people with psoriatic arthritis, drinking around two litres of water daily not only supports maintaining overall health (32), but also helps in joint lubrication and efficient functioning, easing discomfort associated with movement. Some individuals find that certain foods may trigger or exacerbate their psoriatic arthritis symptoms. While these triggers can vary among individuals, common contributors include red and processed meat, low-quality fats, salt and additives, and refined carbohydrates (Figure 3 ; right-hand side). Monitoring your diet and identifying potential trigger foods through a systematic dietary approach or under the guidance of a healthcare professional can help manage pain, fatigue, and flare-ups (33). It is essential to find guidance from a healthcare provider or a dietitian with expertise in psoriatic arthritis to develop a personalised dietary plan (28) aligned with individual preferences and needs. A personalised plan aims to guarantee sufficient nutrient intake, manage weight, and promote overall well-being, addressing the unique challenges associated with psoriatic arthritis. Moreover, embracing a healthy lifestyle, including consistent physical activity, stress management, and a well-balanced diet, holds significant potential to improve the quality of life for people with psoriatic arthritis. Smoking and alcohol consumption Smoking is bad for your overall health, as it increases the likelihood of potential complications, such as heart problems and cancer. Smoking can also make you less sensitive to treatment and worsen your psoriasis symptoms (34, 35). Alcohol can interfere with the effectiveness of some drugs or increase side effects (36, 37). Some studies also suggest that alcohol may act as a trigger for flare-ups (38). See related Key Facts section See related Key Facts Previous page Next page