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Clinical experts team Gail Heritage University of Oxford Position Senior Research Manager What is your role in iPROLEPSIS? UK PDPID coordinating center Manager What are your main activities in the project? UK Study manager What is your motivation? Contribution to clinical research to enhance patient experiences and disease outcomes. Francesca Levi-Schaffer The Hebrew University of Jerusalem, Israel Position Professor What is your role in iPROLEPSIS? Researcher What are your main activities in the project? To try to understand the passage from psoriasis to psoriatic arthritis by evaluating in skin biopsies vascularization, mast cell presence and to correlate this with involved joint vascularization What is your motivation? I would like to discover the connections between skin and joints and find a drug/s that can inhabit this progression Laura Coates Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford Position NIHR Research Professor What is your role in iPROLEPSIS? Lead for WP5 (clinical studies) What are your main activities in the project? I oversee all of the clinical studies within the consortium. What is your motivation? I am a rheumatologist who has worked in research in psoriatic arthritis for around 20 years. My interest is in improving outcomes for people living with psoriatic arthritis and I believe that work in this project can help us to predict, monitor and understand the disease better in day to day clinics. Coordination Clinical Experts Data Science Software Development Ethics, Legal and Exploitation Dissemination and Communication

< BACK iPROLEPSIS Project Presented to Sonova International Sep 10, 2024 Innovative Approaches in Digital Biomarkers In September 2024, the iPROLEPSIS project was presented at a meeting with Sonova International. This event included a series of insightful presentations, highlighting the project's focus on developing digital biomarkers. The iPROLEPSIS concept and vision were shared, showcasing the innovative approaches the project is undertaking. We extend our gratitude for the engaging discussions during the “Sonova-AUTH Day,” hosted by the Signal Processing & Biomedical Technology Unit at Aristotle University of Thessaloniki. The event featured a range of topics, including advancements in digital biomarkers, innovations in hearing instruments by Sonova Group, ear-EEG technology, auditory processing disorders, and insights into the hearing aid market in Greece. 1/2 PREVIOUS NEXT

< BACK iPROLEPSIS at GRAPPA 2025: Advancing Digital Tools for Psoriatic Arthritis Care Jul 18, 2025 Exploring how digital biomarkers can support hand function assessment in real-world settings iPROLEPSIS participated in the GRAPPA Annual Meeting 2025 , held on 10–12 July in Bogotá, Colombia. Vasilis Charisis (Aristotle University of Thessaloniki – AUTH) presented an overview of the project’s key objectives and emerging results. The talk highlighted how digital biomarkers – captured via smartphone typing dynamics and video-based motor tasks – can support the assessment of hand function in real-world conditions. The session reached approximately 350 stakeholders, including clinicians, researchers, and industry representatives, helping raise awareness of iPROLEPSIS and its goals within the psoriatic disease community. 2.jpg 1.jpg 3.jpg 2.jpg 1/3 PREVIOUS NEXT

Learning Hub Explore resources to help you understand and manage psoriatic arthritis. Learning hub Key Facts Handbook News Feed Quizzes Search Psoriatic Arthritis Handbook Handbook Handbook Understanding Psoriatic Arthritis Handbook Sections What is psoriatic arthritis? What causes psoriatic arthritis? What are the symptoms of psoriatic arthritis? How is psoriatic arthritis diagnosed? Read Sections Living with Psoriatic Arthritis Handbook Sections Work Sleep and fatigue Emotional wellbeing Read Sections Managing Psoriatic Arthritis Handbook Sections How is psoriatic arthritis treated? Non-pharmacological treatments Self-care and lifestyle Read Sections Intimacy, Reproductive Health and Family Life Handbook Sections Relationships and sex Fertility, pregnancy, and breastfeeding Read Sections Psoriatic Arthritis Handbook Handbook

Download iProlepsis project applications for psoriatic arthritis. Apps for download miPROLEPSIS app The miPROLEPSIS app facilitates the iPROLEPSIS-PDPID multicenter clinical study as a data collection tool that will enable the development of digital biomarkers for psoriatic arthritis symptoms and predictive models for inflammation exacerbation. More specifically, the app performs (i) passive data collection from the sensors of the smartwatch used in the study (i.e., Garmin Vivoactive 5), (ii) passive data collection from the accelerometer and gyroscope sensors of the smartphone, (iii) patient reported outcomes via questionnaires. Moreover, the app includes (i) a custom keyboard that captures the user’s typing dynamics and (ii) photo- and video-based activities for the collection of hand/feet photos and skeletal data related to joints flexibility, respectively. Note: The app can be used only by psoriatic arthritis patients that have enrolled to the PDPID study. This enrollment is available for patients in the UK, Netherlands, Portugal, and Greece. Information on how to enroll in the study and gain access to the miPROLEPSIS app will be provided soon. miPROLEPSIS app The miPROLEPSIS PDPID Study application functions as a data collection tool, utilized during the PDPID study, in order to produce datasets used for model generation and training. The app utilises both continuous and unobtrusive data collection (via bluetooth) from wearable devices, as well as user interactions (questionnaires, reporting etc). miPROLEPSIS Joint Landmarker app The miPROLEPSIS Joint Landmarker is an accompanying app of the miPROLEPSIS app that enables the video-based active tests feature. More specifically, a set of 6 hand and body movement exercises are presented and the user is asked to perform them in front of the smartphone camera. The app captures the videos and extracts skeletal data (coordinates of skeletal joints) locally. The skeletal data will be further analysed to develop digital biomarkers that assess the functionality and flexibility of joints. Note: The miPROLEPSIS Joint Landmarker app cannot be used without the miPROLEPSIS app. miPROLEPSIS Joint Landmarker app This app is a research app that accompanies the miPROLEPSIS app and aims to assess the physical functioning of people with Psoriatic Arthritis. More specifically, a set of 6 hand and body exercises are given and the user is asked to perform them in front of the smartphone camera. The app uses the collected videos to extract skeletal data (coordinates of skeletal joints), which are then sent to a cloud for further processing. Through the skeletal data processing, the aim is to identify whether a patient with Psoriatic Arthritis have difficulties in performing certain hand and body actions. The videos are immediately discarded and no personal information is retained, saved or transmitted.

Download needed deliverables for iProlepsis project for psoriatic arthritis. Project deliverables D1.2 Data managmeent plan (initial version) WP1 - Management and coordination Read More D2.3 The iPROLEPSIS trustworthy AI framework WP2 - Knowledge mining, foundation and participatory design Read More D6.1 Project branding and communication channels WP6 - Dissemination, communication and exploitation Read More D2.1 Initial report on user research and co-creation process WP2 - Knowledge mining, foundation and participatory design Read More D4.2 The iPROLEPSIS patient and HCP apps (study version) WP4 - Development of the iPROLEPSIS digital health ecosystem for personalised preventive care Read More D6.2 Dissemination, exploitation and communication plan WP6 - Dissemination, communication and exploitation Read More D2.2 Initial report on the state-of-the-art and datasets WP2 - Knowledge mining, foundation and participatory design Read More D5.1 Study initiation package (iPROLEPSIS-PDPID study) WP5 - Clinical studies Read More D6.3 First report on project visibility and educational material WP6 - Dissemination, communication and exploitation Read More

< BACK Understanding Patient Perspectives on Digital Biomarkers for Psoriatic Arthritis Nov 28, 2024 A new study explores opportunities and challenges in using digital biomarkers for Psoriatic Arthritis management A recently published study, Digital biomarkers for psoriatic arthritis: a qualitative focus group study on patient-perceived opportunities and barriers , examines how patients with Psoriatic Arthritis (PsA) perceive the use of digital biomarkers (dBMs) in managing their condition. With the increasing use of wearables like smartphones and smartwatches, there is growing interest in utilizing these tools to track physiological and behavioral data in everyday life. This study, involving 27 PsA patients across six focus groups, sheds light on the potential benefits and limitations of integrating dBMs into PsA care. Key Insights The study identified three main areas of interest: Opportunities: Patients saw value in using digital biomarkers to track early signs of disease flare-ups and monitor symptoms over time. Disease Activity Mapping: Participants highlighted the importance of using a broad range of data points to reflect the complexity of PsA symptoms. Barriers: Concerns about privacy, data security, and maintaining strong connections with healthcare providers were key considerations for patients. Relevance to iPROLEPSIS The findings align with iPROLEPSIS’s goal of integrating patient-centered digital health tools into chronic disease management. This study offers important guidance on ensuring digital health innovations address real-world patient needs while maintaining trust and usability. e004699.full .pdf Download PDF • 1.55MB 1/1 PREVIOUS NEXT

Ethics, legal and exploitation team Dr. Ioannis Drivas DIADIKASIA BUSINESS CONSULTING SYMVOULOI EPICHEIRISEON AE (DBC) Position Principal researcher focusing on the development of digital biomarkers and their translation into healthcare tools and interventions. What is your role in iPROLEPSIS? Project Manager What are your main activities in the project? As Project Manager, I coordinate all iPROLEPSIS-related activities assigned to DBC. What is your motivation? My motivation stems from a strong commitment to upholding ethical and legal standards in research while maximizing the impact and real-world use of the iPROLEPSIS results. Coordination Clinical Experts Data Science Software Development Ethics, Legal and Exploitation Dissemination and Communication

< BACK AI-Driven Nutrition: Advanced Personal Dietary Recommendations through Deep Generative Models and ChatGPT Jun 25, 2024 AI Nutrition Recommendation Using a Deep Generative Model and ChatGPT A recent scientific report titled "AI Nutrition Recommendation Using a Deep Generative Model and ChatGPT," authored by Ilias Papastratis, Dimitrios Konstantinidis, Petros Daras, and Kosmas Dimitropoulos, introduces a novel approach to personalised dietary recommendations. This research was conducted as part of the iPROLEPSIS project. Abstract: In recent years, major advances in artificial intelligence (AI) have led to the development of powerful AI systems for use in the field of nutrition in order to enhance personalized dietary recommendations and improve overall health and well-being. However, the lack of guidelines from nutritional experts has raised questions on the accuracy and trustworthiness of the nutritional advice provided by such AI systems. This paper aims to address this issue by introducing a novel AI-based nutrition recommendation method that leverages the speed and explainability of a deep generative network and the use of novel sophisticated loss functions to align the network with established nutritional guidelines. The use of a variational autoencoder to robustly model the anthropometric measurements and medical condition of users in a descriptive latent space, as well as the use of an optimizer to adjust meal quantities based on users’ energy requirements enable the proposed method to generate highly accurate, nutritious and personalized weekly meal plans. Coupled with the ability of ChatGPT to provide an unparalleled pool of meals from various cuisines, the proposed method can achieve increased meal variety, accuracy and generalization capabilities. Extensive experiments on 3000 virtual user profiles and 84000 daily meal plans, as well as 1000 real profiles and 7000 daily meal plans, demonstrate the exceptional accuracy of the proposed diet recommendation method in generating weekly meal plans that are appropriate for the users in terms of energy intake and nutritional requirements, as well as the easiness with which it can be integrated into future diet recommendation systems. Read the full publication: https://www.nature.com/articles/s41598-024-65438-x AI Nutrition Recommendation Using a Deep Generative Model and ChatGPT .pdf Download PDF • 4.37MB 1/1 PREVIOUS NEXT

< BACK iPROLEPSIS Plenary meeting Jun 22, 2023 iPROLEPSIS Consortium Partners Meet in Lisbon to Plan Next Steps The iPROLEPSIS consortium partners gathered in Lisbon, Portugal on June 20-21 for the 2nd Plenary meeting to review the progress and achievements of the project's work packages and plan the next steps. Over the course of two days, the consortium partners engaged in three productive workshops, each focusing on key aspects of the iPROLEPSIS project: Data Collection and Digital Biomarkers: The first workshop delved into the vital task of data collection and the development of digital biomarkers. Attendees discussed the identification of sensor and user data to be collected, including accelerometer/gyroscope data. Additionally, they explored algorithms for identifying inflammation drivers and defined user profiles to enhance personalized healthcare. System Architecture and Cloud Back-end: The second workshop centered around system architecture. The consortium partners discussed the key components of the system, including the orchestrator, and addressed critical aspects such as data management infrastructure and monitoring of app performance issues. miPROLEPSIS App and Serious Games: The third workshop involved a dynamic co-creation session, bringing together clinicians, patients, researchers, and developers. Focusing on the miPROLEPSIS app and serious games, participants explored various areas such as system architecture, key components, data management infrastructure, and app performance monitoring. The adoption of the "Crazy 8s" technique allowed for the rapid generation of a diverse range of ideas. During the third workshop patient representatives joined the session. Their valuable input and perspectives are crucial for understanding the specific needs and requirements of those who will benefit from our iPROLEPSIS project. By actively involving patient representatives, we can ensure that our solutions are truly patient-centric and tailored to their experiences and challenges. The iPROLEPSIS consortium is excited about the progress made during this meeting and is now equipped with a comprehensive plan for the next steps of the project. 3-1.jpg 3-1.jpg 1/1 PREVIOUS NEXT

iPROLEPSIS project will perform four different clinical studies in four different counties. Learn more about clinical studies by visiting iprolepsis.eu. About clinical studies iPROLEPSIS will perform four different clinical studies: 1. iPROLEPSIS-PDPID PsA digital phenotyping and inflammation drivers study. 2. iPROLEPSIS-MOJMI Mast cells and optoacoustics-enabled joint and microvascular imaging study. 3. iPROLEPSIS-IDBV Inflammation digital biomarkers validation study. 4. iPROLEPSIS-PPIDC Prevention of PsA inflammation through digital care: an intervention study. Clinical studies will be conducted in 5 countries: Netherlands UK Portugal Greece Germany Clinical studies PsA digital phenotyping and inflammation drivers study (iPROLEPSIS-PDPID) Development cohort of smartphone and smartwatch-based, AI-driven digital biomarkers for remote assessment and monitoring of people with psoriatic arthritis. Measure To develop novel smartphone- and smart device (belt, ring, camera) digital biomarkers for the assessment of inflammatory symptoms with special focus on the recognition of changes in movement patterns, pain, fatigue, morning stiffness in comparison to the gold standard – medical evaluation by clinical evaluation of the joints, tendons and skin. Predict To predict the change from uninflamed to inflamed using three triggers that may cause longstanding inflammation in psoriatic arthritis patients at risk for flare. Those three triggers are stress, mechanical stress and changes in the gut microbiome. OBJECTIVES Primary objectives to provide accurate, factual and clinically relevant records of the self-contained smartphone and smartwatch[1] based, AI-driven digital biomarker system in the detection of PsA specific inflammation; to predict accurate, factual and clinically relevant PsA specific inflammation. Secondary objectives to determine interperson reliability of the AI-driven digital biomarker system; to determine construct validity against clinical assessment of inflammation; to determine construct validity against patient assessment of inflammation; to determine clinically relevant changes in the AI-driven digital biomarker system; to determine minimal detectable difference in the AI-driven digital biomarker system; to assess the interperson variation of stress, mechanical stress and changes in gut microbiome on the occurrence of inflammation; to evaluate the compliance and satisfaction of the users with the smartphone and smartwatch-based, AI[1] driven digital monitoring system. The study is designed to develop a new way of measuring inflammation in patient with psoriatic arthritis. Definition of novel optoacoustic biomarkers of psoriasis and psoriatic arthritis (iPROLEPSIS-MOJMI) Mast cells and optoacoustics-enabled joint and microvascular imaging (iPROLEPSIS-MOJMI) study. The proposed multiscale (mesoscopic with RSOM and macroscopic with MSOT) approach aims at exploring and defining novel image-based biomarkers in order to describe the pathophysiological changes characterizing the disease and predict the transition from PsO to PsA. In other words, the unique multiscale nature of optoacoustics is expected to render skin microvasculature a window to later systemic (joint) effects of psoriasis and, thus, improve the prognosis in future patients with PsO. OBJECTIVES Primary objectives To define novel inflammatory mast cell, MSOT- and RSOM extracted biomarkers in patients with PsO/PsA. To quantify the changes of the novel inflammatory mast cell, MSOT- and RSOM-extracted biomarkers' with increasing disease severity. Secondary objectives To reveal correlations among the mast cells and the MSOT-and RSOM-extracted inflammatory biomarkers in patients with PsO/PsA. To define a novel index derived from mast cells, MSOT- and RSOM-based features to enable the early detection of PsA in patients with PsO or high risk for developing PsO. Inflammation digital biomarkers validation study (iPROLEPSIS-IDBV) Finding people that will convert from healthy to inflamed is a difficult task in Immune Mediated Inflammatory Disease (IMID). Initial symptoms look just like any other musculoskeletal disorder such as back pain, finger pain or achilles tendon problems. Over time symptoms can go either temporarily away, become chronic or become so severe that doctor care is needed. Early identification of people with IMID would greatly benefit their quality of live, keeps them at work and prevents high health care cost due to expensive medication. Digital biomarkers will give us for the first time the ability to study the conversion from musculoskeletal disorder to immune mediated inflammatory joint and tendon disease. The aim of this study to validate our digital biomarkers findings in PsA in psoriasis patients. OBJECTIVES Primary objectives to validate accurate, factual and clinically relevant records of the self-contained smartphone and smartwatch-based, AI-driven digital biomarker system in the detection of IMID specific joint or tendon inflammation. Secondary objectives to evaluate take up and acceptability of the digital biomarker in the wild; to evaluate the impact of missing data in detecting inflammation; to assess the number of false positives when data is captured in the wild; to assess the interperson variation of stress and mechanical stress. The aim is to identify inflammation with a software based medical device. This software will consist of an algorithm analysing data collected in the wild via smart devices: phone, watch, ring. Prevention of PsA inflammation through digital care: an intervention study (iPROLEPSIS-PPIDC) This study blends the findings of the newly developed digital biomarkers, the early findings of the triggers: stress, mechanical stress and changes in microbiome from PsA digital phenotyping and inflammation drivers study (iPROLEPSIS-PDPID), to provide a personalised approach to deal with the triggers with state-of-the-art interventions. OBJECTIVES Primary objectives In PsA patients with low disease activity a personalised intervention on food, physical activity and stress based on a personal profile of stress, mechanical stress and microbiome will be compared to usual care on inflammation development as detected by the newly developed digital biomarker system and clinical examination. Secondary objectives to evaluate take up and acceptability of the digital biomarker and intervention as part of normal medical treatment among patients, doctors and nurses; to assess compliance with the personalised intervention.

Learning Hub Explore resources to help you understand and manage psoriatic arthritis. Learning hub Key Facts Handbook News Feed Quizzes Search Psoriatic Arthritis Handbook Living with Psoriatic Arthritis Handbook How will psoriatic arthritis affect me? WORK Work can provide a sense of purpose, identity, achievement, and a supportive social network, contributing positively to your emotional and physical wellbeing. While your condition may pose some challenges, people living with psoriatic arthritis can continue to work as long as their profession does not exacerbate their symptoms and worsen their health. People with certain health conditions have defined rights set out in law, designed to protect them against direct and indirect discrimination in the workplace. Your employer is legally obligated to make “reasonable accommodations” to your working environment and practices to ensure your condition does not prevent you from doing your job to the best of your ability and in a comfortable and safe environment. h3.1 In the European Union, the definition of reasonable accommodation at work was introduced by Article 5 of the Employment Equality Directive (Directive 2000/28/EC): “shall take appropriate measures, where needed in a particular case, to enable a person with disability to have access to, participate in, or advance in employment, or to undergo training, unless such measures would impose a disproportionate burden on the employer.” This directive has been transposed into national law in all EU member states. Research has shown that people who need workplace accommodations and effectively use them are more likely to keep a job and stay productive than those who do not use workplace accommodations (39). However, asking for workplace accommodations can be difficult. You may be concerned about being treated differently and negative reactions from your supervisor(s) or colleague(s). For this reason, you may prefer to negotiate informal workplace accommodations rather than seeking formal accommodations. Some of these accommodations may include those supported by the American College of Sports Medicine guidelines for physical activity and public health (40) and the ISO 11226 standard , https://www. iso.org/standard/25573.html , which defines joint limits to safeguard musculoskeletal health. By aligning workplace practices with these scientifically supported guidelines, employers and healthcare professionals can better accommodate the needs of their employees, fostering an inclusive and supportive work environment. Some examples follow: Recommendation #1: Avoid working for prolonged periods in the same position, whether sitting or standing. During the work shift: a continuous period of time in the standing position should not exceed 1 hour; the total time spent in a standing position should not exceed 4 hours; continuous sitting should be limited to 2 hours; when periods are dedicated to holding meetings, the duration of which should be reasonable, consideration should be given to the possibility of having them while standing or walking (41). Recommendation #2: Take frequent breaks throughout the shift. Please note that he definition of “breaks” must consider the following characteristics: Frequency: number of breaks/interruptions during the working day; Duration: micro-breaks (less than 2 minutes); short breaks (typically those that occur in the morning or afternoon, lasting between 7 and 10 minutes); or long breaks (meal breaks); and Type: passive or resting and active (including stretching or walking) (42). Thus, in an 8-hour working day, a worker should take at least a 7–10-minute break after consecutive 90-minute work periods. Recovery periods can include moments of rest or the performance of any other task to recover the muscle groups that have been worked. Within a period of at least 90 minutes, a worker should enjoy at least 30 seconds after 20 minutes of work. Both recommendations aim to address the prolonged exposure to low-intensity static load by limiting the duration of this exposure. These interventions help to alleviate fatigue and pain symptoms in the short-term, and to prevent work-related musculoskeletal injuries in the long-term. Active breaks add value; however, they do not replace the need to introduce diversity in the intensity of the mechanical load, such as rotational planes suited to the job’s demands (43). Please note that these recommendations refer to low-intensity, physically demanding tasks. Other recommendations apply to high-intensity tasks, such as those involving manual force. Recommendation #3: Physical changes to workstations work surfaces (desks) that allow alternation between standing and sitting, alone or combined with a training and information program for workers, reduce sitting time by approximately 60 minutes per working day (in the medium term, i.e., up to 3-12 months). This change in physical working conditions can bring about a behavioural change, with repercussions in an average reduction of 82 minutes in total sitting time per day (at and away from work) and in the average duration of consecutive periods of sitting (57 minutes) (42, 44). Even though workplace adaptations are consigned in the law, many people living with rheumatic and musculoskeletal diseases report a lack of understanding from their employer(s), colleague(s), and workplace doctor(s). You have options and rights; it is important to understand them and fully explore all available alternatives. If you are unsure about your rights in the workplace, please get in touch with your HR or occupational health department. More information can be found below: The Advisory, Conciliation and Arbitration Service. (ACAS) https://www.acas.org.uk/reasonable-adjustments If you require workplace adaptations, please talk to your assistant doctor about the difficulties you have been feeling and request reports to present to your employer and/or workplace doctor. See related Key Facts section SLEEP Pain, anxiety, and side effects of the medication can make it more difficult for a person with psoriatic arthritis to fall asleep and stay asleep throughout the night. In fact, about 40% of people living with psoriatic arthritis report sleep difficulties (45). Good sleep hygiene habits may help to improve sleep: develop a regular sleep routine, that is, go to bed and get up at a similar time each day; avoid caffeine, alcohol, and large meals before you go to bed; if you smoke, try to stop smoking, or at least do not smoke close to bedtime; a warm bath before bedtime may help ease pain and stiffness; listen to soothing music or sounds before going to bed; avoid watching TV and using computers, tablets, or smartphones in your bedroom; make sure your bedroom is dark, quiet, relaxing, and at a comfortable temperature. h3.2 The impact of exercising before bedtime can vary among individuals. It is essential to listen to your body, establish a consistent routine, and pay attention to how evening workouts affect your sleep patterns. If you have specific concerns about your sleep or exercise routine, it is also advisable to consult with a healthcare professional or a fitness expert. Pros: Improved sleep quality: For some people, engaging in moderate-intensity exercises a few hours before bedtime may promote better sleep quality. It can help reduce stress and anxiety, leading to a more relaxed state conducive to sleep. Body temperature regulation: Exercise increases body temperature, and the subsequent drop in temperature after exercise can signal the body that it is time to sleep. This mimics the natural temperature drop that occurs during the evening. Establishing a routine: Regular exercise, regardless of the time of day, can contribute to better sleep quality. Establishing a consistent exercise routine is often more important than the specific time of day. Cons: Stimulating effect: For some people, intense exercise close to bedtime may have a stimulating effect, making it more challenging to wind down and fall asleep. Body temperature: While the drop in body temperature after exercise can promote sleep, exercising too close to bedtime may disrupt the body’s natural cooling process, potentially interfering with sleep. Individual variability: People respond differently to exercise timing. Some may find that late-night workouts do not impact their sleep, while others may experience difficulties. Recommendations: Timing matters: Try to finish exercising at least 2-3 hours before bedtime to allow your body temperature to return to normal and your adrenaline levels to decrease. Listen to your body: Pay attention to how your body responds to evening workouts. It might be a good fit for you if it helps you relax and improves your sleep. Experiment: Everyone is different. Experiment with varying timings of exercise to see what works best for you. If evening workouts negatively impact your sleep, consider shifting them earlier. Moderation is key: Intense or vigorous exercise close to bedtime might be more likely to interfere with sleep. Opt for moderate-intensity activities in the evening (47). Nearly 50% of patients living with psoriatic arthritis report high levels of fatigue (five or higher on a 10-point scale) and consider fatigue a high-ranking problem, after joint pain and before skin issues (48). See related Key Facts section FATIGUE Problem solving, planning, prioritising, and pacing may help you cope better with your fatigue: PROBLEM SOLVING Identify factors / tasks / chores / activities that are contributing to your fatigue; Think about solutions that could help minimise the impact of these factors/tasks/chores/ activities. PLANNING Plan the tasks/chores/activities you want to complete in a day or week; Make sure to include activities that you enjoy and can improve your mood/wellbeing; Do not beat yourself up if you cannot stick to the plan. PRIORITISING Organise your tasks/chores/activities by order of importance. PACING Do not use your energy all in one go; Break the planned tasks/chores/activities into smaller portions that can be spread out over the course of a day, a week or even longer. See related Key Facts section EMOTIONAL WELLBEING Living with psoriatic arthritis can take a toll on your mental health (49, 50). You need to treat mental health symptoms as seriously as physical symptoms. Poor mental health can cause your psoriatic arthritis to flare, increase pain and fatigue, negatively affect your work and personal relationships, and limit your ability to manage your overall health. If you feel sad, hopeless, and lose interest in things you used to enjoy, talk to your doctor, and let your loved ones know what you are going through. Your doctor may redirect you to useful mental health services such as cognitive behavioural therapy (CBT) and/or they may prescribe you an antidepressant. h3.3 h3.4 Remember that you are not alone. If you need extra support, we are here to help you: NHS Mental Health Services https://www.nhs.uk/nhs-services/mental-health-services/ VERSUS ARTHRITIS / Psoriatic arthritis https://versusarthritis.org/ +44 800 520 0520 Be kind to your joints and your mind. See related Key Facts section See related Key Facts Previous page Next page