How Do You Interpret Radiographic Progression Using Modified-vdHS or mTSS?

Join Kyle George, PA-C, a rheumatology expert in Idaho, as he breaks down two key radiographic scoring systems for psoriatic arthritis (PsA)—the Modified van der Heijde Sharp Score (mVHS) and the Modified Total Sharp Score (MTSS). These tools help clinicians assess structural damage, track disease progression, and guide treatment decisions.

The mVHS score evaluates joint erosion, joint space narrowing, and periarticular changes, providing a comprehensive view of disease impact. Meanwhile, the MTSS score focuses specifically on bone erosions and joint space narrowing, offering a more targeted measure of progression. By understanding these scoring methods, providers can monitor long-term joint health and adjust therapies accordingly.

The Apex Study, a Phase 3B clinical trial, is further investigating the efficacy of Guselkumab (Tremfya®) in PsA, using mVHS to measure radiographic progression. This builds on findings from the Discover-2 trial, which showed minimal joint damage progression with Guselkumab treatment. As evidence grows for IL-23 inhibition in protecting joint integrity, radiographic monitoring remains essential in optimizing PsA management.

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