The novel PRESTO tool may be capable of predicting which patients with psoriasis are at high risk of developing psoriatic arthritis, according to a new study published by Eder et al in Arthritis & Rheumatology. Investigators analyzed data from a prospective cohort of 635 patients with psoriasis, all of whom received annual assessments from their rheumatologists. The investigators found that 51 patients and 71 patients developed psoriatic arthritis after a follow-up of 1 year and 5 years, respectively. They reported that younger male patients; those with a family history of psoriasis, back stiffness, nail pitting, and joint stiffness; those who received biologic agents; and those with increased pain severity had a higher risk of developing psoriatic arthritis after 1 year (area under the curve [AUC] = 72.3). Further, morning stiffness, psoriatic nail lesions, psoriasis severity, fatigue, pain, phototherapy, and systemic nonbiologic use were all correlated with a greater risk of developing psoriatic arthritis after 5 years (AUC = 74.9). The investigators noted that the PRESTO tool successfully utilized these clinical variables to predict high-risk patients. In a companion press release from Wiley, publisher of Arthritis & Rheumatology, the study authors concluded: “PRESTO can be used to enrich prevention trials, … identify patients with psoriasis who can benefit from early treatments, and … serve as an educational tool for patients to increase awareness of psoriatic arthritis risk.”