Janssen Introduces DETECT App to Help in PAH-SSc Screening - Rheumatology Advisor
Content Sponsored by Janssen US Pulmonary Hypertension
On behalf of Janssen, I would like to extend my appreciation to all healthcare providers (HCPs) working to ensure patients receive the essential care they need during these challenging times, especially those with progressive diseases such as pulmonary arterial hypertension (PAH) and who are committed to caring for people living with this rare disease.
In the year that I have been leading the Janssen Pulmonary Hypertension team in the US, I am proud of the advances we have made in developing tools and resources to help raise awareness of screening and facilitate assessment of PAH in patients at risk. Our aim is to support clinicians tasked with identifying and diagnosing people living with PAH. One such tool is the development of the DETECT Screening Tool app to help identify people who may be at a higher risk of PAH.
As rheumatologists, you understand that patients with systemic sclerosis (SSc), a form of connective tissue disease, are at risk of developing PAH and that PAH has been reported as the leading cause of death among those with SSc.1 Sadly, the prognosis for these individuals can be poor, often due to a delay in diagnosis. 1 Echocardiograms (ECGs) are frequently used to help identify PAH in patients with SSc,2 and resting ECGs are recommended as a screening test in asymptomatic patients with SSc.2 However, ECGs alone are not sufficient to screen for mild or asymptomatic PH or to support a treatment decision.2
To assess the validity of other screening measures, Janssen funded and supported the international DETECT study.3Sixty-two experienced centers (managing at least 40 SSc patients) from 18 countries in North America, Europe and Asia participated in the study between 2008 and 2011.3 Adults with SSc at increased risk of PAH underwent a broad panel of noninvasive assessments followed by diagnostic right heart catheterization (RHC), 3 required for PAH diagnosis.
Outcomes from this multicenter study comparing assessment of various clinical variables used to determine identification for RHC led to Janssen supporting and funding the DETECT algorithm. The study suggests that use of this algorithm may reduce missed PAH-SSc diagnoses.3 The DETECT algorithm had a 4% (n=3) rate of missed PAH diagnoses compared with 29% (n=24) using the 2015 ESC/ERS Guidelines.3
Knowing this, we wanted to take it one step further. This evidence from the DETECT study presented an opportunity to create a practical tool based on the algorithm that HCPs can implement within their daily clinical practice. With the continuing increase in use of technology such as smartphones and tablets in clinical settings, Janssen developed the DETECT Screening Tool app, an interactive screening tool in the form of an app based on the DETECT algorithm. It is available for download for free via the Apple App Store and Google Play. The DETECT screening tool is designed to assist physicians screening patients with SSc with the goal of providing a recommendation as to which patients should be referred to ECG as a first step, and if applicable, for RHC as a second step for the diagnosis of PAH. The app can help HCPs identify patients with SSc who are at risk of developing PAH and may reduce potential missed PAH diagnoses.4 The DETECT PAH algorithm is limited for use only by specialists who are treating SSc, and who are familiar with PAH as a complication of SSc. It is not intended to replace the medical or professional judgment of healthcare providers. Healthcare professionals using the tool should exercise clinical judgment as to the information they provide to the patient based upon the tool.
Janssen takes pride in developing tools and resources that have the potential to help clinicians in their identification of patients at risk for PAH and to inform their treatment decisions. Clinicians interested in learning more about the DETECT algorithm and incorporating the free DETECT Screening Tool app into their practice can find information at SuspectPAHCTD.com.
Reference List:
1. Kolstad KD, Li S, Steen V, Chung L; PHAROS Investigators. Long-term outcomes in systemic sclerosis-associated pulmonary arterial hypertension from the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma Registry (PHAROS). Chest. 2018;154:862-871.
2. Galiè N, Humbert M, Vachiery J-L, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Eur Respir J. 2015;46(4):903-975.
3. Coghlan JG, Denton CP, Grünig E, et al; DETECT study group. Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study. Ann Rheum Dis. 2014;73:1340-1349.
4. Mandras SA, Ventura HO, Corris PA. Breaking down the barriers: why the delay in referral for pulmonary arterial hypertension? Ochsner J. 2016;16(3):257-262.
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