PRACA ORYGINALNA
Minimal disease activity and associated factors in patients with psoriatic arthritis: cross-sectional study from a single center
Więcej
Ukryj
1
Division of Rheumatology, Department of Internal Medicine, Istanbul Aydın University, Küçükçekmece/Istanbul, Turkey
2
Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
3
Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Data nadesłania: 25-06-2024
Data ostatniej rewizji: 24-09-2024
Data akceptacji: 13-10-2024
Data publikacji online: 06-11-2024
Autor do korespondencji
Murat Bektas
Division of Rheumatology, Department of Internal Medicine, Istanbul Aydın University, 38 Inonu St., Postal Code: 34295,
Küçükçekmece/Istanbul, Turkey
Reumatologia 2024;62(5):330-337
SŁOWA KLUCZOWE
DZIEDZINY
STRESZCZENIE
Introduction:
Psoriatic arthritis (PsA) is a heterogeneous disease with various manifestations such as dactylitis, enthesitis, spondylitis, and skin involvement. Minimal disease activity (MDA) has been successfully used in daily clinical practice and is considered a reasonable treatment target in patients with PsA. In this study, we aimed to evaluate the MDA status and associated factors in patients with PsA in our tertiary referral clinic.
Material and methods:
This cross-sectional study included patients who met the CASPAR classification criteria and had at least 6 months of follow-up data between 2001 and 2021. Patients who met at least 5 of 7 criteria (tender joint count ≤ 1/68, swollen joint count ≤ 1/66, Psoriasis Area Severity Index [PASI] ≤ 1, Visual Analogue Scale [VAS] ≤ 15, patient global VAS ≤ 20, Health Assessment Questionnaire-Disability Index [HAQ-DI] ≤ 0.5, and enthesitis number ≤ 1) were considered to achieve MDA.
Results:
Data from 172 patients (61% female) were analyzed and included in the study. While most patients had polyarticular involvement (33.7%), mono-oligoarthritis was present in 30.2%, mixed type in 26.2%, isolated distal interphalangeal arthritis in 5.8%, isolated spondylitis in 2.9%, and arthritis mutilans in 1.2%. Overall, 95 (55.2%) of the patients were observed at MDA, which was lower in tumor necrosis factor inhibitor (TNFi) users compared to only conventional synthetic disease-modifying antirheumatic drug users. In univariate analysis, MDA was associated with higher patient age, longer psoriasis duration, late-onset PsA, and continued use of first TNFi. In multivariate analysis, higher patient age, late-onset PsA, and higher continuation rate of first TNFi were associated with MDA.
Conclusions:
In the study, more than half of our patients achieved MDA status. A higher MDA rate was associated with a higher continuation rate at first-line TNFi treatment. The relatively large population who could not reach MDA status in our study indicates an unmet need for monitoring and treatment of PsA.
REFERENCJE (35)
1.
Stolwijk C, Boonen A, van Tubergen A, Reveille JD. Epidemiology of spondyloarthritis. Rheum Dis Clin North Am 2012; 38: 441–476, DOI: 10.1016/j.rdc.2012.09.003.
2.
Eder L, Chandran V, Cook R, Gladman DD. The risk of developing diabetes mellitus in patients with psoriatic arthritis: a cohort study. J Rheumatol 2017; 44: 286–291, DOI: 10.3899/jrheum.160861.
3.
Betteridge N, Boehncke WH, Bundy C, et al. Promoting patient-centred care in psoriatic arthritis: a multidisciplinary European perspective on improving the patient experience. J Eur Acad Dermatol Venereol 2016; 30: 576–585, DOI: 10.1111/jdv.13306.
4.
Kerschbaumer A, Smolen JS, Aletaha D. Disease activity assessment in patients with psoriatic arthritis. Best Pract Res Clin Rheumatol 2018; 32: 401–414, DOI: 10.1016/j.berh.2018.08.004.
5.
Mumtaz A, Gallagher P, Kirby B, et al. Development of a preliminary composite disease activity index in psoriatic arthritis. Ann Rheum Dis 2011; 70: 272–277, DOI: 10.1136/ard.2010.129379.
6.
Helliwell PS, Deodhar A, Gottlieb AB, et al. Composite measures of disease activity in psoriatic arthritis: comparative instrument performance based on the efficacy of guselkumab in an interventional phase II trial. Arthritis Care Res 2020; 72: 1579–1588, DOI: 10.1002/acr.24046.
7.
Ritchlin CT, Kavanaugh A, Gladman DD, et al. Treatment recommendations for psoriatic arthritis. Ann Rheum Dis 2009; 68: 1387–1394, DOI: 10.1136/ard.2008.094946.
8.
Coates LC, Fransen J, Helliwell PS. Defining minimal disease activity in psoriatic arthritis: a proposed objective target for treatment. Ann Rheum Dis 2010; 69: 48–53, DOI: 10.1136/ard.2008.102053..
9.
Mease PJ, Karki C, Liu M, et al. Baseline patient characteristics associated with response to biologic therapy in patients with psoriatic arthritis enrolled in the Corrona Psoriatic Arthritis/Spondyloarthritis Registry. RMD Open 2018; 4: e000638, DOI: 10.1136/rmdopen-2017-000638.
10.
Coates LC, Mease PJ, Gossec L, et al. Minimal disease activity among active psoriatic arthritis patients treated with secukinumab: 2-year results from a multicenter, randomized, double-blind, parallel-group, placebo-controlled phase III study. Arthritis Care Res (Hoboken) 2018; 70: 1529–1535, DOI: 10.1002/acr.23537.
11.
Lee MP, Lii J, Jin Y, et al. Patterns of systemic treatment for psoriatic arthritis in the US: 2004–2015. Arthritis Care Res (Hoboken) 2018; 70: 791–796, DOI: 10.1002/acr.23337.
12.
Ash Z, Gaujoux-Viala C, Gossec L, et al. A systematic literature review of drug therapies for the treatment of psoriatic arthritis: current evidence and meta-analysis informing the EULAR recommendations for the management of psoriatic arthritis. Ann Rheum Dis 2012; 71: 319–326, DOI: 10.1136/ard.2011.150995.
13.
Landewé R, Ritchlin CT, Aletaha D, et al. Inhibition of radiographic progression in psoriatic arthritis by adalimumab independent of the control of clinical disease activity. Rheumatology (Oxford) 2019; 58: 1025–1033, DOI: 10.1093/rheumatology/key417.
14.
Perrotta FM, Lubrano E. Subcutaneous anti-TNF alfa induced sustained minimal disease activity and remission in psoriatic arthritis patients: a retrospective study. Postgrad Med 2016; 128: 693–696, DOI: 10.1080/00325481.2016.1220809.
15.
Taylor W, Gladman D, Helliwell P, et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006; 54: 2665–2673, DOI: 10.1002/art.21972.
16.
Coates LC, Helliwell PS. Validation of minimal disease activity criteria for psoriatic arthritis using interventional trial data. Arthritis Care Res (Hoboken) 2010; 62: 965–969, DOI: 10.1002/acr.20155.
17.
Mease PJ, Heckaman M, Kary S, Kupper H. Application and modifications of minimal disease activity measures for patients with psoriatic arthritis treated with adalimumab: subanalyses of ADEPT. J Rheumatol 2013; 40: 647–652, DOI: 10.3899/jrheum.120970.
18.
Mease PJ, Fleischmann R, Deodhar AA, et al. Effect of certolizumab pegol on signs and symptoms in patients with psoriatic arthritis: 24-week results of a Phase 3 double-blind randomised placebo-controlled study (RAPID-PsA). Ann Rheum Dis 2014; 73: 48–55, DOI: 10.1136/annrheumdis-2013-203696.
19.
Kavanaugh A, van der Heijde D, Beutler A, et al. Radiographic progression of patients with psoriatic arthritis who achieve minimal disease activity in response to golimumab therapy: results through 5 years of a randomized, placebo-controlled study. Arthritis Care Res (Hoboken) 2016; 68: 267–274, DOI: 10.1002/acr.22576.
20.
Theander E, Husmark T, Alenius GM, et al. Early psoriatic arthritis: short symptom duration, male gender and preserved physical functioning at presentation predict favourable outcome at 5-year follow-up. Results from the Swedish Early Psoriatic Arthritis Register (SwePsA). Ann Rheum Dis 2014; 73: 407–413, DOI: 10.1136/annrheumdis-2012-201972.
21.
Kalyoncu U, Bayindir Ö, Ferhat Öksüz M, et al. The psoriatic arthritis registry of Turkey: results of a multicentre registry on 1081 patients. Rheumatology (Oxford) 2017; 56: 279–286, DOI: 10.1093/rheumatology/kew375.
22.
Bakirci S, Solmaz D, Al Osaimi N, et al. What are the main barriers to achieve minimal disease activity in psoriatic arthritis in real life? Clin Exp Rheumatol 2019; 37: 808–812.
23.
Coates LC, Nash P, Kvien TK, et al. Comparison of remission and low disease activity states with DAPSA, MDA and VLDA in a clinical trial setting in psoriatic arthritis patients: 2-year results from the FUTURE 2 study. Semin Arthritis Rheum 2020; 50: 709–718, DOI: 10.1016/j.semarthrit.2020.03.015.
24.
Lubrano E, De Socio A, Perrotta FM. Comparison of composite indices tailored for psoriatic arthritis treated with csDMARD and bDMARD: a cross-sectional analysis of a longitudinal cohort. J Rheumatol 2017; 44: 1159–1164. DOI: 10.3899/jrheum.170112.
25.
Queiro R, Cañete JD, Montilla C, et al. Minimal disease activity and impact of disease in psoriatic arthritis: a Spanish cross-sectional multicenter study. Arthritis Res Ther 2017; 19: 72, DOI: 10.1186/s13075-017-1277-1.
26.
Haddad A, Thavaneswaran A, Ruiz-Arruza I, et al. Minimal disease activity and anti-tumor necrosis factor therapy in psoriatic arthritis. Arthritis Care Res (Hoboken) 2015; 67: 842–847, DOI: 10.1002/acr.22529.
27.
Geijer M, Lindqvist U, Husmark T, et al. The Swedish early psoriatic arthritis registry 5-year followup: substantial radiographic progression mainly in men with high disease activity and development of dactylitis. J Rheumatol 2015; 42: 2110–2117, DOI: 10.3899/jrheum.150165.
28.
Iervolino S, Di Minno MN, Peluso R, et al. Predictors of early minimal disease activity in patients with psoriatic arthritis treated with tumor necrosis factor- blockers. J Rheumatol 2012; 39: 568–573, DOI: 10.3899/jrheum.110763.
29.
Iannone F, Santo L, Anelli MG, et al. Golimumab in real-life settings: 2 years drug survival and predictors of clinical outcomes in rheumatoid arthritis, spondyloarthritis, and psoriatic arthritis. Semin Arthritis Rheum 2017; 47: 108–114, DOI: 10.1016/j.semarthrit.2017.01.008.
30.
Flouri ID, Markatseli TE, Boki KA, et al. Comparative analysis and predictors of 10-year tumor necrosis factor inhibitors drug survival in patients with spondyloarthritis: first-year response predicts longterm drug persistence. J Rheumatol 2018; 45: 785–794, DOI: 10.3899/jrheum.170477.
31.
Perrotta FM, Marchesoni A, Lubrano E. Minimal disease activity and remission in psoriatic arthritis patients treated with anti-TNF- drugs. J Rheumatol 2016; 43: 350–355, DOI: 10.3899/jrheum.150805.
32.
Favalli EG, Becciolini A, Carletto A, et al. Efficacy and retention rate of adalimumab in rheumatoid arthritis and psoriatic arthritis patients after first-line etanercept failure: the FEARLESS cohort. Rheumatol Int 2020; 40: 263–272, DOI: 10.1007/s00296-019-04416-3.
33.
Heiberg MS, Koldingsnes W, Mikkelsen K, et al. The comparative one-year performance of anti-tumor necrosis factor alpha drugs in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: results from a longitudinal, observational, multicenter study. Arthritis Rheum 2008; 59: 234–240, DOI: 10.1002/art.23333.
34.
Coates LC, Cook R, Lee KA, et al. Frequency, predictors, and prognosis of sustained minimal disease activity in an observational psoriatic arthritis cohort. Arthritis Care Res (Hoboken) 2010; 62: 970–976, DOI: 10.1002/acr.20162.
35.
Alharbi S, Ye JY, Lee KA, et al. Remission in psoriatic arthritis: definition and predictors. Semin Arthritis Rheum 2020; 50: 1494–1499, DOI: 10.1016/j.semarthrit.2020.01.012.
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