ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2766

The Predictive Value of Patient’s and Evaluator’s Global Assessment and Tender and Swollen Joint Count Differences on Treatment Efficacy in Psoriatic Arthritis: Data from a Longitudinal Multicenter Study

Brigitte Michelsen1,2, Eirik K Kristianslund1, Hilde B Hammer3, Karen M Fagerli1, Elisabeth Lie1, Glenn Haugeberg4,5 and Tore K Kvien1, 1Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 2Dept. of Rheumatology, Hospital of Southern Norway Trust, Kristiansand, Norway, 3Dept of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 4Dept. of Rheumatology, Martina Hansens Hospital, Bærum, Norway, 5Dept. of Rheumatology, The Norwegian University of Science and Technology, Trondheim, Norway

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords:

Session Information

Date: Tuesday, November 15, 2016

Title: Spondylarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment - Poster III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Discordance between patient’s and physician’s evaluation of disease activity may be challenging in psoriatic arthritis (PsA). The potential impact of such a difference on treatment outcome is to date unexplored. In this study we aimed to investigate the predictive value of baseline patient’s and evaluator’s global assessment difference (deltaPEG) as well as tender and swollen joint count difference (deltaTSJ) for achievement of remission in PsA.

Methods: From the prospective, multicenter NOR-DMARD study we included PsA patients starting first-time tumor necrosis factor inhibitors (TNFi) and DMARD naïve patients starting methotrexate between 2000 and 2012. The predictive value of deltaPEG and deltaTSJ on remission, defined by various criteria, was explored in prespecified logistic regression models adjusted for age, sex, disease duration and smoking.

Results: A total of 1236 PsA patients were included (mean (SD) age 48.3 (12.4) years, disease duration 4.8 (7.5) years, 48.4% females, 29.8% current smokers, baseline mean (SD) evaluator’s global assessment 34.1 (16.6), patient’s global assessment 51.1 (22.6), deltaPEG 17.0 (24.3), median (IQR) 32 tender joint count 5 (8), 32 swollen joint count 3 (5), deltaTSJ 1 (5), DAS28ESR 4.2 (1.3), baseline median (IQR) SDAI 16.9 (12.8), CDAI 8.6 (10.3), modified DAPSA 21.0 (14.1) (including 32 instead of the original 66/68 joint count). Bar charts of percentages of PsA patients in remission at 6 months according to categorization of deltaPEG and deltaTSJ into quartiles showed reduced probability of remission with increasing deltaPEG and deltaTSJ (unadjusted values; figures).

Baseline deltaPEG and deltaTSJ predicted DAS28<2.6, SDAI≤3.3, CDAI≤2.8, ACR/EULAR Boolean and DAPSA<4 remission after 3 and 6 months, except for deltaPEG and DAS28 remission at 6 months (adjusted analyses; table).  

  Months DAS28ESR < 2.6 SDAI ≤ 3.3 CDAI ≤ 2.8 ACR/EULAR Boolean DAPSA < 4
deltaTSJ 3 0.92 [0.89, 0.96] p<0.001 0.91 [0.86, 0.95] p<0.001 0.93 [0.89, 0.97] p=0.001 0.93 [0.88, 0.98] p=0.004 0.91 [0.86, 0.95] p<0.001
6 0.94 [0.90, 0.97] p=0.001 0.94 [0.90, 0.98] p=0.003 0.93 [0.89, 0.97] p=0.001 0.92 [0.88, 0.97] p=0.002 0.93 [0.89, 0.98] p=0.002
deltaPEG 3 0.89 [0.84, 0.94] p<0.001 0.98 [0.98, 0.99] p<0.001 0.99 [0.98, 0.995] p=0.001 0.99 [0.98, 0.99] p=0.001 0.99 [0.98, 0.995] p=0.002
6 1.00 [0.99, 1.01] p=0.94 0.99 [0.98, 0.995] p=0.001 0.99 [0.98, 0.99] p<0.001 0.98 [0.97, 0.99] p<0.001 0.99 [0.98, 0.99] p=0.001

Data are presented as OR [95% CI]  

Conclusion: DeltaPEG and deltaTSJ constitute new and important predictors of treatment efficacy in PsA and may be considered in the shared decision of a target in a treat-to-target strategy.  

Disclosure: B. Michelsen, None; E. K. Kristianslund, None; H. B. Hammer, None; K. M. Fagerli, None; E. Lie, None; G. Haugeberg, None; T. K. Kvien, Biogen, BMS, Boehringer Ingelheim, Celltrion, Eli Lilly, Epirus, Hospira, Merck-Serono, Novartis, Orion Pharma, Prizer, Sandoz, UCB, 5.

To cite this abstract in AMA style:

Michelsen B, Kristianslund EK, Hammer HB, Fagerli KM, Lie E, Haugeberg G, Kvien TK. The Predictive Value of Patient’s and Evaluator’s Global Assessment and Tender and Swollen Joint Count Differences on Treatment Efficacy in Psoriatic Arthritis: Data from a Longitudinal Multicenter Study [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/the-predictive-value-of-patients-and-evaluators-global-assessment-and-tender-and-swollen-joint-count-differences-on-treatment-efficacy-in-psoriatic-arthritis-data-from-a-longitudina/. Accessed .

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