Session Information
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose:
The target of treatment in psoriatic arthritis (PsA) should be remission or inactive disease. A potential definition that would fit with the Treat-to-Target Recommendations would be minimal disease activity (MDA) meeting all 7 criteria1, proposed as a definition of very low disease activity (VLDA) in PsA. Patient reported outcomes (PROs), such as those provided by the novel PsAID questionnaire 2, are also important to evaluate healthcare interventions and to reflect the impact of PsA on patients’ lives. The aims of this study were to evaluate the prevalence of VLDA in patients with PsA and how much residual active disease is still present, so as to determine whether PsAID could be an additional useful tool to assess PsA interventions in clinical practice.
Methods:
This was a sub-analysis of the MAAPs study3. Patients were considered in VLDA when they met all the MDA criteria: tender joint count ≤1, swollen joint count ≤1, Psoriasis Area Severity index (PASI) score ≤1 or body surface area ≤3%, patient pain visual analog scale (VAS) score ≤ 15, patient global disease activity VAS score ≤ 20, Health Assessment Questionnaire (HAQ) score ≤ 0.5, and tender entheseal points ≤ 1. Patient acceptable symptoms state (PASS) is considered a PsAID value <4. Comparisons of qualitative variables have been made with the chi-square test or Fisher’s exact test. Comparisons of quantitative variables were made with the Student’s T test or with non-parametric tests if necessary.
Results: 227 patients from 25 Spanish rheumatology departments were included, and among them, 26 (11.5%) were in VLDA. The majority (96.2%) of VLDA patients had a PASS situation while 49.2% of non VLDA patients had a PASS, p<0.001.
|
Variable |
Non-VLDA (n: 201) |
VLDA (n: 26) |
p-values |
|
Age (yrs) Sex (male) Disease duration (yr) Family history (PsA) CHD Obesity CRP (mg/L) Hand erosive disease Foot erosive disease NSAID Corticoids csDMARDs Duration (months) Biologics Duration (months) ETA/ADA HAQ PsAID BASDAI Pain VAS (0-10) Pt. disease activity |
53.1 (12.1) 52.7% 9.6 (7.6) 13.9% 3% 19.4% 3.8 (6.5) 35.8% 29.4% 52.2% 18.9% 77.6% 77.1 (72.2) 47.3% 46.1 (35.5) 64.2% 0.6 (0.5) 5.4 (4.5) 3.0 (2.3) 3.4 (2.7) 3.5 (2.5) |
53.7 (14.4) 65.4% 9.5 (9.1) 0% 11.5% 34.6% 1.9 (1.9) 42.3% 30.8% 34.6% 3.8% 57.7% 38.5 (38.6) 65.4% 43.9 (30.9) 94.2% 0.06 (0.1) 1.1 (1.2) 0.6 (0.6) 0.6 (1.2) 0.5 (0.6)
|
NS NS NS 0.042 0.035 0.074 0.002 NS NS 0.091 0.055 0.027 0.051 0.082 NS 0.027 <0.001 <0.001 <0.001 <0.001 <0.001 |
|
|
|
|
CHD: coronary heart disease. ETA: etanercept. ADA: adalimumab. PsAID: psoriatic arthritis impact of disease. Pt: patient. Values are expressed as percentages and mean (SD).
Conclusion:
11.5% of Spanish PsA patients achieved VLDA state in routine clinical practice. PsA patients who reached this state also had a minimal impact of disease according to PsAID. VLDA state could represent a situation of clinical remission in PsA.
References
1. Coates LC, et al. Ann Rheum Dis 2010; 69(1): 48-53.
2. Gossec L, et al. Ann Rheum Dis 2014; 73(6): 1012-1019.
3. Queiro R, et al. Arthritis Res Ther 2017; 19(1):72.
To cite this abstract in AMA style:
Queiro R, Cañete JD, Montilla-Morales CA, Abad MA, Gomez Castro S, Cabez A. Psoriatic Arthritis Patients Who Attain a Very Low Disease Activity State Have a Minimal Impact of the Disease on Their Lives [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/psoriatic-arthritis-patients-who-attain-a-very-low-disease-activity-state-have-a-minimal-impact-of-the-disease-on-their-lives/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/psoriatic-arthritis-patients-who-attain-a-very-low-disease-activity-state-have-a-minimal-impact-of-the-disease-on-their-lives/