Session Information
Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose:
Several disease activity measures were
developed for use in psoriatic arthritis (PsA) .
Little data is available on their performance in usual care. This study aims to
describe longitudinal evolution of the PASDAS, CPDAI and MDA in the first 6
months after treatment start and in addition treatment initiation and disease
characteristics at baseline.
Methods:
Data was used from PsA
patients participating in the ongoing DEPAR cohort in 11 Dutch hospitals in the
period August 2013 to May 2015. Data was analyzed using a linear mixed model to
evaluate PASDAS (0-10) and CPDAI (0-15) over time and descriptives
were used to summarize patient characteristics and treatment and % of patients
achieving MDA (5 out of 7 domains).
Results:
Untill May 2015 213
patients had had a baseline assessment, 177 had a 3 months and 139 a 6 months
assessment. 52% were male; the mean age was 50.3 years (sd 21.7). Mono-, oligo-, and polyarthritis were
present in 21% (48.9 sd
12.9; 51% male), 38% (48.8 sd 13.6; 61% male) and 33%
(53.7 sd 14.3; 48% male), respectively. 6.5% was
diagnosed with enthesitis and 1.5% with axial disease
only. Methotrexate was started in 110 patients (51.6%), while 11 patients (6.1%)
received prednisone monotherapy (IA or IM), Sulfasalazine was given to 5
patients (2.3%) and 9 patients used other DMARDS (4.6%; 4 used a biological at
baseline due to skin disease). Further
baseline details are presented in table 1. At baseline PASDAS scored 2.6 (sd 0.70; n=115), CPDAI 5.9 (sd2.9;
n=113) and MDA was present in 13 patients (9%; n=145). Over time all measures
decreased, see figure 1. At 3 months low PASDAS(<=3.2)
was achieved by 95% of the patients, low CPDAI(<=4) by 51% and MDA by 23%
and at 6 months this was 97%, 54% and 24%, respectively.
Conclusion:
Methotrexate was the most common DMARD
initiated after diagnosis of Psoriatic Arthritis. MDA evolution over time seems
the most stringent criterion to guide treatment on compared to the PASDAS and
CPDAI in a real world early Psoriatic Arthritis Cohort. Further evaluation of
these measures is needed to assess the impact on patient’s quality of life and
radiological progression.
Table 1
Baseline disease characteristics of DEPAR patients (n=213)
LINK Excel.Sheet.12 "Book1"
"Sheet2!R4C3:R26C6" a f 5 h
* MERGEFORMAT
|
Disease characteristic
|
Patients (n=)
|
Mean / % |
sd |
|
Tender Joint Count
|
212
|
5.41 |
7.15 |
|
Swollen Joint Count
|
212
|
3.44 |
5.76 |
|
|
|
|
|
|
Dactylitis (%) |
212
|
24% |
|
|
Enthesitis (LEI and MASES)
|
213
|
0.56 |
1.12 |
|
Lei |
213
|
0.65 |
1.06 |
|
PASI |
211
|
5.71 |
8.54 |
|
CRP (median; IQR)
|
168
|
5 |
2-9 |
|
DLQI |
181
|
3.43 |
4.43 |
|
HAQ |
184
|
0.65 |
0.52 |
|
Bodily Pain (SF36)
|
176
|
50 |
18.21 |
|
Physical functioning (SF36)
|
175
|
40.87 |
8.65 |
|
Mental functioning (SF36)
|
175
|
47.52 |
10.66 |
|
VAS global
|
172
|
42.86 |
26.34 |
|
VAS joints |
172
|
43.21 |
27.32 |
|
VAS psoriasis |
172
|
30.64 |
28.07 |
|
VAS pain
|
146
|
45.12 |
27.02 |
|
PASDAS |
115
|
2.09 |
0.86 |
|
CPDAI |
175
|
5.9 |
2.31 |
|
MDA (%) |
145
|
9% |
|
To cite this abstract in AMA style:
Luime J, Tchetverikov I, Vis M, Appels C, van der Graaff W, Veris J, Gerards A, van Groenendaal H, Kok M, Korswagen LA, Stolk C. Pasdas, Cpdai and MDA Evolution in the First 6 Months after Diagnosis of Early Psoriatic Arthritis Patients: Results of the Depar Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/pasdas-cpdai-and-mda-evolution-in-the-first-6-months-after-diagnosis-of-early-psoriatic-arthritis-patients-results-of-the-depar-study/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/pasdas-cpdai-and-mda-evolution-in-the-first-6-months-after-diagnosis-of-early-psoriatic-arthritis-patients-results-of-the-depar-study/