Predictors of Early Minimal Disease Activity in Psa Patients Treated with Anti-TNF in a Real-World Registry

Michel Zummer¹, Proton Rahman², Regan Arendse³, Michael Starr⁴, John Kelsall⁵, J Antonio Avina-Zubieta⁶, Philip Baer⁷, Dalton Sholter⁸, Michelle Teo⁹, Emmanouil Rampakakis¹⁰, Eliofotisti Psaradellis¹¹, Brendan Osborne¹², Karina Maslova¹³, Francois Nantel¹⁴, Allen J Lehman¹³ and Cathy Tkaczyk¹², ¹Rheumatology, Hôpital Maisonneuve-Rosemont and University of Montreal, Montreal, QC, Canada, ²Medicine, Memorial University, St John's, NF, Canada, ³University of Saskatchewan, Saskatoon, SK, Canada, ⁴Rheumatology, McGill University, Montreal, QC, Canada, ⁵Mary Pack Arthritis Centre, Vancouver, Vancouver, BC, Canada, ⁶Arthritis Research Canada / University of British Columbia, Vancouver, BC, Canada, ⁷Section on Rheumatology, Ontario Medical Association/Journal of the Canadian Rheumatology Association, Toronto, ON, Canada, ⁸Rheumatology Associates, Edmonton, AB, Canada, ⁹Rheumatology, Penticton Regional Hospital, Penticton, BC, Canada, ¹⁰JSS Medical Research, St-Laurent, QC, Canada, ¹¹JSS Medical Research, Montreal, QC, Canada, ¹²Medical Affairs, Janssen Inc., Toronto, ON, Canada, ¹³Janssen Inc., Toronto, ON, Canada, ¹⁴19 Green belt Dr, Janssen Inc., Toronto, ON, Canada

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: anti-TNF therapy, psoriatic arthritis and registry

Session Information

Date: Tuesday, November 10, 2015

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

Session Type: ACR Poster Session C

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

Background/Purpose: Early achievement of minimal disease activity (MDA) is recommended as a valid treat-to-target approach in psoriatic arthritis (PsA). The purpose of the current analysis was to evaluate predictors of MDA achievement in PsA patients treated with anti-TNF agents in Canadian routine clinical care.

Methods:

Biologic Treatment Registry Across Canada (BioTRAC) is an ongoing, prospective registry of patients initiating treatment for rheumatoid arthritis, ankylosing spondylitis, or PsA with Infliximab (IFX) or Golimumab (GLM). Eligible people for this analysis included PsA patients treated with IFX who were enrolled since 2005 or with GLM enrolled since 2010 and with available MDA information at baseline, 6 months, and/or 12 months. MDA was defined as the fulfillment of ≥5 of the following criteria: TJC28≤1, SJC28≤1, PASI≤1 or BSA≤3, Pain (VAS)≤15mm, PtGA (VAS)≤20mm, HAQ ≤0.5, tender entheseal points ≤1. Independent predictors of MDA achievement were assessed with logistic regression.

Results:

A total of 196 patients (51.4% male and 87.2% bionaive) were included with a mean (SD) age and disease duration of 49.8 (11.1) and 5.4 (6.3) years, respectively. The proportion of patients with MDA was 11.7% at baseline, 43.5% at 6 months, 44.8% at 12 months, and 49.1% at either 6 or 12 months. Among patients with MDA at 6 months, 75.7% had sustained MDA at 12 months. Patients achieving MDA during follow-up had significantly lower disease activity at baseline; mean (SD) disease parameters were: SJC28: 3.24 (3.58) vs. 5.47 (4.31), P<0.001; TJC28: 3.75 (4.00) vs. 8.66 (6.53), P<0.001; pain: 35.39 (25.11) vs. 55.70 (22.93), P<0.001; PtGA: 38.51 (25.00) vs. 56.15 (25.13), P<0.001; HAQ-DI: 0.71 (0.61) vs. 1.33 (0.57), P<0.001; MDGA: 4.25 (2.38) vs. 5.84 (2.07), P<0.001); enthesitis count: 2.62 (1.60) vs. 4.97 (3.48), P=0.008.

Multivariate logistic regression analysis showed that lower baseline HAQ (OR=0.243; P<0.001), lower TJC28 (OR=0.889; P=0.008), and lower enthesitis count (OR=0.817; P=0.817) were significant predictors of MDA achievement over 12 months of treatment.

Conclusion: The results of the current analysis have shown that 50% of patients treated with IFX or GLM in routine clinical care achieve MDA within the first year of treatment. Lower baseline HAQ, lower TJC28, and lower enthesitis count were identified as significant predictors of MDA achievement.

Disclosure: M. Zummer, Janssen Inc, 5; P. Rahman, None; R. Arendse, Janssen Inc., 5; M. Starr, Janssen Inc, 5; J. Kelsall, Janssen Inc., 5; J. A. Avina-Zubieta, Janssen Inc., 5; P. Baer, Janssen Inc., 5,AbbVie, 5,Amgen, 5,BMS, 5,Pfizer Inc, 5,Roche Pharmaceuticals, 5; D. Sholter, Janssen Inc., 5; M. Teo, Janssen Inc., 5; E. Rampakakis, JSS, 3; E. Psaradellis, JSS Medical Research, 3; B. Osborne, Janssen Inc., 3; K. Maslova, Janssen Inc., 3; F. Nantel, Janssen Inc., 3; A. J. Lehman, Janssen Inc., 3; C. Tkaczyk, Janssen Inc., 3.

To cite this abstract in AMA style:

Zummer M, Rahman P, Arendse R, Starr M, Kelsall J, Avina-Zubieta JA, Baer P, Sholter D, Teo M, Rampakakis E, Psaradellis E, Osborne B, Maslova K, Nantel F, Lehman AJ, Tkaczyk C. Predictors of Early Minimal Disease Activity in Psa Patients Treated with Anti-TNF in a Real-World Registry [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/predictors-of-early-minimal-disease-activity-in-psa-patients-treated-with-anti-tnf-in-a-real-world-registry/. Accessed .

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