A 2-year observational study on treatment targets in psoriatic arthritis patients treated with TNF inhibitors

Clinical Rheumatology | September 13, 2017

Chimenti MS, et al. - The specialists undertook this work to analyze clinical remission and minimal disease activity (MDA) in psoriatic arthritis (PsA) patients who started TNF-inhibitors (TNFi) treatment with a 2-year follow-up. Outcomes approved that TNFi was highly effective in achieving treatment targets in PsA patients. Moreover, DAS28, CPDAI, DAPSA, and MDA displayed a good agreement. However, female sex and metabolic syndrome (MetS) were associated with a lower probability to achieve remission in PsA patients.

Methods

  • In this study, concomitant therapies as well as comorbidities were evaluated.
  • Level of concordance of clinimetric indices and the potential predictive factors of remission/MDA were also explored.
  • In PsA patients at baseline (T0) and after 22 (T22), 54 (T54), and 102 (T102) weeks of treatment, clinical and laboratory evaluations were performed.
  • Disease activity and disability were evaluated using DAS28, CPDAI, DAPSA, MDA, and HAQ-SpA. 
  • The Pearson correlation coefficient, univariate, and multivariate binary logistic regression were performed.

Results

  • This study enrolled 221 PsA patients.
  • Cardiovascular diseases and metabolic syndrome (MetS) resulted as the most frequent comorbidities. 
  • Over a half of the patients clinical remission was achieved, during the follow-up. 
  • During the follow-up, use of concomitant therapies, such as csDMARDs and steroids, was significantly reduced.
  • Agreement among indices of treatment targets by k-statistics was excellent for CPDAI and DAPSA and good for MDA and DAS28 or DAPSA.
  • Female sex and MetS resulted as negative prognostic factors of clinical remission and MDA at all the time points. 

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