Baseline Characteristics Associated With Response to Biologic Therapy in PsA

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Almost 25% of patients with psoriatic arthritis attained minimal disease activity with their index biologic therapy at the second follow-up visit.
Almost 25% of patients with psoriatic arthritis attained minimal disease activity with their index biologic therapy at the second follow-up visit.

Almost 25% of patients with psoriatic arthritis (PsA) enrolled in the US-based Corrona Psoriatic Arthritis/Spondyloarthritis Registry attained minimal disease activity (MDA) with their index biologic therapy at the second follow-up visit, according to the results of a study recently published in RMD Open. Several baseline characteristics were similar in patients who achieved and did not achieve MDA, but patients who did not achieve MDA had worse tender joint counts and patient-reported outcomes.

Patients  older than 18 years with PsA were enrolled in the study between March 2013 and March 2016. All participants who were receiving biologic therapy at baseline, were not in MDA, and had ≥2 follow-up visits were included in the study.

Patients were classified as either MDA achievers, defined as participants who remained on their index biologic agent and achieved MDA at the second follow-up visit, or MDA nonachievers, defined as participants who did not achieve MDA at the second follow-up visit. Comparisons between the groups with respect to demographics, clinical characteristics, patient-reported outcomes, and medication history were performed.

In 148 patients with PsA who met study inclusion criteria, 23.0% and 77.0% were classified as MDA achievers and MDA nonachievers, respectively. At baseline, 96.6% of the participants were receiving tumor necrosis factor inhibitors. Both groups were similar in age, gender, race, medication history, enthesitis and dactylitis counts, disease duration, and comorbidities.

Compared with participants who achieved MDA, MDA non-achievers had significantly worse mean tender joint counts (7.2 vs 3.4) patient-reported pain (51.2 vs 35.7) patient-reported fatigue (54.1 vs 42.4); physical function assessed using the Health Assessment Questionnaire (1.0 vs 0.6); Bath Ankylosing Disease Activity Index (5.0 vs 3.4); and Bath Ankylosing Spondylitis Functional Index (4.0 vs 2.0) scores (P< .05 for all).

Patients who did not achieve MDA generally had higher tender joint counts and significantly worse patient-reported outcomes. The investigators concluded that additional studies with larger sample sizes are warranted in order to further explore predictors of biologic response in patients with PsA.

Reference

Mease PJ, Karki C, Liu M, et al. Baseline patient characteristics associated with response to biologic therapy in patients with psoriatic arthritis enrolled in the Corrona Psoriatic Arthritis/Spondyloarthritis Registry. RMD Open. 2018;4(1):e000638.

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