Prognostic factors for minimal disease activity in early psoriatic arthritis revealed

MDA following a treat-to-target strategy in early PsA can be predicted by a combination of factors, including Tender Joint Count, PGA of disease activity, pain, and the absence of enthesitis and dactylitis.

Paying attention to prognostic factors can help therapy outcome prediction, and manage patient expectations

Minimal disease activity (MDA) following a treat-to-target (T2T) strategy in early psoriatic arthritis (PsA) can be predicted by a combination of factors, including Tender Joint Count (TJC), patient global assessment (PGA) of disease activity, pain, and the absence of enthesitis and dactylitis. As a consequence, these prognostic factors could be useful in predicting therapy outcomes and managing patient expectations in early PsA patients.

Prof. Tatiana Korotaeva (Nasonova Research Institute of Rheumatology, Russian Federation) emphasised that this is the first study to investigate prognostic factors for MDA in early PsA following a T2T strategy. Early PsA patients (n=77, mean age 36.9) were given methotrexate therapy for 12 months. Biologic disease-modifying anti-rheumatic drugs (DMARDs) were added for 29 patients between 3 and 9 months due to therapy ineffectiveness. At baseline and after 12 months of therapy, disease activity and the disease characteristics PsA duration and psoriasis duration were evaluated.

A combination of features helped in the prediction of MDA

Logistic regression analysis was conducted to compare patients who had achieved MDA (n=45) at 12 months with patients who had not reached MDA (n=32) at this point in time. The results showed that baseline scores of TJC, Swelling Joint Count (SJC), pain, PGA, C-reactive protein, dactylitis, enthesitis (Leeds Enthesitis Index [LEI] and plantar fascia), body surface area, Health Assessment Questionnaire (HAQ) and fatigue were significantly associated with achieving MDA at 12 months of therapy.

In combination, these features were predictive of reaching MDA in early PsA patients (OR 9.68). Prof. Korotaeva stressed that these results could have clinical value: “The prognostic factors revealed in this study should be taken into account when assessing an early PsA patient, because it helps us to predict treatment outcomes in clinical practice.”

Loginova EY, et al. Prognostic factors associated with achieving minimal disease activity in early psoriatic arthritis patients treated according to treat to target strategy. POS0192, EULAR 2021 Virtual Congress, 2-5 June.

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