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Prognostic factors for minimal disease activity in early psoriatic arthritis revealed

Presented By
Prof. Tatiana Korotaeva, Nasonova Research Institute of Rheumatology, Russia
EULAR 2021
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)68, 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, Russia) 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 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 of PsA and psoriasis duration were evaluated. Logistic regression analysis was conducted to compare patients who had achieved MDA (n=45) and not achieved MDA (n=32) at 12 months.

The results showed a significant association between achieving MDA at 12 months and baseline for TJC68 (<3; P<0.001), Swollen Joint Count (SJC)66 (<3; P<0.001), pain visual analogue scale (≤15 mm; P<0.001), Patient Global Assessment (PGA) of disease activity (≤20 mm; P<0.001), C-reactive protein (≤5 mg/L; P=0.03), absence of dactylitis (P=0.029), absence of enthesitis (Leeds Enthesitis Index [LEI] and plantar fascia; P=0.003), Health Assessment Questionnaire (HAQ; ≤0.5; P=0.001), absence of nail damage (P=0.012), and fatigue (FACIT>30,  P=0.021). In combination, these features were predictive of reaching MDA in early PsA patients (OR 9.68; 95% CI 4.6–20.4). 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 predict treatment outcomes in clinical practice.”

  1. 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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