Sustained Very Low Disease Activity and Remission in Psoriatic Arthritis Patients

Abstract Introduction Sustained remission should be considered the main therapeutic target in psoriatic arthritis (PsA). Very low disease activity (VLDA) and a DAPSA score ≤ 4 are the most commonly used criteria. The aim of the present study was to evaluate the rate of sustained remission in a group...

Full description

Bibliographic Details
Main Authors: Ennio Lubrano, Fabio Massimo Perrotta, Silvia Scriffignano, Laura C. Coates, Philip Helliwell
Format: Article
Language:English
Published: Adis, Springer Healthcare 2019-08-01
Series:Rheumatology and Therapy
Subjects:
Online Access:http://link.springer.com/article/10.1007/s40744-019-00171-w
_version_ 1818281622324117504
author Ennio Lubrano
Fabio Massimo Perrotta
Silvia Scriffignano
Laura C. Coates
Philip Helliwell
author_facet Ennio Lubrano
Fabio Massimo Perrotta
Silvia Scriffignano
Laura C. Coates
Philip Helliwell
author_sort Ennio Lubrano
collection DOAJ
description Abstract Introduction Sustained remission should be considered the main therapeutic target in psoriatic arthritis (PsA). Very low disease activity (VLDA) and a DAPSA score ≤ 4 are the most commonly used criteria. The aim of the present study was to evaluate the rate of sustained remission in a group of PsA patients followed in a real-life setting. Methods All PsA patients satisfying CASPAR criteria were followed prospectively every 3–6 months, in a context of clinical practice by January 2013. Sustained remission was defined when patients achieved a DAPSA score ≤ 4 and/or VLDA for at least 12 months. The exclusion criterion was the presence of a condition of VLDA or DAPSA ≤ 4 at the baseline assessment. Kaplan–Meier survival curve was used to evaluate the survival of patients. Results A total of 147 PsA patients were evaluated for the study. Of these, 80 performed at least 12 consecutive months of follow-up. The average duration of follow-up was 24 months (range, 12–60 months). At the last follow-up, 22 patients were on csDMARDs treatment while 58 patients were on bDMARDs. Of the 80 patients, 14 (17.5%) achieved a sustained VLDA while 24 (30%) achieved sustained remission according to the DAPSA criteria. The mean duration of remission in patients achieving VLDA and DAPSA ≤ 4 was 17 months for both criteria. High baseline levels of CRP, shorter disease duration, and less pain at baseline were found to be predictors of sustained VLDA and DAPSA remission. Conclusions In our study, based on clinical practice, a sustained VLDA was achieved in 17.5% and a sustained remission according to the DAPSA criteria in 30% of patients with PsA.
first_indexed 2024-12-13T00:08:03Z
format Article
id doaj.art-4b7d0d8d69e44901bdce5d645213d557
institution Directory Open Access Journal
issn 2198-6576
2198-6584
language English
last_indexed 2024-12-13T00:08:03Z
publishDate 2019-08-01
publisher Adis, Springer Healthcare
record_format Article
series Rheumatology and Therapy
spelling doaj.art-4b7d0d8d69e44901bdce5d645213d5572022-12-22T00:06:08ZengAdis, Springer HealthcareRheumatology and Therapy2198-65762198-65842019-08-016452152810.1007/s40744-019-00171-wSustained Very Low Disease Activity and Remission in Psoriatic Arthritis PatientsEnnio Lubrano0Fabio Massimo Perrotta1Silvia Scriffignano2Laura C. Coates3Philip Helliwell4Dipartimento di Medicina e Scienze, della Salute “Vincenzo Tiberio”, Università degli Studi del MoliseDipartimento di Medicina e Scienze, della Salute “Vincenzo Tiberio”, Università degli Studi del MoliseDipartimento di Medicina e Scienze, della Salute “Vincenzo Tiberio”, Università degli Studi del MoliseDepartment of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of OxfordLeeds Institute of Rheumatic and Musculoskeletal Medicine, University of LeedsAbstract Introduction Sustained remission should be considered the main therapeutic target in psoriatic arthritis (PsA). Very low disease activity (VLDA) and a DAPSA score ≤ 4 are the most commonly used criteria. The aim of the present study was to evaluate the rate of sustained remission in a group of PsA patients followed in a real-life setting. Methods All PsA patients satisfying CASPAR criteria were followed prospectively every 3–6 months, in a context of clinical practice by January 2013. Sustained remission was defined when patients achieved a DAPSA score ≤ 4 and/or VLDA for at least 12 months. The exclusion criterion was the presence of a condition of VLDA or DAPSA ≤ 4 at the baseline assessment. Kaplan–Meier survival curve was used to evaluate the survival of patients. Results A total of 147 PsA patients were evaluated for the study. Of these, 80 performed at least 12 consecutive months of follow-up. The average duration of follow-up was 24 months (range, 12–60 months). At the last follow-up, 22 patients were on csDMARDs treatment while 58 patients were on bDMARDs. Of the 80 patients, 14 (17.5%) achieved a sustained VLDA while 24 (30%) achieved sustained remission according to the DAPSA criteria. The mean duration of remission in patients achieving VLDA and DAPSA ≤ 4 was 17 months for both criteria. High baseline levels of CRP, shorter disease duration, and less pain at baseline were found to be predictors of sustained VLDA and DAPSA remission. Conclusions In our study, based on clinical practice, a sustained VLDA was achieved in 17.5% and a sustained remission according to the DAPSA criteria in 30% of patients with PsA.http://link.springer.com/article/10.1007/s40744-019-00171-wPsoriatic arthritisRemissionVery low disease activity
spellingShingle Ennio Lubrano
Fabio Massimo Perrotta
Silvia Scriffignano
Laura C. Coates
Philip Helliwell
Sustained Very Low Disease Activity and Remission in Psoriatic Arthritis Patients
Rheumatology and Therapy
Psoriatic arthritis
Remission
Very low disease activity
title Sustained Very Low Disease Activity and Remission in Psoriatic Arthritis Patients
title_full Sustained Very Low Disease Activity and Remission in Psoriatic Arthritis Patients
title_fullStr Sustained Very Low Disease Activity and Remission in Psoriatic Arthritis Patients
title_full_unstemmed Sustained Very Low Disease Activity and Remission in Psoriatic Arthritis Patients
title_short Sustained Very Low Disease Activity and Remission in Psoriatic Arthritis Patients
title_sort sustained very low disease activity and remission in psoriatic arthritis patients
topic Psoriatic arthritis
Remission
Very low disease activity
url http://link.springer.com/article/10.1007/s40744-019-00171-w
work_keys_str_mv AT enniolubrano sustainedverylowdiseaseactivityandremissioninpsoriaticarthritispatients
AT fabiomassimoperrotta sustainedverylowdiseaseactivityandremissioninpsoriaticarthritispatients
AT silviascriffignano sustainedverylowdiseaseactivityandremissioninpsoriaticarthritispatients
AT lauraccoates sustainedverylowdiseaseactivityandremissioninpsoriaticarthritispatients
AT philiphelliwell sustainedverylowdiseaseactivityandremissioninpsoriaticarthritispatients