Sustained very low disease activity and remission in psoriatic arthritis patients

<p><strong>Introduction:</strong><br /> 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...

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Bibliographic Details
Main Authors: Lubrano, E, Perrotta, F, Scriffignano, S, Coates, L, Helliwell, P
Format: Journal article
Language:English
Published: Springer 2019
Description
Summary:<p><strong>Introduction:</strong><br /> 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.</p><br /> <p><strong>Methods:</strong><br /> 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.</p><br /> <p><strong>Results:</strong><br /> 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.</p><br /> <p><strong>Conclusions:</strong><br /> 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.ith PsA.</p>