Cargando…

Real-world validation of the minimal disease activity index in psoriatic arthritis: an analysis from a prospective, observational, biological treatment registry

OBJECTIVE: To describe the minimal disease activity (MDA) rate over time in patients with psoriatic arthritis (PsA) receiving antitumour necrosis factor agents, evaluate prognostic factors of MDA achievement and identify the most common unmet criteria among MDA achievers. DESIGN: Biologic Treatment...

Descripción completa

Detalles Bibliográficos
Autores principales: Rahman, Proton, Zummer, Michel, Bessette, Louis, Baer, Philip, Haraoui, Boulos, Chow, Andrew, Kelsall, John, Kapur, Suneil, Rampakakis, Emmanouil, Psaradellis, Eliofotisti, Lehman, Allen J, Nantel, Francois, Osborne, Brendan, Tkaczyk, Cathy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5629663/
https://www.ncbi.nlm.nih.gov/pubmed/28855200
http://dx.doi.org/10.1136/bmjopen-2017-016619
_version_ 1783269090334343168
author Rahman, Proton
Zummer, Michel
Bessette, Louis
Baer, Philip
Haraoui, Boulos
Chow, Andrew
Kelsall, John
Kapur, Suneil
Rampakakis, Emmanouil
Psaradellis, Eliofotisti
Lehman, Allen J
Nantel, Francois
Osborne, Brendan
Tkaczyk, Cathy
author_facet Rahman, Proton
Zummer, Michel
Bessette, Louis
Baer, Philip
Haraoui, Boulos
Chow, Andrew
Kelsall, John
Kapur, Suneil
Rampakakis, Emmanouil
Psaradellis, Eliofotisti
Lehman, Allen J
Nantel, Francois
Osborne, Brendan
Tkaczyk, Cathy
author_sort Rahman, Proton
collection PubMed
description OBJECTIVE: To describe the minimal disease activity (MDA) rate over time in patients with psoriatic arthritis (PsA) receiving antitumour necrosis factor agents, evaluate prognostic factors of MDA achievement and identify the most common unmet criteria among MDA achievers. DESIGN: Biologic Treatment Registry Across Canada (BioTRAC): ongoing, prospective registry of patients initiating treatment for rheumatoid arthritis, ankylosing spondylitis or PsA with infliximab (IFX), golimumab (GLM) or ustekinumab. SETTING: 46 primary-care Canadian rheumatology practices. PARTICIPANTS: 223 patients with PsA receiving IFX (enrolled since 2005) and GLM (enrolled since 2010) with available MDA information at baseline, 6 months and/or 12 months. PRIMARY AND SECONDARY OUTCOME MEASURES: MDA was defined as ≥5 of the following criteria: 28-item tender joint count (TJC28) ≤1, 28-item swollen joint count (SJC28) ≤1, Psoriasis Area and Severity Index (PASI) ≤1 or body surface area≤3, Pain Visual Analogue Scale (VAS) ≤15 mm, patient’s global assessment (PtGA) (VAS) ≤20 mm, Health Assessment Questionnaire (HAQ) ≤0.5, tender entheseal points ≤1. Independent prognostic factors of MDA achievement were assessed with multivariate logistic regression. RESULTS: MDA was achieved by 11.7% of patients at baseline, 43.5% at 6 months, 44.8% at 12 months and 48.8% at either 6 or 12 months. Among MDA achievers at 6 months, 75.7% had sustained MDA at 12 months. Lower baseline HAQ (OR=0.210; 95% CI: 0.099 to 0.447) and lower TJC28 (OR=0.880; 95% CI: 0.804 to 0.964), were significant prognostic factors of MDA achievement over 12 months of treatment. The most commonly unmet MDA criteria among MDA achievers was patient reported pain (25%), PtGA (15%) and PASI (12%). CONCLUSIONS: Almost 50% of patients treated with IFX or GLM in routine clinical care achieved MDA within the first year of treatment. Lower baseline HAQ and lower TJC28, were identified as significant prognostic factors of MDA achievement. The most commonly unmet criteria in patients who achieved MDA were pain, PtGA and PASI. TRIAL REGISTRATION NUMBER: BioTRAC (NCT00741793).
format Online
Article
Text
id pubmed-5629663
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-56296632017-10-11 Real-world validation of the minimal disease activity index in psoriatic arthritis: an analysis from a prospective, observational, biological treatment registry Rahman, Proton Zummer, Michel Bessette, Louis Baer, Philip Haraoui, Boulos Chow, Andrew Kelsall, John Kapur, Suneil Rampakakis, Emmanouil Psaradellis, Eliofotisti Lehman, Allen J Nantel, Francois Osborne, Brendan Tkaczyk, Cathy BMJ Open Rheumatology OBJECTIVE: To describe the minimal disease activity (MDA) rate over time in patients with psoriatic arthritis (PsA) receiving antitumour necrosis factor agents, evaluate prognostic factors of MDA achievement and identify the most common unmet criteria among MDA achievers. DESIGN: Biologic Treatment Registry Across Canada (BioTRAC): ongoing, prospective registry of patients initiating treatment for rheumatoid arthritis, ankylosing spondylitis or PsA with infliximab (IFX), golimumab (GLM) or ustekinumab. SETTING: 46 primary-care Canadian rheumatology practices. PARTICIPANTS: 223 patients with PsA receiving IFX (enrolled since 2005) and GLM (enrolled since 2010) with available MDA information at baseline, 6 months and/or 12 months. PRIMARY AND SECONDARY OUTCOME MEASURES: MDA was defined as ≥5 of the following criteria: 28-item tender joint count (TJC28) ≤1, 28-item swollen joint count (SJC28) ≤1, Psoriasis Area and Severity Index (PASI) ≤1 or body surface area≤3, Pain Visual Analogue Scale (VAS) ≤15 mm, patient’s global assessment (PtGA) (VAS) ≤20 mm, Health Assessment Questionnaire (HAQ) ≤0.5, tender entheseal points ≤1. Independent prognostic factors of MDA achievement were assessed with multivariate logistic regression. RESULTS: MDA was achieved by 11.7% of patients at baseline, 43.5% at 6 months, 44.8% at 12 months and 48.8% at either 6 or 12 months. Among MDA achievers at 6 months, 75.7% had sustained MDA at 12 months. Lower baseline HAQ (OR=0.210; 95% CI: 0.099 to 0.447) and lower TJC28 (OR=0.880; 95% CI: 0.804 to 0.964), were significant prognostic factors of MDA achievement over 12 months of treatment. The most commonly unmet MDA criteria among MDA achievers was patient reported pain (25%), PtGA (15%) and PASI (12%). CONCLUSIONS: Almost 50% of patients treated with IFX or GLM in routine clinical care achieved MDA within the first year of treatment. Lower baseline HAQ and lower TJC28, were identified as significant prognostic factors of MDA achievement. The most commonly unmet criteria in patients who achieved MDA were pain, PtGA and PASI. TRIAL REGISTRATION NUMBER: BioTRAC (NCT00741793). BMJ Publishing Group 2017-08-30 /pmc/articles/PMC5629663/ /pubmed/28855200 http://dx.doi.org/10.1136/bmjopen-2017-016619 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Rheumatology
Rahman, Proton
Zummer, Michel
Bessette, Louis
Baer, Philip
Haraoui, Boulos
Chow, Andrew
Kelsall, John
Kapur, Suneil
Rampakakis, Emmanouil
Psaradellis, Eliofotisti
Lehman, Allen J
Nantel, Francois
Osborne, Brendan
Tkaczyk, Cathy
Real-world validation of the minimal disease activity index in psoriatic arthritis: an analysis from a prospective, observational, biological treatment registry
title Real-world validation of the minimal disease activity index in psoriatic arthritis: an analysis from a prospective, observational, biological treatment registry
title_full Real-world validation of the minimal disease activity index in psoriatic arthritis: an analysis from a prospective, observational, biological treatment registry
title_fullStr Real-world validation of the minimal disease activity index in psoriatic arthritis: an analysis from a prospective, observational, biological treatment registry
title_full_unstemmed Real-world validation of the minimal disease activity index in psoriatic arthritis: an analysis from a prospective, observational, biological treatment registry
title_short Real-world validation of the minimal disease activity index in psoriatic arthritis: an analysis from a prospective, observational, biological treatment registry
title_sort real-world validation of the minimal disease activity index in psoriatic arthritis: an analysis from a prospective, observational, biological treatment registry
topic Rheumatology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5629663/
https://www.ncbi.nlm.nih.gov/pubmed/28855200
http://dx.doi.org/10.1136/bmjopen-2017-016619
work_keys_str_mv AT rahmanproton realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT zummermichel realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT bessettelouis realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT baerphilip realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT haraouiboulos realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT chowandrew realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT kelsalljohn realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT kapursuneil realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT rampakakisemmanouil realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT psaradelliseliofotisti realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT lehmanallenj realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT nantelfrancois realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT osbornebrendan realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry
AT tkaczykcathy realworldvalidationoftheminimaldiseaseactivityindexinpsoriaticarthritisananalysisfromaprospectiveobservationalbiologicaltreatmentregistry