Minimal disease activity in psoriatic arthritis patients using TNFα blockers

[Fred]

This study looked at the Minimal disease activity (MDA) in patients with psoriatic arthritis that are being treated with TNFα blockers, MDA is a concept that has been defined by the Outcome Measures in Rheumatology (OMERACT) as a state of disease activity deemed a useful target of treatment by both the patient and physician.

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Objective:
A state of minimal disease activity (MDA) was defined and validated as target for treatment in psoriatic arthritis (PsA). We aimed to identify disease characteristics, outcome, and predictors of MDA in patients treated with tumor necrosis factor α (TNFα) blockers.

Methods:
Patients fulfilling the Classification of Psoriatic Arthritis criteria treated with TNFα blockers were followed every 3–6 months. Patients were considered in MDA when they meet at least 5 of the 7 criteria. Sustained MDA was defined as an MDA state lasting ≥12 months. Patients achieving MDA were compared to non-MDA patients. A proportional odds discrete time survival analysis model was applied, adjusting for sex, age, PsA duration, abnormal erythrocyte sedimentation rate (ESR) and clinically damaged joint count at each visit to identify predictors for MDA.

Results:
Of the 306 patients treated with TNFα blockers identified from our database, 23 patients were in an MDA state when treatment was commenced; 57 were taking TNFα blockers prior to enrollment. Therefore, 226 subjects were in a non-MDA state and constituted the study population. One hundred forty-five patients of 226 patients (64%) achieved MDA within a mean ± SD duration of 1.30 ± 1.68 years. The mean ± SD duration of MDA was 3.46 ± 2.25 years. At total of 17 patients withdrew from therapy and remained in an MDA state. Male sex (odds ratio [OR] 1.65, 95% confidence interval [95% CI] 1.08–2.53; P = 0.02) and normal ESR (OR 2.27, 95% CI 1.22–4.17; P = 0.009) increased the odds for achieving MDA.

Conclusion:
MDA is achieved in 64% of patients treated with TNFα blockers in a clinical setting. Male sex and normal ESR are predictors for MDA. On withdrawal or reduction in treatment, 11.6% of patients maintained MDA state.

Source: onlinelibrary.wiley.com

*Funding:
Arthritis Society, Canadian Institutes of Health Research
Krembil Foundation
Janssen
UCB

[jiml]

Very interesting reading , but there's always a but.....with such a small number is patients studied 226 patients I think a study like this to have real value would need to encompass a much larger number of patients to have any real meaning

[Quest4Cure]

Very interesting reading , but there's always a but.....with such a small number is patients studied 226 patients  I think a study like this to have real value would need to encompass a much larger number of patients to have any real meaning

Very true. And sometimes it depends on those whose P. Is only seasonal... Like mine.... All winter....