PsA Disease Activity Often Persists, Despite Treatment

Almost two-thirds patients with psoriatic arthritis (PsA) have persistent disease despite regular rheumatology care, according to the results of a recent study.

With the expansion of therapeutic possibilities for PsA, it will become increasingly important to identify residual disease and when to adjust treatment, the researchers noted. They conducted a cross-sectional study in which disease activity and treatment decisions were scored prospectively in 142 consecutive PsA patients who visited an outpatients clinic for routine follow-up. Disease activity parameters were scored by patient and rheumatologist.
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Overall, two-thirds of the patients (90/142) had remaining disease activity (determined by joint disease and pain) despite treatment, and 46% of these patients had moderate to high disease activity, according to the clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA).

Among those with residual disease activity, 74% had been treated with conventional synthetic disease-modifying anti-rheumatic drug only or with a first TNF-inhibiting biological agent, which suggested opportunities for treatment modification, according to the researchers. However, treatment modification was initiated in only 23% of those with residual disease activity.

“Remaining disease activity is present in almost two-thirds of patients with PsA when scored by the treating rheumatologist, but triggers treatment adjustment in only a minority. Further research to understand why disease activity does not lead to treatment adjustment is required to enable implementation of treatment strategies in clinical practice.”

—Michael Potts

Reference:

Van Mens LJJ, van de Sande MGH, Fluri IA, et al. Residual disease activity and treatment adjustments in psoriatic arthritis in current clinical practice [published online October 10, 2017]. Arth Res Ther. https://doi.org/10.1186/s13075-017-1424-8.