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Minimal disease activity and anti-tumor necrosis factor therapy in psoriatic arthritis

Amir Haddad1, Arane Thavaneswaran1, Ioana Ruiz-Arruza1

  • 1University of Toronto Psoriatic Arthritis Program and Toronto Western Hospital, Toronto, Ontario, Canada.

Arthritis Care & Research
|December 4, 2014
PubMed
Abstract

Insights

Minimal disease activity (MDA) is achievable in 64% of psoriatic arthritis patients using tumor necrosis factor α (TNFα) blockers. Male sex and normal erythrocyte sedimentation rate (ESR) predict achieving MDA.

Area of Science:

  • Rheumatology
  • Immunology
  • Clinical Medicine

Background:

  • Psoriatic arthritis (PsA) treatment aims for minimal disease activity (MDA).
  • Tumor necrosis factor α (TNFα) blockers are a key therapy for PsA.
  • Understanding predictors of MDA is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To define and validate minimal disease activity (MDA) as a treatment target in psoriatic arthritis (PsA).
  • To identify patient characteristics, outcomes, and predictors of achieving MDA in PsA patients treated with TNFα blockers.

Main Methods:

  • A cohort of PsA patients treated with TNFα blockers was followed over time.
  • MDA was defined as meeting at least 5 out of 7 predefined criteria.
  • Survival analysis was used to identify predictors of MDA, adjusting for clinical factors.

Main Results:

  • 64% of 226 PsA patients achieved MDA within a mean of 1.3 years.
  • Male sex (OR 1.65) and normal erythrocyte sedimentation rate (ESR) (OR 2.27) were significant predictors of achieving MDA.
  • 11.6% of patients maintained MDA after treatment withdrawal or reduction.

Conclusions:

  • Minimal disease activity (MDA) is a feasible treatment target for a majority of psoriatic arthritis patients receiving TNFα blockers.
  • Male gender and a normal ESR are favorable predictors for achieving MDA.
  • A significant proportion of patients can sustain MDA even after reducing or stopping TNFα blocker therapy.

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