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Subcutaneous anti-TNF alfa induced sustained minimal disease activity and remission in psoriatic arthritis patients:
Fabio Massimo Perrotta1, Ennio Lubrano1
1a Dipartimento di Medicina e Scienze della salute 'Vincenzo Tiberio' , Università degli studi del Molise , Campobasso , Italy.
Objective:
The aim of the present study was to assess the rate of sustained Minimal Disease Activity (MDA) and remission in a group of psoriatic arthritis (PsA) patients treated with TNFα blockers.
Methods:
We perform a retrospective study on our database of PsA patients treated with adalimumab, etanercept and golimumab, with a minimum of 12 months of follow up. Patients were considered in sustained MDA when they met at least 5/7 of the criteria previously defined for at least 12 months of follow up. DAS28-CRP < 2.6, DAPSA score ≤ 4 and patient global assessment (PGA) ≤ 20 mm were also evaluated as remission criteria. Concordance between the remission criteria and MDA was also performed.
Results:
Of the 81 patients treated with TNFα blockers, at baseline no patients were in MDA or had a DAPSA score ≤ 4, while 17 (20.9%) had a DAS28-CRP score < 2.6. PGA ≤ 20 was recorded in 6 patients (7%). Sustained MDA was achieved in 35 (43.2%) patients while sustained DAPSA, DAS28-CRP and PGA remission were obtained respectively in 19.7%, 35.8% and 44.4% of patients. No difference was found between the three anti-TNFα in respect to the probability of achieve MDA.
Conclusions:
In this retrospective study, sustained MDA was achieved in 43.2% of patients treated with TNFα blockers. Moreover, sustained remission was achieved in a consistent number of patients, configuring this as an achievable target for PsA patients.
Insights
Sustained Minimal Disease Activity (MDA) was achieved in 43.2% of psoriatic arthritis (PsA) patients treated with TNFα blockers. These findings indicate that achieving sustained remission is an attainable goal for PsA patients.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Psoriatic arthritis (PsA) is a chronic inflammatory condition requiring effective long-term treatment strategies.
- Tumor Necrosis Factor-alpha (TNFα) blockers are a key therapeutic class for managing PsA.
- Assessing sustained disease control is crucial for evaluating treatment efficacy in PsA.
Purpose of the Study:
- To evaluate the rate of sustained Minimal Disease Activity (MDA) in PsA patients receiving TNFα inhibitor therapy.
- To determine the achievement of remission using various established criteria (DAS28-CRP, DAPSA, PGA) in this patient cohort.
- To compare the efficacy of different TNFα blockers (adalimumab, etanercept, golimumab) regarding sustained MDA.
Main Methods:
- Retrospective analysis of 81 PsA patients treated with adalimumab, etanercept, or golimumab.
- Minimum follow-up duration of 12 months.
- Sustained MDA defined as meeting ≥5/7 criteria for ≥12 months; remission assessed by DAS28-CRP < 2.6, DAPSA ≤ 4, and PGA ≤ 20 mm.
Main Results:
- Sustained MDA was achieved by 43.2% of patients.
- Sustained remission rates were 19.7% (DAPSA), 35.8% (DAS28-CRP), and 44.4% (PGA).
- No significant differences in achieving MDA were observed among the three anti-TNFα agents.
Conclusions:
- Sustained Minimal Disease Activity is achievable in a substantial proportion of PsA patients treated with TNFα blockers.
- Remission is a realistic and attainable treatment target for patients with psoriatic arthritis.
- The study supports the efficacy of TNFα inhibitors in achieving long-term disease control in PsA.
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