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Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
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Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients

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Trial Characteristics as Contextual Factors When Evaluating Targeted Therapies in Patients With Psoriatic Disease: A

Christine Ballegaard1, Tanja S Jørgensen2, Marie Skougaard2

  • 1Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospital, and Gentofte Hospital, Copenhagen, Denmark.

Arthritis Care & Research
|October 27, 2017
PubMed
Abstract

Insights

Patients with psoriatic arthritis (PsA) showed better adherence to targeted therapies than those with psoriasis. Specific trial criteria influenced treatment outcomes in PsA and psoriasis studies.

Area of Science:

  • Rheumatology and Dermatology
  • Clinical Trial Analysis
  • Pharmacotherapy Efficacy

Background:

  • Psoriatic disease encompasses psoriatic arthritis (PsA) and psoriasis, both managed with targeted therapies.
  • Evaluating treatment effectiveness requires understanding contextual factors within clinical trials.
  • Drug retention and specific clinical response criteria (ACR20, PASI75) are key outcome measures.

Purpose of the Study:

  • To assess the impact of trial characteristics on the effectiveness of targeted therapies in psoriatic disease.
  • To identify specific eligibility criteria that influence treatment outcomes in randomized controlled trials (RCTs).

Main Methods:

  • Systematic review and meta-analysis of RCTs for targeted therapies in PsA and psoriasis.
  • Analysis of drug retention, ACR20 (for PsA), and PASI75 (for psoriasis) as primary outcomes.
  • Stratified and meta-regression analyses to explore effect modification by trial characteristics.

Main Results:

  • Forty-eight trials (17,737 patients) were analyzed, showing higher drug retention odds in PsA trials compared to psoriasis trials.
  • Specific eligibility criteria, including prior targeted therapy, disease duration, rheumatoid factor status, and classification criteria, were significant for ACR20 in PsA.
  • "Minimum disease duration" was important for PASI75 in psoriasis.
  • Seven PsA trials employed adaptive designs with early rescue provisions.

Conclusions:

  • Patients with PsA demonstrate greater adherence to targeted therapies than those with psoriasis.
  • Identified key trial eligibility criteria that are important for achieving treatment efficacy (ACR20 and PASI75) in PsA and psoriasis, respectively.

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