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Performance and Predictors of Minimal Disease Activity Response in Patients With Peripheral Spondyloarthritis Treated

Laura C Coates1, Sonya Abraham2, William Tillett3

  • 1University of Oxford, Oxford, UK.

Arthritis Care & Research
|September 16, 2020
PubMed
Abstract

Insights

Modified minimal disease activity (MDA) criteria effectively assess peripheral spondyloarthritis (SpA) treatment response. Early achievement of modified MDA predicts long-term success, making it a valuable treatment target for peripheral SpA patients.

Area of Science:

  • Rheumatology
  • Clinical Trial Analysis
  • Outcome Measurement

Background:

  • Peripheral spondyloarthritis (SpA) requires validated measures for disease activity.
  • Minimal Disease Activity (MDA) is a key target, but modified criteria are needed for peripheral SpA.
  • Outcome Measures in Rheumatology (OMERACT) principles guide the development of new assessment tools.

Purpose of the Study:

  • To evaluate the concurrent validity and discriminative ability of modified MDA criteria in peripheral SpA.
  • To identify predictors of achieving and sustaining a modified MDA response.
  • To align with OMERACT filter principles for robust outcome measures.

Main Methods:

  • Four modified MDA versions were developed using the Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index or Leeds Enthesitis Index (LEI), excluding psoriasis.
  • Concurrent validity was assessed by correlating modified MDA with PSpARC remission, ASDAS inactive disease, and physician global assessment.
  • Treatment discrimination between adalimumab and placebo was evaluated at week 12, with logistic regression identifying predictors of long-term response.

Main Results:

  • All four modified MDA versions demonstrated strong concurrent validity and discriminated effectively between adalimumab and placebo groups.
  • Patients receiving adalimumab showed significantly higher rates of achieving modified MDA compared to placebo at week 12.
  • Achieving modified MDA by week 12 was a strong predictor of sustained modified MDA achievement through 3 years.

Conclusions:

  • The evaluated modified MDA criteria possess concurrent validity and discriminative ability in peripheral SpA.
  • Early modified MDA response is a more reliable predictor of long-term outcomes than baseline patient characteristics.
  • Several modified MDA versions are suitable as treatment targets for patients with peripheral SpA.

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