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Updated: Jul 14, 2026
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
The Effect of Early Attainment of Minimal Disease Activity on Radiographic Outcomes: A Real-World Longitudinal Cohort
Gonul Hazal Koc1, Marc R Kok2, Selinde V J Snoeck Henkemans3
1G.H. Koc, MD, S.V.J. Snoeck Henkemans, MD, J.J. Luime, PhD, R.J.E.M. Dolhain, MD, M. Vis, MD, Department of Rheumatology, Erasmus MC, Rotterdam; g.yanmaz-koc@erasmusmc.nl.
Objective:
To evaluate the effect of achieving minimal disease activity (MDA) within the first year on radiologic damage at 3-year follow-up in patients with newly diagnosed psoriatic arthritis (PsA).
Methods:
Data were used from the Dutch southwest Early PsA cohort, a real-world cohort of newly diagnosed patients with PsA, focusing on those with oligoarthritis or polyarthritis. Patients were stratified into 3 groups: (1) sustained MDA, achieving MDA at least at both 9 and 12 months post diagnosis; (2) nonsustained MDA, achieving MDA in the first year but not sustaining it at 9 and 12 months; (3) no MDA, not achieving MDA in the first year. Radiographic assessment was used by the modified Total Sharp/van der Heijde score for PsA. Group comparisons at 3-year follow-up for radiographic changes were conducted using a linear mixed model.
Results:
Two hundred eighty-four patients were categorized into 3 groups: 96 patients (34%) in the sustained MDA group, 83 (29%) in the nonsustained MDA group, and 105 (37%) in the no-MDA group. According to baseline characteristics, in the no-MDA group, a notably higher rate of female individuals (70%) and an elevated tender joint count (median 7, IQR 4-12) were observed. Patients who did not achieve MDA in the first year experienced remarkably higher radiographic changes during follow-up than the sustained MDA group (β 0.05, 95% CI 0.02-0.08, P < 0.01).
Conclusion:
Radiographic changes during the 3-year follow-up were markedly higher in those unable to achieve MDA within the first year of follow-up, emphasizing the long-term structural benefits of reaching stringent disease activity targets early in the disease course.
