AB0478 RATES OF REMISSION IN PATIENTS WITH PSORIATIC ARTHRITIS TREATED IN TERTIARY CARE (2024)

AB0478 RATES OF REMISSION IN PATIENTS WITH PSORIATIC ARTHRITIS TREATED IN TERTIARY CARE (1)

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Psoriatic arthritis

AB0478 RATES OF REMISSION IN PATIENTS WITH PSORIATIC ARTHRITIS TREATED IN TERTIARY CARE

  1. U. Kiltz1,2,
  2. M. J. Kluecken1,2,
  3. I. Redeker1,2,
  4. S. Tsiami1,2,
  5. D. Kiefer1,2,3,
  6. B. Guminski1,2,
  7. X. Baraliakos1,2
  1. 1Ruhr-Universität Bochum, Bochum, Germany
  2. 2Rheumazentrum Ruhrgebiet, Herne, Germany
  3. 3Private Practice Rheumatology, Hattingen, Germany

Abstract

Background: Less than one third of patients (pts) with psoriatic arthritis (PsA) achieve a state of remission in clinical trials. A recent meta-analysis investigating clinical trials and observational data showed that Disease Activity index for Psoriatic Arthritis (DAPSA)-defined remission was only achieved by one fourth of PsA pts [1]. Although remission is the main target in PsA, there is a lack of data retrieved from routine care.

Objectives: To evaluate the prevalence and remission rate over time in PsA pts in a tertiary care center.

Methods: Adult PsA pts who had ≥ 2 documented visits in the hospital information system were recruited consecutively. Patients’ and disease characteristics were documented prospectively at a clinical visit. Data of the initial visit (index visit) and date of first occurrence of remission (remission visit) between index and clinical visit were taken retrospectively from the hospital information system. Standardized assessment on disease activity (DAPSA, (Disease Activity Score 28 joints) DAS28) and physical function (HAQ-DI) were documented at index, clinical and remission visits. Remission was defined as DAPSA ≤ 4 or DAS28 < 2.6. Uni- and multivariable logistic regression analyses were used to examine the association between DAS28-remission (dependent variable) and various patients’ characteristics (independent variables) additionally adjusted for potential confounders (age, sex).

Results: We included 197 PsA pts with retrospective data for 3.8 (4.8) years with a total of 440 DAPSA and 1139 DAS28 values. At the clinical visit, disease activity was moderate and one third had severe disability (HAQ ≥ 1.28) and 25 pts (12.7 %) structural damage (Table 1). Almost half of the pts was receiving bDMARDs. Remission was achieved at least once by 118 pts (59.9 %) and varied between 16.2% (DAPSA-REM) and 38.1% (DAS28-REM) at clinical visit. State of remission occurred at a median of 1 year (IQE 0-3.8) after the index visit. 57 (48.3%) pts achieved the first remission state within the first year of treatment. No association between achieving a state of remission and the selected variables (sex, disease duration, CRP, swollen joints count (SJC), global pain (NRS), bDMARD use and BMI) could be found (Table 2).

Conclusion: Almost 60 % of PsA pts treated in routine care achieved at least once a state of remission during the observation period of 18 years. The remission rate was unexpectedly high even though the cohort had a high rate of severe disability. The data indicates that there is still a need for remission in PsA pts despite the bDMARDs-era. Further research is needed to evaluate pts factors associated with achievement of remission.

REFERENCES: [1] NIL. Hagége et al. Rheumatol 2020;59:1818-1825

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Table 1.

Patients’ demographics and disease characteristics at clinical visit.

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Table 2.

Association between DAS28 remission and patient characteristics: results from logistic regression.

REFERENCES: NIL.

Acknowledgements: This study was funded in parts by Novartis Germany.

Disclosure of Interests: Uta Kiltz AbbVie, Amgen, Fresenius, GSK, Hexal, Janssen, Novartis, UCB, AbbVie, Amgen, Fresenius, GSK, Hexal, Janssen, Novartis, UCB, AbbVie, Amgen, Fresenius, GSK, Hexal, Janssen, Novartis, UCB, Markus J. Kluecken: None declared, Imke Redeker: None declared, Styliani Tsiami: None declared, David Kiefer Abbvie, BMS, Roche, Chugai, Novartis, UCB, Sanofi, MSD, Merck, GSK, Janssen, Boehringer Ingelheim, Galapagos, Abbvie, BMS, Roche, Chugai, Novartis, UCB, Sanofi, MSD, Merck, GSK, Janssen, Boehringer Ingelheim, Galapagos, Abbvie, Novartis, Barbara Guminski: None declared, Xenofon Baraliakos AbbVie, Amgen, Chugai, Galapagos, Lilly, MSD, Novartis, Pfizer, UCB and Sandoz., AbbVie, Amgen, Chugai, Galapagos, Lilly, MSD, Novartis, Pfizer, UCB and Sandoz., AbbVie, Amgen, Chugai, Galapagos, Lilly, MSD, Novartis, Pfizer, UCB and Sandoz.

  • Remission
  • Observational studies/ registry
  • Pain
  • biological DMARD
  • Outcome measures

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    • Remission
    • Observational studies/ registry
    • Pain
    • biological DMARD
    • Outcome measures

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    AB0478 RATES OF REMISSION IN PATIENTS WITH PSORIATIC ARTHRITIS TREATED IN TERTIARY CARE (2024)

    FAQs

    AB0478 RATES OF REMISSION IN PATIENTS WITH PSORIATIC ARTHRITIS TREATED IN TERTIARY CARE? ›

    Remission was achieved at least once by 118 pts (59.9 %) and varied between 16.2% (DAPSA-REM) and 38.1% (DAS28-REM) at clinical visit. State of remission occurred at a median of 1 year (IQE 0-3.8) after the index visit. 57 (48.3%) pts achieved the first remission state within the first year of treatment.

    What is the remission rate for psoriatic arthritis? ›

    Remission rates were 33%/40%/45%/56% for men and 17%/23%/24%/32% for women. For patients <45 years at diagnosis, 6-months LUNDEX-adjusted remission rate for pain was 28% vs. 18% for patients ≥45 years. Conclusion In 12,262 biologic-naïve PsA patients, 6 months treatment with TNFi reduced pain by approximately 50%.

    What is the long-term prognosis for psoriatic arthritis? ›

    PsA is a chronic condition, which means there's no cure. Medications can treat its symptoms, however, and PsA isn't life-threatening. Some research suggests that people with PsA have a slightly shorter life expectancy than the general population.

    What is the mortality rate for psoriatic arthritis? ›

    Results: Among 1490 patients followed over 15062.8 patient-years, 225 (15%) confirmed deaths were recorded (111 females, 114 males). The overall SMR was 0.92 (95% CI: 0.81-1.05), the sex-specific SMRs were 1.08 (95% CI: 0.89-1.30) for females and 0.81 (95% CI: 0.66-0.97) for males.

    What is the safest drug for psoriatic arthritis? ›

    Nonsteroidal anti-inflammatory drugs (NSAIDs)

    For both psoriasis and PsA, NSAIDs are a common first-line treatment. Typically available over the counter, NSAIDs include aspirin, ibuprofen (Advil), and naproxen sodium (Aleve). Your doctor may provide a prescription-strength NSAID if appropriate.

    How long can psoriatic arthritis stay in remission? ›

    Studies show that some patients had a recurrence within six months of stopping medication and most of them flared within the first two to three months. It appears that though the disease may quiet down during remission, it doesn't cease to exist.

    What percentage of RA patients achieve remission? ›

    The Odds of Remission

    Because the definition of RA remission has been subjective in the past, published rates vary greatly, ranging from as little as 10% to more than 60%. The most important factor is early diagnosis and aggressive treatment.

    Does psoriatic arthritis get better with age? ›

    Both psoriatic arthritis and psoriasis are chronic diseases that worsen over time. However, you might have periods when your symptoms improve or go away temporarily.

    Is psoriatic arthritis always progressive? ›

    Like psoriasis, psoriatic arthritis is a chronic condition. It can worsen over time, but you may also have periods of remission where you don't have any symptoms. It doesn't have a cure, but treatment can make a difference.

    How long does it take to become disabled with psoriatic arthritis? ›

    Qualifying for disability benefits

    You can apply when PsA makes it difficult or impossible to perform a job. While you do not need to have a disability for a certain amount of time before you apply, you'll need to show that PsA will prevent you from working for at least 12 months.

    How close are we to curing psoriatic arthritis? ›

    There is no cure for psoriatic arthritis (PsA) yet, but research into effective therapies is ongoing. Treatment options currently include medications to reduce inflammation, pain, and skin symptoms.

    Is psoriatic arthritis considered a critical illness? ›

    It is possible to get psoriatic arthritis covered under critical illness insurance. However, before a provider can make a decision regarding your lump-sum payment, they will take into consideration factors such as the date of your diagnosis, how severe your symptoms are and what type of treatment you're receiving.

    How many people have died from biologics? ›

    There have been at least 34,000 reports to the U.S. Food and Drug Administration of people who died while using biologic drugs since 2004, according to an extensive analysis by the Milwaukee Journal Sentinel of data from the agency.

    What is the most successful treatment for psoriatic arthritis? ›

    These drugs can slow the progression of psoriatic arthritis and save joints and other tissues from permanent damage. The most commonly used disease-modifying antirheumatic drug (DMARD) is methotrexate (Trexall, Otrexup, others). Others include leflunomide (Arava) and sulfasalazine (Azulfidine).

    What is the best climate for psoriatic arthritis? ›

    Some people find that joint pain and swelling gets better in the summer. It's not always clear why, but many people with psoriatic arthritis find that their symptoms improve when the weather gets warm. For those who also struggle with skin symptoms (psoriasis), their plaques may also improve during the summer months.

    What is the new pill for psoriatic arthritis? ›

    Psoriatic arthritis (PsA) is a common and difficult-to-treat condition that often occurs with psoriasis. The drug company UCB recently developed a new PsA treatment called Bimzelx. Bimzelx appears to be effective even in individuals who have not previously responded to treatment.

    Has anyone cured psoriatic arthritis? ›

    No cure exists for psoriatic arthritis. Treatment focuses on controlling inflammation in your affected joints to prevent joint pain and disability and controlling skin involvement.

    Can you stop psoriatic arthritis from progressing? ›

    Psoriatic arthritis disease progression is not inevitable. When your PsA is treated with medications that reduce immune system overactivity, you can reduce your disease activity to a point that it's no longer causing significant symptoms or increasing the risk of long-term health issues.

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