Full Papers
What are the main barriers to achieve minimal disease activity in psoriatic arthritis in real life?
S. Bakirci1, D. Solmaz2, N. Al Osaimi3, E. Dalkilic4, M. Can5, A. Erden6, C. Ozisler7, M. Cinar8, L. Kilic9, A. Küçük10, A. Omma11, F. Yildiz12, A. Doğru13, A. Tufan14, S.E. Esmen15, S. Akar16, U. Kalyoncu17, S.Z. Aydin18
- Department of Internal Medicine, Division of Rheumatology, University of Ottawa Faculty of Medicine, Canada.
- Department of Internal Medicine, Division of Rheumatology, Izmir Katip Celebi University, Izmir, Turkey.
- Department of Internal Medicine, Division of Rheumatology, University of Ottawa Faculty of Medicine, Canada.
- Department of Internal Medicine, Division of Rheumatology, Uludag University, Bursa, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Marmara University, Istanbul, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Gulhane Education and Research Hospital, Ankara, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Meram University, Konya, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Saglik Bakanligi, Saglik Bilimleri University, Van Education and Research Hospital, Van, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Suleyman Demirel University, Isparta, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Gazi Üniversity, Ankara, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Konya Education and Research Hospital, Konya, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Izmir Katip Celebi University, Izmir, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey.
- Department of Internal Medicine, Division of Rheumatology, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute, Canada. saydin@toh.ca
on behalf of PsArt-ID (Psoriatic Arthritis-International Database)
CER11650
2019 Vol.37, N°5
PI 0808, PF 0812
Full Papers
Free to view
(click on article PDF icon to read the article)
PMID: 30767863 [PubMed]
Received: 22/08/2018
Accepted : 03/12/2018
In Press: 11/02/2019
Published: 29/08/2019
Abstract
OBJECTIVES:
Minimal disease activity (MDA) is an important target in patients with psoriatic arthritis (PsA), however it is also criticised for having a low threshold for patient reported outcomes (PRO).The aim of the study was to assess the prevalence of MDA and its components in patients with PsA and to evaluate disease characteristics and patterns in patients with or without MDA (MDA+ or MDA-).
METHODS:
PsArt-ID (Psoriatic Arthritis-International Database) is a prospective, multicentre web-based registry. PsA patients who had at least 1 year of disease duration and had full data for MDA were included for this analysis (n=317). Patients were considered in MDA+ when they met at least 5/7 of the MDA criteria.
RESULTS:
MDA was achieved in 46% patients. Within MDA- patients, body surface area (51.2%) and swollen joint count (53.5%) domains could still be achieved in the majority and 93.5% of them had no enthesitis using the Leeds enthesitis index. Of 170 patients with MDA-, 90 patients did not fulfill all 3 PROs of MDA. Mono-arthritis subtype (RR: 2.01), absence of enthesitis (RR: 1.570) and absence of distal interphalangeal (DIP) joint disease (RR: 1.1) were associated with higher probability of achieving MDA.
CONCLUSIONS:
The MDA criteria provide an objective target for treatment in trials and clinical practice; however, in real life PROs are the most significant barriers to achieve MDA. The presence of DIP joints disease makes it difficult to reach MDA due to active PROs.
