Perrotta Fabio Massimo, Lubrano Ennio
a Dipartimento di Medicina e Scienze della salute 'Vincenzo Tiberio' , Università degli studi del Molise , Campobasso , Italy.
Postgrad Med. 2016 Sep;128(7):693-6. doi: 10.1080/00325481.2016.1220809. Epub 2016 Aug 16.
The aim of the present study was to assess the rate of sustained Minimal Disease Activity (MDA) and remission in a group of psoriatic arthritis (PsA) patients treated with TNFα blockers.
We perform a retrospective study on our database of PsA patients treated with adalimumab, etanercept and golimumab, with a minimum of 12 months of follow up. Patients were considered in sustained MDA when they met at least 5/7 of the criteria previously defined for at least 12 months of follow up. DAS28-CRP < 2.6, DAPSA score ≤ 4 and patient global assessment (PGA) ≤ 20 mm were also evaluated as remission criteria. Concordance between the remission criteria and MDA was also performed.
Of the 81 patients treated with TNFα blockers, at baseline no patients were in MDA or had a DAPSA score ≤ 4, while 17 (20.9%) had a DAS28-CRP score < 2.6. PGA ≤ 20 was recorded in 6 patients (7%). Sustained MDA was achieved in 35 (43.2%) patients while sustained DAPSA, DAS28-CRP and PGA remission were obtained respectively in 19.7%, 35.8% and 44.4% of patients. No difference was found between the three anti-TNFα in respect to the probability of achieve MDA.
In this retrospective study, sustained MDA was achieved in 43.2% of patients treated with TNFα blockers. Moreover, sustained remission was achieved in a consistent number of patients, configuring this as an achievable target for PsA patients.
本研究旨在评估一组接受肿瘤坏死因子α（TNFα）阻滞剂治疗的银屑病关节炎（PsA）患者的持续最小疾病活动度（MDA）率和缓解率。
我们对数据库中接受阿达木单抗、依那西普和戈利木单抗治疗的PsA患者进行了一项回顾性研究，随访时间至少为12个月。当患者在至少12个月的随访中至少满足先前定义的7项标准中的5项时，被认为处于持续MDA状态。还将DAS28-CRP<2.6、DAPSA评分≤4和患者整体评估（PGA）≤20mm作为缓解标准进行评估。同时也对缓解标准与MDA之间的一致性进行了分析。
在81例接受TNFα阻滞剂治疗的患者中，基线时无患者处于MDA状态或DAPSA评分≤4，而17例（20.9%）患者的DAS28-CRP评分<2.6。6例患者（7%）记录到PGA≤20。35例（43.2%）患者实现了持续MDA，而分别有19.7%、35.8%和44.4%的患者实现了持续DAPSA、DAS28-CRP和PGA缓解。在实现MDA的概率方面，三种抗TNFα药物之间未发现差异。
在这项回顾性研究中，43.2%接受TNFα阻滞剂治疗的患者实现了持续MDA。此外，相当数量的患者实现了持续缓解，这表明这是PsA患者可以实现的目标。
