Queiro Rubén, Cañete Juan D, Montilla Carlos, Abad Miguel, Montoro María, Gómez Susana, Cábez Ana
Department of Rheumatology, HU, Central de Asturias, Av. Roma, s/n, 33011, Oviedo, Asturias, Spain.
Department of Rheumatology, HU, Clinic and IDIBAPS, C/Villarroel, 170-08036, Barcelona, Spain.
Arthritis Res Ther. 2017 Mar 29;19(1):72. doi: 10.1186/s13075-017-1277-1.
Patients with psoriatic arthritis (PsA) experience functional impairment and reduced quality of life, and thus patient global assessment in PsA is explained mainly by the physical, but also by the psychological, aspect of the disease. To assess the prevalence of minimal disease activity (MDA) in Spanish patients with PsA, we examined their characteristics and the association between MDA and the impact of the disease as assessed by the PsA Impact of Disease (PsAID) questionnaire.
A cross-sectional multicenter study was carried out in patients who fulfilled the Classification for Psoriatic Arthritis (CASPAR) criteria with at least 1 year of disease duration, and who were treated with biological or conventional synthetic (cs) disease-modifying anti-rheumatic drugs (DMARDs) according to routine clinical practice in Spain. Patients were considered in MDA if they met at least 5/7 of the MDA criteria. The association between MDA and the recently developed PsAID questionnaire was also recorded.
Of 227 patients included, 133 (58.6%) were in the MDA state (52% with antitumor necrosis factor (anti-TNF)α monotherapy, 24% with csDMARD monotherapy, and 24% with anti-TNFα in combination with csDMARD). Using multivariate logistic regression analysis, male gender (odds ratio (OR) 2.74, p = 0.001), a sedentary lifestyle (OR 3.13, p = 0.002), familial history of PsA (OR 0.38, p = 0.036), C-reactive protein (CRP) level (OR 0.92, p = 0.010), and use of corticoids (OR 0.33, p = 0.007) were considered features related to MDA. MDA patients had a significantly lower impact of the disease according to PsAID (mean total score (SD): MDA 3.3 (3.1) vs. non-MDA 7.1 (5.2); p < 0.001).
Nearly 60% of Spanish PsA patients achieve MDA in routine clinical practice. MDA remains one of the most useful therapeutic targets for PsA since patients who reached this state also had a significantly lower impact of disease according to PsAID.
银屑病关节炎（PsA）患者存在功能障碍且生活质量下降，因此PsA患者的整体病情评估主要由疾病的身体方面决定，但也受心理方面影响。为评估西班牙PsA患者中最小疾病活动度（MDA）的患病率，我们研究了他们的特征以及MDA与通过银屑病关节炎疾病影响（PsAID）问卷评估的疾病影响之间的关联。
对符合银屑病关节炎分类标准（CASPAR）且病程至少1年、按照西班牙常规临床实践接受生物或传统合成（cs）改善病情抗风湿药物（DMARDs）治疗的患者进行了一项横断面多中心研究。若患者符合至少5/7项MDA标准，则被认为处于MDA状态。还记录了MDA与最近开发的PsAID问卷之间的关联。
在纳入的227例患者中，133例（58.6%）处于MDA状态（52%接受抗肿瘤坏死因子（anti-TNF）α单药治疗，24%接受csDMARD单药治疗，24%接受anti-TNFα与csDMARD联合治疗）。采用多因素逻辑回归分析，男性（比值比（OR）2.74，p = 0.001）、久坐的生活方式（OR 3.13，p = 0.002）、PsA家族史（OR 0.38，p = 0.036）、C反应蛋白（CRP）水平（OR 0.92，p = 0.010）以及使用皮质类固醇（OR 0.33，p = 0.007）被认为是与MDA相关的特征。根据PsAID，MDA患者的疾病影响显著更低（平均总分（标准差）：MDA 3.3（3.1）vs.非MDA 7.1（5.2）；p < 0.001）。
在西班牙的常规临床实践中，近60%的PsA患者达到MDA。MDA仍然是PsA最有用的治疗靶点之一，因为达到此状态的患者根据PsAID评估的疾病影响也显著更低。
