Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
University of California, San Diego.
Arthritis Care Res (Hoboken). 2018 May;70(5):797-800. doi: 10.1002/acr.23345. Epub 2018 Apr 12.
To compare radiographic outcomes according to the magnitude of the response utilizing 3 new psoriatic composite disease activity measures (the Psoriatic Arthritis Disease Activity Score [PASDAS], the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis Composite Exercise [GRACE], and the Disease Activity in PsA [DAPSA]).
The data were taken from the GO-REVEAL data set, a large randomized, double-blind study that evaluated the safety and efficacy of 2 doses of the tumor necrosis factor inhibitor golimumab in subjects with active psoriatic arthritis (PsA). Response criteria at 24 weeks were applied across the whole data set, irrespective of treatment group. Radiographic scores at baseline and 24 weeks were assessed using the modified Sharp/van der Heijde method for PsA.
Overall, for each measure, radiographic progression was significantly greater in subjects with a moderate or poor outcome, and absent in those with a good outcome. The proportion of subjects without radiographic progression in the good outcome group was 83% using the PASDAS (χ = 7.9; P = 0.02), 80% using the GRACE (χ = 5.8; P = 0.05), and 76% using the DAPSA (χ = 3.4; P = 0.19).
Response criteria for disease-specific composite measures enable separation between groups in terms of radiographic progression and may therefore be used as suitable targets for interventional studies, as well as in the clinic.
利用 3 种新的银屑病关节炎综合疾病活动测量指标（银屑病关节炎疾病活动评分[PASDAS]、研究和评估银屑病和银屑病关节炎综合运动的团体[GRACE]以及银屑病关节炎疾病活动[DAPSA]），根据反应的程度比较影像学结果。
数据来自 GO-REVEAL 数据集，这是一项大型随机、双盲研究，评估了两种剂量的肿瘤坏死因子抑制剂戈利木单抗在活动性银屑病关节炎（PsA）患者中的安全性和有效性。整个数据集都应用了 24 周的反应标准，而不论治疗组如何。基线和 24 周的影像学评分采用改良的 Sharp/van der Heijde 方法评估。
总体而言，对于每种测量指标，影像学进展在中度或较差结局的患者中明显更大，而在良好结局的患者中不存在。在良好结局组中，使用 PASDAS（χ=7.9；P=0.02）、GRACE（χ=5.8；P=0.05）和 DAPSA（χ=3.4；P=0.19）的患者中，没有影像学进展的比例分别为 83%、80%和 76%。
疾病特异性综合测量指标的反应标准可以根据影像学进展将患者分组，因此可以用作干预性研究以及临床实践中的合适目标。
