Mease Philip J, Karki Chitra, Liu Mei, Kavanaugh Arthur, Ritchlin Christopher T, Huynh Doquyen Hoa, Palmer Jacqueline B, Greenberg Jeffrey D
Rheumatology Clinical Research Division, Swedish Medical Center and University of Washington, Seattle, Washington, USA.
Corrona, Waltham, Massachusetts, USA.
RMD Open. 2018 Apr 25;4(1):e000638. doi: 10.1136/rmdopen-2017-000638. eCollection 2018.
To compare baseline characteristics between patients with psoriatic arthritis (PsA) who achieved and did not achieve minimal disease activity (MDA) with biologic therapy in the US-based Corrona Psoriatic Arthritis/Spondyloarthritis Registry.
Patients with PsA aged ≥18 years enrolled between March 2013 and March 2016 who were receiving biologics at enrolment (baseline), not in MDA and had ≥2 follow-up visits were included. Patients were classified as those who remained on their index biologic and achieved MDA at the second follow-up visit (MDA achievers (MDA-A)) and those who did not (MDA non-achievers (MDA-NA)). Demographics, clinical characteristics, patient-reported outcomes and medication history were compared between groups.
Of 148 patients with PsA who met the inclusion criteria, 34 (23.0%) and 114 (77.0%) were classified as MDA-A and MDA-NA, respectively. At baseline, most patients (96.6%) were receiving tumour necrosis factor inhibitors, and both groups were similar in age, sex, race, medication history, enthesitis and dactylitis counts, disease duration and comorbidities. Compared with MDA-A, MDA-NA had significantly worse mean tender joint count (7.2 vs 3.4), patient-reported pain (51.2 vs 35.7), patient-reported fatigue (54.1 vs 42.4), physical function (Health Assessment Questionnaire, 1.0 vs 0.6), Bath Ankylosing Disease Activity Index (5.0 vs 3.4) and Bath Ankylosing Spondylitis Functional Index (4.0 vs 2.0) scores (all p<0.05).
Approximately one in four patients achieved MDA with their index biologic at the time of the second follow-up visit. Both groups were similar in several baseline demographic and clinical features; however, patients who did not achieve MDA generally had worse tender joint counts and patient-reported outcomes.
在美国Corrona银屑病关节炎/脊柱关节炎注册中心,比较接受生物治疗后达到和未达到最小疾病活动度(MDA)的银屑病关节炎(PsA)患者的基线特征。
纳入2013年3月至2016年3月期间入组的年龄≥18岁、入组时(基线)正在接受生物制剂治疗、未达到MDA且有≥2次随访就诊的PsA患者。患者被分为在第二次随访时仍使用初始生物制剂并达到MDA的患者(MDA达标者(MDA-A))和未达到MDA的患者(MDA未达标者(MDA-NA))。比较两组之间的人口统计学、临床特征、患者报告的结局和用药史。
在148例符合纳入标准的PsA患者中,分别有34例(23.0%)和114例(77.0%)被分类为MDA-A和MDA-NA。基线时,大多数患者(96.6%)正在接受肿瘤坏死因子抑制剂治疗,两组在年龄、性别、种族、用药史、附着点炎和指(趾)炎计数、疾病持续时间和合并症方面相似。与MDA-A相比,MDA-NA的平均压痛关节计数(7.2对3.4)、患者报告的疼痛(51.2对35.7)、患者报告的疲劳(54.1对42.4)、身体功能(健康评估问卷,1.0对0.6)、巴斯强直性脊柱炎疾病活动指数(5.0对3.4)和巴斯强直性脊柱炎功能指数(4.0对2.0)得分均显著更差(所有p<0.05)。
在第二次随访时,约四分之一的患者使用初始生物制剂达到了MDA。两组在一些基线人口统计学和临床特征方面相似;然而,未达到MDA的患者通常压痛关节计数更差,患者报告的结局也更差。