Mease Philip J, Nowak Miroslawa, Choi Jiyoon, Lehman Thomas, Sreih Antoine, Ho Kaylee, Middaugh Nicole, Ogdie Alexis
Swedish Medical Center/Providence St Joseph Health and University of Washington, Seattle.
Bristol Myers Squibb, Princeton, New Jersey.
ACR Open Rheumatol. 2025 Jun;7(6):e70019. doi: 10.1002/acr2.70019.
Our objective was to describe characteristics and compare clinical and patient-reported outcomes (PROs) for disease-modifying antirheumatic drug (DMARD)-naive patients with psoriatic arthritis (PsA) who initiate DMARD therapy early versus late.
Patients with PsA from the CorEvitas PsA/Spondyloarthritis Registry were classified by reported time between diagnosis and DMARD initiation. Early and late initiators were patients whose first DMARD treatment occurred ≤1 year or >1 year, respectively, following PsA diagnosis. Change in disease activity and PRO measures from initiation to the six-month follow-up was calculated for each group; mean change for each continuous outcome and proportion achieving binary outcomes were reported for early and late initiators. Associations of early versus late DMARD initiation with disease activity and PROs at six months were calculated using adjusted linear and Poisson regressions.
The mean patient age was 53 years, more than half of patients were female, and 90% of patients were White. Mean time from diagnosis to DMARD initiation was 0.2 years in early initiators (n = 229, 79%) and 8.6 years in late initiators (n = 62, 21%). In adjusted analyses, achievement of minimal disease activity (adjusted risk ratio 2.01, 95% confidence interval [CI] 1.03-4.40) and mean change in Clinical Disease Activity Index (β -3.4, 95% CI -6.2 to -0.49) were statistically different between early and late initiators.
Among patients from the PsA registry, those who had both early and late initiation of DMARD therapy experienced improvements throughout all disease activity and PROs across six months of treatment. Minimal disease activity, a key treatment target, was more likely observed in early initiators, highlighting the value of early identification and treatment. Delay of Treatment With Disease-Modifying Antirheumatic Drugs in Psoriatic Arthritis: The CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry.
我们的目的是描述疾病修饰抗风湿药物（DMARD）初治的银屑病关节炎（PsA）患者的特征，并比较早期与晚期开始DMARD治疗的患者的临床和患者报告结局（PRO）。
来自CorEvitas PsA/脊柱关节炎注册中心的PsA患者根据报告的诊断时间与开始使用DMARD的时间进行分类。早期和晚期开始治疗的患者分别是首次DMARD治疗在PsA诊断后≤1年或>1年的患者。计算每组从开始治疗到六个月随访时疾病活动度和PRO指标的变化；报告早期和晚期开始治疗的患者每个连续结局的平均变化以及达到二元结局的比例。使用校正线性回归和泊松回归计算早期与晚期开始使用DMARD与六个月时疾病活动度和PRO之间的关联。
患者平均年龄为53岁，超过一半的患者为女性，90%的患者为白人。早期开始治疗的患者（n = 229，79%）从诊断到开始使用DMARD的平均时间为0.2年，晚期开始治疗的患者（n = 62，21%）为8.6年。在校正分析中，早期和晚期开始治疗的患者在达到最小疾病活动度（校正风险比2.01，95%置信区间[CI] 1.03 - 4.40）和临床疾病活动指数的平均变化（β -3.4，95% CI -6.2至-0.49）方面存在统计学差异。
在PsA注册中心的患者中，那些早期和晚期开始DMARD治疗的患者在整个六个月的治疗期间，所有疾病活动度和PRO均有改善。最小疾病活动度是一个关键治疗目标，在早期开始治疗的患者中更可能观察到，这突出了早期识别和治疗的价值。银屑病关节炎中疾病修饰抗风湿药物治疗的延迟：CorEvitas银屑病关节炎/脊柱关节炎注册中心。
