PMID- 26269398 OWN - NLM STAT- MEDLINE DCOM- 20160829 LR - 20220330 IS - 1468-2060 (Electronic) IS - 0003-4967 (Linking) VI - 75 IP - 5 DP - 2016 May TI - Disease activity in psoriatic arthritis (PsA): defining remission and treatment success using the DAPSA score. PG - 811-8 LID - 10.1136/annrheumdis-2015-207507 [doi] AB - BACKGROUND: The Disease Activity Index for Psoriatic Arthritis (DAPSA) is a valid and discriminative tool. Definitions of disease activity states and therapeutic response are still missing. We derived such criteria for the DAPSA. METHODS: We retrieved 30 patient profiles from an observational database including joint counts, patient pain and global activity ratings and C-reactive protein (CRP) and carried out a survey among experts to classify patients into remission (REM), low (LDA), moderate (MDA) or high (HDA) disease activity. Based on the distributions of DAPSA in each of these expert-assigned states we defined the cutpoints between groups. We performed similar analyses evaluating a clinical score (cDAPSA), omitting CRP. To define minor, moderate and major treatment response, we used Cohen's Kappa statistics and analysed agreement of DAPSA percentage change with ACR20/50/70-response in three randomised controlled trials. RESULTS: Our survey yielded a response rate of 75% (n=33). Mean DAPSA differed significantly between patients classified as REM, LDA, MDA or HDA (p<0.001). Based on the distributions of DAPSA in these groups, we propose cut-off values of 4 and 14 and 28 for HDA. We observed best agreement with ACR20/50/70-response at DAPSA changes of 50/75/85%, reflecting minor, moderate and major improvement. CONCLUSIONS: The DAPSA constitutes a disease-specific, validated and feasible tool for PsA assessment. In this study, we provide criteria for disease activity states and treatment response. They are based on an international expert survey, and show good performance in clinical trials and observational data. CI - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ FAU - Schoels, Monika M AU - Schoels MM AD - Second Department of Internal Medicine, Hietzing Hospital, Vienna, Austria. FAU - Aletaha, Daniel AU - Aletaha D AD - Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria. FAU - Alasti, Farideh AU - Alasti F AD - Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria. FAU - Smolen, Josef S AU - Smolen JS AD - Second Department of Internal Medicine, Hietzing Hospital, Vienna, Austria Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria. LA - eng PT - Journal Article PT - Observational Study PT - Validation Study DEP - 20150812 PL - England TA - Ann Rheum Dis JT - Annals of the rheumatic diseases JID - 0372355 RN - 0 (Antirheumatic Agents) RN - 0 (Biomarkers) RN - 9007-41-4 (C-Reactive Protein) SB - IM CIN - Ann Rheum Dis. 2015 Dec;74(12):e66. PMID: 26408570 CIN - Ann Rheum Dis. 2015 Dec;74(12):e67. PMID: 26493815 CIN - Ann Rheum Dis. 2016 May;75(5):787-90. PMID: 26802182 MH - Adult MH - Aged MH - Antirheumatic Agents/therapeutic use MH - Arthritis, Psoriatic/*diagnosis/*drug therapy MH - Biomarkers/blood MH - C-Reactive Protein/metabolism MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Pain Measurement MH - Remission Induction MH - *Severity of Illness Index MH - Treatment Outcome OTO - NOTNLM OT - Arthritis OT - Outcomes research OT - Psoriatic Arthritis EDAT- 2015/08/14 06:00 MHDA- 2016/08/30 06:00 CRDT- 2015/08/14 06:00 PHST- 2015/02/25 00:00 [received] PHST- 2015/07/20 00:00 [accepted] PHST- 2015/08/14 06:00 [entrez] PHST- 2015/08/14 06:00 [pubmed] PHST- 2016/08/30 06:00 [medline] AID - annrheumdis-2015-207507 [pii] AID - 10.1136/annrheumdis-2015-207507 [doi] PST - ppublish SO - Ann Rheum Dis. 2016 May;75(5):811-8. doi: 10.1136/annrheumdis-2015-207507. Epub 2015 Aug 12.