PMID- 29080861
OWN - NLM
STAT- MEDLINE
DCOM- 20190128
LR  - 20220316
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Linking)
VI  - 77
IP  - 2
DP  - 2018 Feb
TI  - Ideal target for psoriatic arthritis? Comparison of remission and low disease 
      activity states in a real-life cohort.
PG  - 251-257
LID - 10.1136/annrheumdis-2017-211998 [doi]
AB  - BACKGROUND: Psoriatic arthritis (PsA) recommendations state that the target of 
      treatment should be remission or low disease activity (LDA). We used a real-life 
      dataset to compare different potential targets. METHODS: 250 patients with PsA 
      considered in an acceptable disease state according to their rheumatologist were 
      included. Targets for remission were the Disease Activity Index for Psoriatic 
      Arthritis (DAPSA) and clinical DAPSA (cDAPSA) remission (</=4), very low disease 
      activity (VLDA) and Psoriatic Arthritis Disease Activity Score </=1.9. LDA targets 
      analysed were the DAPSA </=14, cDAPSA </=13, minimal disease activity (MDA) and 
      adjusted MDA targets: MDAjoints with both tender joint count (TJC) and swollen 
      joint count (SJC) mandated, MDAskin (psoriasis area and severity index (PASI) 
      mandated) and MDAjoints&skin with TJC, SJC and PASI mandated. RESULTS: Comparison 
      of the several candidate targets demonstrates that VLDA is achieved by the lowest 
      proportion of patients and includes patients with the lowest residual disease 
      activity compared with the other remission targets. The modified MDA measures are 
      the most stringent targets for LDA in terms of residual disease on joints, 
      psoriasis and enthesitis within patients achieving the target. In both remission 
      and LDA, the inclusion of C reactive protein did not show an added value. The 
      exclusion of a skin domain, as in the DAPSA measures, resulted in negligence of 
      skin disease and a negative impact on the quality of life in some patients. 
      CONCLUSIONS: The different remission and LDA targets show us significant overlap 
      between measures, but these measures targeting the same definition do differ in 
      terms of allowance of residual disease. Inclusion of laboratory markers seems 
      unnecessary, although exclusion of a skin domain may result in psoriasis not 
      being assessed resulting in residual impactful skin disease.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of 
      the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - van Mens, Leonieke J J
AU  - van Mens LJJ
AD  - Clinical Immunology & Rheumatology, Amsterdam Rheumatology and Immunology Center, 
      Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
FAU - van de Sande, Marleen G H
AU  - van de Sande MGH
AD  - Clinical Immunology & Rheumatology, Amsterdam Rheumatology and Immunology Center, 
      Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
FAU - van Kuijk, Arno W R
AU  - van Kuijk AWR
AD  - Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, 
      Amsterdam, The Netherlands.
FAU - Baeten, Dominique
AU  - Baeten D
AD  - Clinical Immunology & Rheumatology, Amsterdam Rheumatology and Immunology Center, 
      Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
FAU - Coates, Laura C
AU  - Coates LC
AD  - Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, 
      University of Oxford, Oxford, UK.
LA  - eng
GR  - CS-2016-16-016/DH_/Department of Health/United Kingdom
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20171028
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
SB  - IM
CIN - Ann Rheum Dis. 2019 Jul;78(7):e61. PMID: 29730635
CIN - Ann Rheum Dis. 2019 Jul;78(7):e62. PMID: 29776975
CIN - Ann Rheum Dis. 2020 Nov;79(11):e143. PMID: 31331923
MH  - Adult
MH  - Arthritis, Psoriatic/*diagnosis
MH  - Cross-Sectional Studies
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care/*methods
MH  - Quality of Life
MH  - Remission Induction
MH  - *Severity of Illness Index
OTO - NOTNLM
OT  - disease activity
OT  - outcomes research
OT  - psoriatic arthritis
COIS- Competing interests: LJJvM, none declared. MGHvdS has received 
      speakers/consultancy fees from Takeda, Tillotts and Benecke MSD. DB has received 
      research grants and speakers/consultancy fees from Pfizer, MSD, AbbVie, UCB, 
      Novartis, Janssen, Boehringer Ingelheim; speakers/consultancy fees from Eli 
      Lilly, Roche, BMS and Glenmark; and is currently an employee of UCB. AWRvK has 
      received speakers/consultancy fees from Celgene, Janssen-Cilag, Novartis, MSD and 
      Roche. LCC, none declared.
EDAT- 2017/10/31 06:00
MHDA- 2019/01/29 06:00
CRDT- 2017/10/30 06:00
PHST- 2017/06/29 00:00 [received]
PHST- 2017/09/01 00:00 [revised]
PHST- 2017/10/06 00:00 [accepted]
PHST- 2017/10/31 06:00 [pubmed]
PHST- 2019/01/29 06:00 [medline]
PHST- 2017/10/30 06:00 [entrez]
AID - annrheumdis-2017-211998 [pii]
AID - 10.1136/annrheumdis-2017-211998 [doi]
PST - ppublish
SO  - Ann Rheum Dis. 2018 Feb;77(2):251-257. doi: 10.1136/annrheumdis-2017-211998. Epub 
      2017 Oct 28.