Minimal disease activity and associated factors in patients with psoriatic arthritis: cross-sectional study from a single center
Introduction Psoriatic arthritis (PsA) is a heterogeneous disease with various manifestations such as dactylitis, enthesitis, spondylitis, and skin involvement. Minimal disease activity (MDA) has been successfully used in daily clinical practice and is considered a reasonable treatment target in pat...
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Termedia Publishing House
2024-11-01
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| Series: | Rheumatology |
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| Online Access: | https://reu.termedia.pl/Minimal-disease-activity-and-associated-factors-in-patients-with-psoriatic-arthritis,194595,0,2.html |
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| author | Murat Bektas Berk Çelik Burak İnce Yasemin Yalçınkaya Bahar Artım Esen Ahmet Gül Murat İnanç |
| author_facet | Murat Bektas Berk Çelik Burak İnce Yasemin Yalçınkaya Bahar Artım Esen Ahmet Gül Murat İnanç |
| author_sort | Murat Bektas |
| collection | DOAJ |
| description | Introduction
Psoriatic arthritis (PsA) is a heterogeneous disease with various manifestations such as dactylitis, enthesitis, spondylitis, and skin involvement. Minimal disease activity (MDA) has been successfully used in daily clinical practice and is considered a reasonable treatment target in patients with PsA. In this study, we aimed to evaluate the MDA status and associated factors in patients with PsA in our tertiary referral clinic.
Material and methods
This cross-sectional study included patients who met the CASPAR classification criteria and had at least 6 months of follow-up data between 2001 and 2021. Patients who met at least 5 of 7 criteria (tender joint count ≤ 1/68, swollen joint count ≤ 1/66, Psoriasis Area Severity Index [PASI] ≤ 1, Visual Analogue Scale [VAS] ≤ 15, patient global VAS ≤ 20, Health Assessment Questionnaire-Disability Index [HAQ-DI] ≤ 0.5, and enthesitis number ≤ 1) were considered to achieve MDA.
Results
Data from 172 patients (61% female) were analyzed and included in the study. While most patients had polyarticular involvement (33.7%), mono-oligoarthritis was present in 30.2%, mixed type in 26.2%, isolated distal interphalangeal arthritis in 5.8%, isolated spondylitis in 2.9%, and arthritis mutilans in 1.2%. Overall, 95 (55.2%) of the patients were observed at MDA, which was lower in tumor necrosis factor inhibitor (TNFi) users compared to only conventional synthetic disease-modifying antirheumatic drug users. In univariate analysis, MDA was associated with higher patient age, longer psoriasis duration, late-onset PsA, and continued use of first TNFi. In multivariate analysis, higher patient age, late-onset PsA, and higher continuation rate of first TNFi were associated with MDA.
Conclusions
In the study, more than half of our patients achieved MDA status. A higher MDA rate was associated with a higher continuation rate at first-line TNFi treatment. The relatively large population who could not reach MDA status in our study indicates an unmet need for monitoring and treatment of PsA. |
| format | Article |
| id | doaj-art-28f50424760c41f592b7ec927a74db75 |
| institution | Kabale University |
| issn | 0034-6233 2084-9834 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Rheumatology |
| spelling | doaj-art-28f50424760c41f592b7ec927a74db752025-01-27T11:20:37ZengTermedia Publishing HouseRheumatology0034-62332084-98342024-11-0162533033710.5114/reum/194595194595Minimal disease activity and associated factors in patients with psoriatic arthritis: cross-sectional study from a single centerMurat Bektas0https://orcid.org/0000-0002-1788-3837Berk Çelik1Burak İnce2https://orcid.org/0000-0001-9813-2228Yasemin Yalçınkaya3https://orcid.org/0000-0001-9357-0456Bahar Artım Esen4https://orcid.org/0000-0002-5659-3955Ahmet Gül5https://orcid.org/0000-0001-8219-3720Murat İnanç6https://orcid.org/0000-0002-6376-5583Division of Rheumatology, Department of Internal Medicine, Istanbul Aydın University, Küçükçekmece/Istanbul, TurkeyIstanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyDivision of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyDivision of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyDivision of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyDivision of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyDivision of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyIntroduction Psoriatic arthritis (PsA) is a heterogeneous disease with various manifestations such as dactylitis, enthesitis, spondylitis, and skin involvement. Minimal disease activity (MDA) has been successfully used in daily clinical practice and is considered a reasonable treatment target in patients with PsA. In this study, we aimed to evaluate the MDA status and associated factors in patients with PsA in our tertiary referral clinic. Material and methods This cross-sectional study included patients who met the CASPAR classification criteria and had at least 6 months of follow-up data between 2001 and 2021. Patients who met at least 5 of 7 criteria (tender joint count ≤ 1/68, swollen joint count ≤ 1/66, Psoriasis Area Severity Index [PASI] ≤ 1, Visual Analogue Scale [VAS] ≤ 15, patient global VAS ≤ 20, Health Assessment Questionnaire-Disability Index [HAQ-DI] ≤ 0.5, and enthesitis number ≤ 1) were considered to achieve MDA. Results Data from 172 patients (61% female) were analyzed and included in the study. While most patients had polyarticular involvement (33.7%), mono-oligoarthritis was present in 30.2%, mixed type in 26.2%, isolated distal interphalangeal arthritis in 5.8%, isolated spondylitis in 2.9%, and arthritis mutilans in 1.2%. Overall, 95 (55.2%) of the patients were observed at MDA, which was lower in tumor necrosis factor inhibitor (TNFi) users compared to only conventional synthetic disease-modifying antirheumatic drug users. In univariate analysis, MDA was associated with higher patient age, longer psoriasis duration, late-onset PsA, and continued use of first TNFi. In multivariate analysis, higher patient age, late-onset PsA, and higher continuation rate of first TNFi were associated with MDA. Conclusions In the study, more than half of our patients achieved MDA status. A higher MDA rate was associated with a higher continuation rate at first-line TNFi treatment. The relatively large population who could not reach MDA status in our study indicates an unmet need for monitoring and treatment of PsA.https://reu.termedia.pl/Minimal-disease-activity-and-associated-factors-in-patients-with-psoriatic-arthritis,194595,0,2.htmlpsoriatic arthritisminimal disease activitybiological disease-modifying anti-rheumatic drugstumor necrosis factor inhibitors |
| spellingShingle | Murat Bektas Berk Çelik Burak İnce Yasemin Yalçınkaya Bahar Artım Esen Ahmet Gül Murat İnanç Minimal disease activity and associated factors in patients with psoriatic arthritis: cross-sectional study from a single center Rheumatology psoriatic arthritis minimal disease activity biological disease-modifying anti-rheumatic drugs tumor necrosis factor inhibitors |
| title | Minimal disease activity and associated factors in patients with psoriatic arthritis: cross-sectional study from a single center |
| title_full | Minimal disease activity and associated factors in patients with psoriatic arthritis: cross-sectional study from a single center |
| title_fullStr | Minimal disease activity and associated factors in patients with psoriatic arthritis: cross-sectional study from a single center |
| title_full_unstemmed | Minimal disease activity and associated factors in patients with psoriatic arthritis: cross-sectional study from a single center |
| title_short | Minimal disease activity and associated factors in patients with psoriatic arthritis: cross-sectional study from a single center |
| title_sort | minimal disease activity and associated factors in patients with psoriatic arthritis cross sectional study from a single center |
| topic | psoriatic arthritis minimal disease activity biological disease-modifying anti-rheumatic drugs tumor necrosis factor inhibitors |
| url | https://reu.termedia.pl/Minimal-disease-activity-and-associated-factors-in-patients-with-psoriatic-arthritis,194595,0,2.html |
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