E. Loginova, T. Korotaeva, E. Gubar, S. Glukhova
2021 Annals of the Rheumatic Diseases  
Background:The goal of treat to target strategy (T2T) in psoriatic arthritis (PsA) is attaining remission or minimal disease activity (MDA). The benefits of T2T have been seen recently [1]. But prognostic factors for MDA achievement in PsA patients (pts) at an early-stage hasn't been studied yet.Objectives:to determine the prognostic factors associated with MDA achievement within 12 months (mos.) of treatment according to T2T strategy in early PsA pts.Methods:77 pts (M/F=36/41) with early
more » ... PsA fulfilling the CASPAR criteria were included. Mean age 36.9±10.45 years (yrs.), PsA duration 11.1±10.0 mos., Psoriasis (PsO) duration 82.8±92.1 mos. At baseline (BL) and at 12 mos. of therapy PsA activity by tender joint count (TJC)/68, swelling joint count (SJC)/66, Pain (VAS), Patient global assessment disease activity (PtGA, VAS), CRP mg/l, dactylitis, enthesitis by LEI and plantar fascia, BSA (%), HAQ and fatigue by FACIT (Functional Assessment of Chronic Illness Therapy) Fatigue Scale (Version 4) were evaluated. A score FACIT <30 indicates severe fatigue and > 30 – less fatigue. All pts was given therapy with Methotrexate (MTX) s/c. After 3-9 mos. of ineffectiveness of MTX treatment 29 pts were given biologic DMARDs. By 12 mos. of therapy, the proportion of pts who had reached MDA (5/7) were calculated. Pts were split into 2 groups: MDA + (n=45) and MDA - (n=32). The one-factor model of logistic regression was used to identify a group of features that are associated with MDA achievement. M±SD, Me [Q25; Q75], Min-Max, %, t-test, Pierson-χ2, Manna-Whitney tests, ORs with 95% CI were performed. All p<0.05, were considered to indicate statistical significance.Results:Comparative analysis in both groups and one-factor model of logistic regression showed the following features at BL were associated with MDA achievement: TJC/SJC < 3 (p<0.001), PGA ≤ 20 mm (p<0.001), Pain (VAS) ≤ 15 mm (p<0.001), CRP ≤ 5 mg/l (p< 0.03), HAQ ≤ 0.5 (p< 0.001), FACIT > 30 (p< 0.021), absent of entesitis (p< 0.003), dactylitis (p< 0.029) and nail damage (p< 0.012). Early PsA pts with combination of these features at first visit have more chance to achieve MDA within 12 mos in comparison to PsA pts without them, OR=9.684 [CI 95% 4.6-20.4]. (Figure 1).Conclusion:It is a combination of features at first visit to clinic – TJC, SJC < 3, PGA ≤ 20 mm, pain ≤ 15 mm, CRP ≤ 5 mg/l, HAQ ≤ 0.5, FACIT > 30 points, absent of entesitis, dactylitis and nail PsO - that constitutes a clinical prognostic factors for MDA achievement within 12 mos of T2T strategy in early PsA pts.References:[1]Coates LC, et al. Lancet. 2015 Dec 19;386(10012):2489-98. doi: 10.1016/S0140-6736(15)00347-5Figure 1.The prognostic factors associated with achievement MDA within 12 months in early PsA ptsDisclosure of Interests:None declared
doi:10.1136/annrheumdis-2021-eular.1704 fatcat:buruu54nizgkfo5ew5ifazpeky