scholarly journals THU0304 Association of anxiety, depression and fatigue with disease activity, joints erosion and skin lesion severity in early psoriatic arthritis patients

2018 ◽  
Author(s):  
E.E. Gubar ◽  
E.Y. Loginova ◽  
A.D. Koltakova ◽  
S.I. Glukhova ◽  
T.V. Korotaeva
Keyword(s):  
Psoriatic Arthritis ◽  
Skin Lesion ◽  
Disease Activity ◽  
Anxiety Depression ◽  
Early Psoriatic Arthritis ◽  
Lesion Severity

scholarly journals FRI0341 RISK FACTORS FOR AXIAL INVOLVEMENT IN EARLY PSORIATIC ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 764-765
Author(s):  
E. Gubar ◽  
E. Loginova ◽  
S. Glukhova ◽  
T. Korotaeva
Keyword(s):  
Psoriatic Arthritis ◽  
Skin Lesion ◽  
Early Stage ◽  
Hla B27 ◽  
Peripheral Arthritis ◽  
X Ray ◽  
Male Sex ◽  
Early Psoriatic Arthritis ◽  
Axial Involvement ◽  
Lesion Severity

Background:Axial Involvement in psoriatic arthritis (PsA) is quite common [1]. Predictors of axial involvement at early-stage of disease haven’t been sufficiently studied.Objectives:To identify predictors of axial involvement in PsA patients (pts) at early-stage of disease.Methods:95 patients (pts) (M/F–47/48) with early PsA fulfilling the CASPAR criteria were included. All pts had peripheral arthritis for≤2 years; no inflammatory back pain (IBP) pts were specifically selected. Mean (Me) age 36.5±10.7 yrs, disease duration 12.2±10.3 mo. Pts underwent standard clinical examination of PsA activity. Me disease activity indexes DAS=4.0±1.4, DAS28=4.2±1.1, BASDAI=4.5±1.6; Me pts global disease activity VAS 56.9±17.1. All patients were evaluated for the presence of IBP by ASAS criteria, underwent sacroiliac joints (SIJs) X-ray (pelvic radiographs) and HLA B27 antigen status study. MRI of SIJs was performed in 79 pts, regardless of IBP presence, on Signa Ovation 0.35T. Radiographic sacroiliitis (R-SI) was identified according to New York criteria (unilateral grade≥3 or bilateral grade≥2). Bone marrow edema/ osteitis on MRI (STIR) was considered active MRI sacroiliitis (MRI-SI). X-ray and MRI results were evaluated by an independent reader. IBP was observed in 63 (66.3%) cases, MRI-SI in 28 of 79 (35.4%) examined cases, R-SI in 29 (30.5%) cases. Skin lesion severity was evaluated as body surface area (BSA) affected: minor at <3%, mild at 3-10%, severe at >10%. Pts were split into 2 groups (gr.): those with axial involvement (axPsA), that is with IBP and/or R-SI and/or MRI-SI; and those without axial involvement (having only peripheral PsA [pPsA]).The axPsA gr. included 65 (68.4%) cases, the pPsA gr. 30 (31.6%) cases. Multi-dimensional step-by-step discriminant analysis was used to identify a group of features that are more typical for the axPsA patients.Results:The following features proved to be the most informative: male sex (р = 0.300), presence of HLA B27 (р = 0.107), mild or high DAS (р = 0.098), skin lesion severity BSA>3% (р = 0.118), and CRP > 5 mg/L (0.038).Sensitivity of model 79.0%, specificity of model 57.7%. Area under ROC curve 0.756; 95% CI (0.642-0.869).Conclusion:It is a combination of features – male sex, HLA-B27 positivity, mild or high activity of peripheral arthritis according to DAS, CRP > 5 mg/L, and BSA> 3% – that constitutes a clinical predictor for the development of axial involvement in early psoriatic arthritis.References:[1]V. Chandran et al. Curr Opin Rheumatol. 2019;31:329-34Disclosure of Interests:ELENA GUBAR: None declared, Elena Loginova Speakers bureau: Janssen, Svetlana Glukhova: None declared, Tatiana Korotaeva Grant/research support from: Pfizer, Consultant of: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB, Speakers bureau: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB

scholarly journals Achieving sustained minimal disease activity with methotrexate in early interleukin 23-driven early psoriatic arthritis

RMD Open ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e001175
Author(s):  
Hannah den Braanker ◽  
Kim Wervers ◽  
Adriana M C Mus ◽  
Priyanka S Bangoer ◽  
Nadine Davelaar ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Usual Care ◽  
Treat To Target ◽  
Minimal Disease Activity ◽  
Cytokine Profiles ◽  
First Line Therapy ◽  
Minimal Disease ◽  
Interleukin 23 ◽  
Early Psoriatic Arthritis

ObjectivesMethotrexate (MTX) is currently the recommended first-line therapy for treating psoriatic arthritis (PsA), despite lacking clear evidence. No estimates of efficacy of MTX in usual care and no clear MTX responsive clinical or laboratory variables are currently available. This study describes the response to MTX monotherapy in newly diagnosed patients with PsA in usual care. Second, we compared clinical variables and cytokine profiles in patients responding and not responding to MTX monotherapy.MethodsWe used data collected in the Dutch southwest Early Psoriatic Arthritis cohoRt study to select patients with PsA with oligoarthritis or polyarthritis, and at least 1 year follow-up. We analysed disease activity at 6 months of patients who started MTX monotherapy and still used MTX monotherapy 1 year after diagnosis. Cytokine profiles were determined at baseline and after 3 and 6 months with a bead-based multi-immunoassay.ResultsWe identified 219 patients of which 183 (84%) patients started MTX monotherapy within 6 months after diagnosis. 90 patients used MTX monotherapy throughout the first year of which 44 patients (24%) reached minimal disease activity(MDA) at 6 months, decreasing to 33 patients (18%) after 1 year. Non-responders had significantly higher concentrations of interleukin (IL) 23 and IL-10 before and during MTX therapy.ConclusionsOur results showed that only 18% of patients with PsA are in sustained MDA after 1 year of MTX monotherapy and non-responders more often had IL-23-driven disease. Our results indicate the need for more treat-to-target and personalised therapy strategies in PsA.

scholarly journals Long-term follow-up of patients in the TIght COntrol of inflammation in early Psoriatic Arthritis (TICOPA) trial

Rheumatology ◽  
2019 ◽  
Vol 59 (4) ◽  
pp. 807-810 ◽  
Author(s):  
Laura C Coates ◽  
Farrouq Mahmood ◽  
Jane Freeston ◽  
Paul Emery ◽  
Philip G Conaghan ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Drug Use ◽  
Disease Activity ◽  
Clinical Outcomes ◽  
Therapeutic Drug ◽  
Tight Control ◽  
Low Disease Activity ◽  
Clinical Advantage ◽  
Early Psoriatic Arthritis

Abstract Objectives The TIght COntrol of inflammation in early Psoriatic Arthritis (TICOPA) study was the first strategy trial in psoriatic arthritis using an early treat-to-target strategy to improve clinical outcomes. The current study aimed to review a cohort of patients who had completed TICOPA to judge if the clinical advantage gained by participants in the tight control (TC) arm was sustained, and to explore subsequent therapy. Methods A case note review was conducted for a cohort of patients who had participated in TICOPA. Current drug use and clinical status were obtained, with low disease activity judged as no tender or swollen joints, no dactylitis and enthesitis, and no change in treatment required. Results Approximately five years after completion of the TICOPA study, notes were reviewed for 110 patients [TC, n = 54; standard care (StdC), n = 56]. Disease activity was found to be similar in both groups (current low disease activity: TC 69%, StdC 76%). Biologic use at the end of the study was higher in the TC arm (TC 33%, StdC 9%), but at review a similar percentage in both groups were taking biologic drugs (TC 54%, StdC 52%), whereas MTX use diminished. Conclusion After several years, clinical outcomes and therapeutic drug use were similarly good for patients in both arms of the TICOPA study, with no obvious clinical advantage after TC ended. Notably, TC did not result in greater biological use long term, and MTX use decreased in both arms of the study.

SAT0294 Monitoring disease activity in early psoriatic arthritis with ultrasound - comparison of clinical responders and nonresponders

2013 ◽  
Vol 71 (Suppl 3) ◽  
pp. 571.3-571
Author(s):  
A.P. Nigg ◽  
A.M. Malchus ◽  
M. Grünke ◽  
M. Witt ◽  
J.C. Prinz ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Early Psoriatic Arthritis

scholarly journals Effectiveness, Safety and Tolerance of Methotrexate in Vietnamese Psoriatic Arthritis Patients

2019 ◽  
Vol 7 (2) ◽  
pp. 250-252
Author(s):  
Van Bui Thi ◽  
Vinh Ngo Minh ◽  
Anh Tran Ngoc ◽  
Quyet Tran Dang ◽  
Diep Le Ngoc ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Skin Lesion ◽  
Complete Remission ◽  
Disease Activity ◽  
Treatment Response ◽  
Disease Activity Score ◽  
Nausea And Vomiting ◽  
Activity Score ◽  
Normal Range ◽  
Upper Limit

AIM: To access the effectiveness, safety and tolerance of methotrexate (MTX) in psoriatic arthritis (PsA) treatment. METHODS:  We recruit 37 patients, admitted at HCMC Hospital of Dermato-Venereology from 1/2016 to 3/2017, with MTX dosage ranging from 10 mg to 15 mg per week. RESULTS: Skin lesion response after 12 weeks improved PASI 50: 40.5%, PASI 75: 24.3%. Disease activity score decreased after 12 weeks with ∆DAS28 = -1.43 + 0.79, 37.8% PsA achieved complete remission. Nausea and vomiting were 8.1%. These symptoms were mild and transient. We did not stop MTX usage. The rate of elevating SGPT 2-3 times as much as the upper limit of the normal range was 2.7%. CONCLUSION: We finally demonstrated that the rate of treatment response in Vietnam is the same as demonstrated by foreign authors in other countries.

scholarly journals Sex-Specific Differences and How to Handle Them in Early Psoriatic Arthritis

2021 ◽  
Author(s):  
Evangelia Passia ◽  
Marijn Vis ◽  
Laura Coates ◽  
Anuska Soni ◽  
Ilja Tchetverikov ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Functional Capacity ◽  
Cohort Analysis ◽  
Treatment Strategies ◽  
Patient Characteristics ◽  
Tender Joint Count ◽  
Tender Joint ◽  
Duration Of Symptoms ◽  
Early Psoriatic Arthritis

Abstract Objectives:The prevalence of Psoriatic Arthritis (PsA) is the same in men and women, however, the latter experience a higher burden of disease and are affected more frequently by polyarthritis. Here, we performed an early PsA cohort analysis to assess sex-related differences in demographics, disease characteristics and evolution over 1 year including applied treatment strategies. Methods:Our study is embedded in the Dutch south-west Early Psoriatic Arthritis cohoRt. We described patient characteristics and treatment decisions. For the comparison across sexes and baseline and 1 year follow up, appropriate tests depending on the distribution were used. Results:273 men and 294 women with no significant differences in age and ethnicity were included. Women reported significantly longer duration of symptoms before diagnosis and significantly higher tender joint count, a higher disease activity, higher levels of pain and lower functional capacity. Although minimal disease activity (MDA) rates increased over time for both sexes, MDA remained significantly more prevalent among men at one year (58.1% vs 35.7%, p<0.00). Initially, treatment strategies were similar in both sexes with Methotrexate being the most frequently used drug during the first year. Women received Methotrexate for a shorter period [196(93-364) vs 306(157-365), p<0.00] and therefore received a lower cumulative dose compared to men. Retention time was shorter for all DMARDs and women had a delayed start on b-DMARDs. Conclusion:After 1 year of standard-of-care treatment women didn’t surpass their baseline disadvantages. Despite the overall improvement, they still presented higher disease activity, higher levels of pain and lower functional capacity score than men. The nature of these findings may advocate a need for sex specific adjustment of treatment strategies and evaluation in early PsA patients.

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