SAT0443 Identification of predictors of minimal disease activity in early psoriatic arthritis. (15th June 2017)

• Record Type: Journal Article
• Authors: Zabotti, A; Idolazzi, L; Quartuccio, L; Sartori, M; Fassio, A; Zuliani, F; Gatti, D; Rossini, M; Vita, S De
• Is Part Of: Annals of the rheumatic diseases. Volume 76(2017)Supplement 2
• Page Start: 940
• Page End: 940
• Publication Date: 2017-06-15
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2017-eular.4987
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Psoriatic arthritis (PsA) is a systemic inflammatory disease with articular and extra-articular features, the disease activity ranges from mild mono-oligoarthritis to destructive polyarthritis. Hence, establishing the prognosis of a patient with PsA is important to better define the treatment strategy. Furthermore, minimal disease activity (MDA) is a validated composite outcome measure since it correlates well with long-term outcomes (e.g. development of joint damage) 1 . Objectives: The aim of this study was to identify the baseline clinical variables associated with MDA at 12th month of follow up in two cohorts of early PsA. Methods: Consecutive PsA patients, attending the outpatient Early Arthritis Clinic in Udine or Verona in the last two years, were assessed. All the included patients had: I) CASPAR score ≥2 2 II) new diagnosis of PsA III) a complete clinical data and follow-up of at least 12 months. The GRAPPA recommendations on the management of PsA were followed. Statistical analysis included T- test, ANOVA and Pearson's test in order to find possible predictors of MDA. Results: Eighty-one early PsA patients were included in the study. 47/81 (58.2%) reached MDA at 12th month of follow-up; 68/81 (83.9%) were in c-DMARDs while 11/81 (13.6%) were in b-DMARDs. Two variables at baseline were selected comparing the groups based on achievement of MDA. These were: 1) LEI, which was significantly lower at baseline in patients reaching MDA (0.43 Vs 0.86, p=0.001); and 2) a lower baseline CRP (1.2 mg/dl vs 2.8 mg/dl, p=0.008). Of note, neither the baseline disease activity evaluated with DAPSA nor the time to referral were selected by statistical analysis. Conclusions: Baseline lower LEI score and lower CRP were identified as clinical predictors of MDA after 12 months of treatment in PsA. Therefore, patients with a more active enthesitis or higher inflammation may have a less responsive disease. This may be relevant to select proper treatments at baseline, and indirectly confirms that enthesitis is a key therapeutic target in PsA. References: Coates LC, Fransen J, Helliwell PS. Defining minimal disease activity in psoriatic arthritis: a proposed objective target for treatment. Ann Rheum Dis 2010; 69: 48–53. Coates LC, Conaghan PG, Emery P et al. Sensitivity and specificity of the classification of psoriatic arthritis criteria in early psoriatic arthritis. Arthritis Rheum 2012; 64: 3150–3155. Disclosure of Interest: None declared