Möller, Burkhard; Scholz, Godehard A; Amsler, Jennifer; Ciurea, Adrian; Micheroli, Raphael; Nissen, Michael J; Papagiannoulis, Eleftherios; Blapp, Christoph; Scherer, Almut; Yawalkar, Nikhil (2023). Biological disease-modifying anti-rheumatic drugs are equally effective in psoriatic arthritis patients with low and high joint counts. (In Press). Rheumatology Oxford University Press 10.1093/rheumatology/kead455
Text
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OBJECTIVE
A lack of representation in pivotal trials currently limits guidance for the use of biological disease-modifying anti-rheumatic drugs (bDMARDs) in psoriatic arthritis (PsA) patients with a low number of actively inflamed joints. The aim of this study was to compare the effectiveness of a first bDMARD in PsA patients with low vs high number of affected joints.
METHODS
PsA patients with available 66/68 joint count assessments were divided into low joint count (LJC) patients when presenting with <3 tender or < 3 swollen joints or high joint count patients (HJC) with > =3 joints in both categories. We studied drug retention as a joint count independent effectiveness variable in LJC and HJC patients in univariate and multivariable adjusted Cox regression models.
RESULTS
197 LJC patients differed not only in joint counts, but also had lower enthesitis scores, less often dactylitis, less disability and a better health related quality of life at first bDMARD initiation than 190 HJC patients. However, LJC were less often on conventional synthetic (cs) DMARDs. Despite these differences at baseline, bDMARD retention was not significantly different between LJC and HJC in both crude and adjusted analyses (Hazard Ratio (HR) 1.09 [0.76-1.58], p= 0.52). Furthermore, bDMARD retention was significantly better (HR 0.63 [0.47-0.85], p< 0.002) when administered with csDMARD co-therapy.
CONCLUSIONS
Biological DMARDs were similarly effective in terms of drug retention in patients with low and high joint counts. In the setting of absent remission and a significant disease burden, bDMARDs should not be withheld from patients because they exhibit only a low joint count.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology 04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology |
UniBE Contributor: |
Möller, Burkhard, Scholz, Godehard Albert, Amsler, Jennifer Susann, Yawalkar, Nikhil |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1462-0332 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
12 Sep 2023 12:03 |
Last Modified: |
12 Sep 2023 12:08 |
Publisher DOI: |
10.1093/rheumatology/kead455 |
PubMed ID: |
37676822 |
Uncontrolled Keywords: |
Psoriatic arthritis bDMARD retention effectiveness low/high joint count |
BORIS DOI: |
10.48350/186143 |
URI: |
https://boris.unibe.ch/id/eprint/186143 |