AB0478 RATES OF REMISSION IN PATIENTS WITH PSORIATIC ARTHRITIS TREATED IN TERTIARY CARE (2024)

Abstract

Background: Less than one third of patients (pts) with psoriatic arthritis (PsA) achieve a state of remission in clinical trials. A recent meta-analysis investigating clinical trials and observational data showed that Disease Activity index for Psoriatic Arthritis (DAPSA)-defined remission was only achieved by one fourth of PsA pts [1]. Although remission is the main target in PsA, there is a lack of data retrieved from routine care.

Objectives: To evaluate the prevalence and remission rate over time in PsA pts in a tertiary care center.

Methods: Adult PsA pts who had ≥ 2 documented visits in the hospital information system were recruited consecutively. Patients’ and disease characteristics were documented prospectively at a clinical visit. Data of the initial visit (index visit) and date of first occurrence of remission (remission visit) between index and clinical visit were taken retrospectively from the hospital information system. Standardized assessment on disease activity (DAPSA, (Disease Activity Score 28 joints) DAS28) and physical function (HAQ-DI) were documented at index, clinical and remission visits. Remission was defined as DAPSA ≤ 4 or DAS28 < 2.6. Uni- and multivariable logistic regression analyses were used to examine the association between DAS28-remission (dependent variable) and various patients’ characteristics (independent variables) additionally adjusted for potential confounders (age, sex).

Results: We included 197 PsA pts with retrospective data for 3.8 (4.8) years with a total of 440 DAPSA and 1139 DAS28 values. At the clinical visit, disease activity was moderate and one third had severe disability (HAQ ≥ 1.28) and 25 pts (12.7 %) structural damage (Table 1). Almost half of the pts was receiving bDMARDs. Remission was achieved at least once by 118 pts (59.9 %) and varied between 16.2% (DAPSA-REM) and 38.1% (DAS28-REM) at clinical visit. State of remission occurred at a median of 1 year (IQE 0-3.8) after the index visit. 57 (48.3%) pts achieved the first remission state within the first year of treatment. No association between achieving a state of remission and the selected variables (sex, disease duration, CRP, swollen joints count (SJC), global pain (NRS), bDMARD use and BMI) could be found (Table 2).

Conclusion: Almost 60 % of PsA pts treated in routine care achieved at least once a state of remission during the observation period of 18 years. The remission rate was unexpectedly high even though the cohort had a high rate of severe disability. The data indicates that there is still a need for remission in PsA pts despite the bDMARDs-era. Further research is needed to evaluate pts factors associated with achievement of remission.

REFERENCES: NIL.

Acknowledgements: This study was funded in parts by Novartis Germany.

Disclosure of Interests: Uta Kiltz AbbVie, Amgen, Fresenius, GSK, Hexal, Janssen, Novartis, UCB, AbbVie, Amgen, Fresenius, GSK, Hexal, Janssen, Novartis, UCB, AbbVie, Amgen, Fresenius, GSK, Hexal, Janssen, Novartis, UCB, Markus J. Kluecken: None declared, Imke Redeker: None declared, Styliani Tsiami: None declared, David Kiefer Abbvie, BMS, Roche, Chugai, Novartis, UCB, Sanofi, MSD, Merck, GSK, Janssen, Boehringer Ingelheim, Galapagos, Abbvie, BMS, Roche, Chugai, Novartis, UCB, Sanofi, MSD, Merck, GSK, Janssen, Boehringer Ingelheim, Galapagos, Abbvie, Novartis, Barbara Guminski: None declared, Xenofon Baraliakos AbbVie, Amgen, Chugai, Galapagos, Lilly, MSD, Novartis, Pfizer, UCB and Sandoz., AbbVie, Amgen, Chugai, Galapagos, Lilly, MSD, Novartis, Pfizer, UCB and Sandoz., AbbVie, Amgen, Chugai, Galapagos, Lilly, MSD, Novartis, Pfizer, UCB and Sandoz.