Predictors of early minimal disease activity in patients with psoriatic arthritis treated with tumor necrosis factor-α blockers

Salvatore Iervolino, Matteo Nicola Dario Di Minno, Rosario Peluso, Mariana Lofrano, Anna Russolillo, Giovanni Di Minno, Raffaele Scarpa

Research output: Contribution to journalArticle

Abstract

Objective. To identify predictors of early minimal disease activity in patients with psoriatic arthritis (PsA) receiving tumor necrosis factor-&αλπηα; (TNF-α) antagonists. Methods. In total 146 consecutive patients with PsA eligible for anti-TNF- &αλπηα; therapy were enrolled. At baseline (T0) information about age, sex, PsA subset, disease duration, comorbidities, and treatments was collected. All subjects were tested for metabolic syndrome (MetS) and/or liver steatosis. A clinical and laboratory evaluation was performed at T0 and at 3 months (T3). Changes in all these variables were compared in subjects achieving minimal disease activity (MDA) and those who did not. Results. Among 146 PsA subjects, 10 discontinued therapy before 3-month followup because of adverse events; thus 136 concluded the study. All clinical outcome measures changed significantly from T0 to T3. Erythrocyte sedimentation rate showed a significant reduction (p <0.001). C-reactive protein (CRP), serum cholesterol, and triglycerides showed no significant variation (p > 0.05). The prevalence of MetS and liver steatosis showed no significant differences between subjects achieving MDA and those who did not (p = 0.347 and 0.053, respectively). Patients achieving MDA at T3 were younger than those not achieving MDA (p = 0.001). A lower baseline tender joint count (p = 0.001), swollen joint count (p = 0.013), Bath Ankylosing Spondylitis Disease Activity Index (p = 0.021), and Ritchie index (p = 0.006) were found in subjects achieving MDA. Age (OR 0.896, p = 0.003) and Bath Ankylosing Spondylitis Functional Index (BASFI) (OR 0.479, p = 0.007) inversely predicted, whereas CRP (OR 1.78, p = 0.018) directly predicted, achievement of MDA at T3. Conclusion. In patients with PsA, age, CRP, and BASFI at the beginning of treatment were found to be reliable predictors of MDA after 3 months of TNF-α blocker therapy. The Journal of Rheumatology

Original languageEnglish
Pages (from-to)568-573
Number of pages6
JournalJournal of Rheumatology
Volume39
Issue number3
DOIs
Publication statusPublished - Mar 2012

Keywords

  • Minimal disease activity
  • Predictors of response
  • Psoriatic arthritis
  • Tumor necrosis factor-α blocker

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

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    Iervolino, S., Di Minno, M. N. D., Peluso, R., Lofrano, M., Russolillo, A., Di Minno, G., & Scarpa, R. (2012). Predictors of early minimal disease activity in patients with psoriatic arthritis treated with tumor necrosis factor-α blockers. Journal of Rheumatology, 39(3), 568-573. https://doi.org/10.3899/jrheum.110763