Certain PsA Treatment Targets Are Linked To Vascular Benefits

Achieving certain psoriatic arthritis (PsA) treatment targets may yield vascular benefits for patients, according to findings from a new analysis.

“Achieving [sustained minimal disease activity/sustained PsA Disease Activity Score-low disease activity], but not [sustained Disease Activity in PsA-low disease activity], was associated with a protective effect in subclinical atherosclerosis and arterial stiffness progression,” the researchers wrote.

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The finding stemmed from a posthoc analysis of a 2-year treat-to-target study that focused on minimal disease activity among 101 consecutive patients with PsA without overt cardiovascular disease. 

The researchers assessed the vascular effects of achieving low disease activity as defined by 3 treatment targets: minimal disease activity, Disease Activity in PsA score of 14 or less, or PsA Disease Activity Score of 3.2 or less. Disease control was considered sustained when targets were achieved at each visit from month 12 through month 24.

The analysis findings focused on 90 patients who had completed 24 months of follow-up. Among them, 44% achieved sustained Disease Activity in PsA-low disease activity, 48% achieved sustained PsA Disease Activity Score-low disease activity, and 45% achieved sustained minimal disease activity.

Sustained minimal disease activity was associated with significantly less progression of carotid intima-media thickness, the findings showed.

“Using multivariate analysis, achieving [sustained minimal disease activity] and [sustained PsA Disease Activity Score-low disease activity] had a protective effect on plaque progression, less increase in total plaque area, reduced mean intima-media thickness, and reduced augmentation index after adjusting for covariates,” the researchers wrote.

“In contrast, no significant differences in the progression of vascular parameters were demonstrated between patients who did or did not achieve [sustained Disease Activity in PsA-low disease activity.]”

According to the researchers, the findings suggest that a multidimensional domain of disease control may be effective in minimizing cardiovascular risk among patients with PsA.

—Jolynn Tumolo

Reference:

Cheng IT, Li EK, Wong PC, et al. Treat to target and prevention of subclinical atherosclerosis in psoriatic arthritis—Which target should we choose? Rheumatology (Oxford). 2020;59(10):2881-2892. https://doi.org/10.1093/rheumatology/keaa025