Patients with psoriatic arthritis (PsA) initiating biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) face challenges in achieving minimal disease activity (MDA) and very low disease activity (VLDA), according to a study presented at the American College of Rheumatology Convergence in Washington, DC.

Philip Mease, MD, of St. Joseph Health in Seattle, Washington, on behalf of himself and colleagues, presented a poster on a retrospective analysis to understand the unmet MDA/VLDA criteria among patients initiating b/tsDMARDs.

Dr Mease is a clinical professor and director of rheumatology research at Swedish Medical Center/Providence St. Joseph Health in Seattle, Washington.

The study included 2093 patients in the MDA cohort and 2491 in the VLDA cohort, spanning March 2013 to October 2023. Patients were evaluated at treatment initiation (index) and again at 6 months. Those already achieving MDA or VLDA at index were excluded from respective cohorts.

Results revealed that at 6 months, only 18% of patients in the MDA cohort and 8% in the VLDA cohort met the criteria for achieving MDA and VLDA, respectively. Notably, 24% of MDA nonachievers (n=398/1686) and 11% of VLDA nonachievers (n=236/2242) were 1 criterion short of reaching their targets.

Among MDA nonachievers, the most frequently unmet criteria were patient-reported outcomes (PROs) such as pain (86%), patient’s global assessment (PGA; 75%), and the Health Assessment Questionnaire (HAQ; 64%). Similarly, for VLDA nonachievers, pain (41%), tender joint count (12%), and HAQ (12%) were the primary unmet criteria.

Baseline characteristics showed that nonachievers were older, more likely to be female, current smokers, and obese, with higher rates of depression, anxiety, and fibromyalgia. Despite treatment, 40% of patients who achieved MDA still reported pain above the acceptable threshold at the 6-month mark.

The researchers concluded that while some progress is made with b/tsDMARDs, significant unmet needs remain, especially related to PROs. Addressing patient-reported symptoms could enhance the achievement of MDA and VLDA and improve overall patient outcomes.

Reference:

Mease P, Ogdie A, Song C, et al. 0581: Unmet criteria for achieving minimal and very low disease activity among patients with psoriatic arthritis initiating biologic or targeted synthetic disease-modifying antirheumatic drugs in the CorEvitas PsA/SpA registry. Presented at: American College of Rheumatology. November 14–19, 2024. Washington, DC.