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Biological Disease-Modifying Anti-Rheumatic Drugs Effective in Patients With Psoriatic Arthritis
According to a study published in Rheumatology, biological disease-modifying anti-rheumatic drugs (bDMARDs) were similarly effective in terms of drug retention in patients with low and high joint counts.
Researchers aimed to address the lack of representation in pivotal trials regarding the use of bDMARDs in patients with psoriatic arthritis (PsA) with varying degrees of joint inflammation. Specifically, the study aimed to compare the effectiveness of a first bDMARD in patients with PsA and a low number of actively inflamed joints (LJC) vs those with a high number of affected joints (HJC).
The research involved categorizing patients with PsA based on their joint counts: patients with LJC had less than 3 tender or swollen joints, whereas patients with HJC had 3 or more joints in both categories. Notably, patients with LJC, in addition to having lower joint counts, exhibited lower enthesitis scores, less dactylitis, lower disability levels, and better health-related quality of life at the initiation of their first bDMARD. However, they were less frequently on conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). Despite these baseline differences, the study found that bDMARD retention, a key measure of effectiveness, was not significantly different between patients with LJC and patients with HJC in both unadjusted and adjusted analyses. This suggests that bDMARDs were similarly effective in terms of drug retention regardless of the initial joint count.
“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,” the authors concluded.
Reference
Möller B, Scholz GA, Amsler J, et al. Biological disease-modifying anti-rheumatic drugs are equally effective in psoriatic arthritis patients with low and high joint counts. Rheumatology (Oxford). Published online September 7, 2023. doi:10.1093/rheumatology/kead455
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