Assessment of Enthesitis in Psoriatic Arthritis

Helliwell, Philip S.

doi:10.3899/jrheum.181380

Cited by 18 publications

(24 citation statements)

References 11 publications

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“…This article also highlights another unmet need in the field of axial PsA: specific axial disease activity measures 23,24 .…”

mentioning

confidence: 92%

“…The disease activity measures used in this study (BASDAI, ASDAS, and BASFI) are used in AS and nonradiographic axial SpA. They are borrowed for the assessment of axial PsA because there are no outcome measures developed specifically for axial PsA 23,24 . The BASDAI has not been found to correlate well with external indicators of axial disease activity such as treatment decisions, perhaps owing to the influence of peripheral joint disease on the BASDAI score.…”

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confidence: 99%

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What Is Axial Psoriatic Arthritis?

2018

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“…This article also highlights another unmet need in the field of axial PsA: specific axial disease activity measures 23,24 .…”

mentioning

confidence: 92%

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confidence: 99%

What Is Axial Psoriatic Arthritis?

2018

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“…However, PsA is not just about joints and skin, and one of the challenges of managing PsA is the heterogeneity of its clinical features. These features are reflected in the complexity of the clinical composite scores being developed and validated with organizations such as the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), an international organization of experts in this field …”

Section: Introductionmentioning

confidence: 99%

“…Two examples of such scores are the Psoriatic Arthritis Disease Activity Score (PASDAS) and Composite Psoriatic Disease Activity Index (CPDAI) . PASDAS is a complex weighted equation incorporating active joint counts (not spine), patient and physician global assessments, dactylitis, enthesitis, C‐reactive protein (CRP) and the Short Form‐36 (SF‐36) . CPDAI involves the sum of activity of the broadest number of clinical domains, including peripheral arthritis, function, skin, dactylitis, enthesitis and spine measured on 4‐point scales .…”

Section: Introductionmentioning

confidence: 99%

“…There are also composite scores modified specifically for PsA which are joint focused, such as DAPSA (Disease Activity index for PSoriatic Arthritis), which assesses 68 peripheral joints, patient pain and global assessments and CRP . However, this may not encompass the various features of psoriatic disease which need attention when considering treatment options, and which are important to patients . The optimal clinical composite score for those with PsA remains a highly contentious question among experts …”

Section: Introductionmentioning

confidence: 99%

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Prevalence of minimal disease activity in Australian patients with Psoriatic Arthritis: Assessing the outcome of national funding criteria for biologic disease‐modifying antirheumatic drug prescribing

et al. 2018

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Aim: Discrepancies exist between international treatment guidelines and currentAustralian Pharmaceutical Benefits Scheme (PBS) criteria for funding biologic disease-modifying antirheumatic drug (bDMARD) prescribing in psoriatic arthritis (PsA).We aimed to determine the prevalence of minimal disease activity (MDA) achievement and differences in inflammatory marker levels between PsA patients who have and have not met the Australian PBS criteria for bDMARDs. Method:Consecutive participants diagnosed with PsA were assessed for MDA components and serum inflammatory markers. For those on bDMARDs, joint counts and inflammatory markers at the time of bDMARD qualification were compared with matched rheumatoid arthritis (RA) controls.Results: Minimal disease activity was achieved by 56/105 participants overall. There were no differences in inflammatory marker levels or involved joint count patterns between the PsA and RA groups at the time of bDMARD qualification. Seventy-three percent of the 53 PsA patients on bDMARD achieved MDA, vs 33% in the non-bD-MARD group (P < 0.001). More bDMARD than non-bDMARD patients achieved four out of seven MDA components. Of those with any enthesitis, its prevalence was higher in the non-bDMARD group (22 vs 10, P = 0.009). Regardless of treatment, there was no difference in inflammatory marker levels between those who did and did not achieve MDA. Conclusion:The Australian PBS criteria, funding bDMARD prescribing for PsA, select well for MDA achievers. A high prevalence of MDA non-achievement remains in patients ineligible for bDMARD funding, and enthesitis in this population is more common. Inflammatory markers were not discriminators between treatment or MDA achievement groups. K E Y W O R D Sbiologics, enthesitis, inflammatory markers, minimal disease activity, psoriatic arthritis | 263 PONTIFEX ET al.

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Guselkumab, a Selective Interleukin‐23 p19 Subunit Inhibitor, Resolves Dactylitis in Patients With Active Psoriatic Arthritis: Pooled Results Through Week 52 From Two Phase 3 Studies

McGonagle

McInnes

Deodhar

et al. 2023

ACR Open Rheumatology

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Objective Previous analyses of pooled DISCOVER‐1 and DISCOVER‐2 data through Week 24 showed significantly higher rates of dactylitis resolution in patients treated with guselkumab compared with placebo. Here, we investigate associations between dactylitis resolution and other outcomes through 1 year. Methods Patients were randomized 1:1:1 to receive subcutaneous injections of guselkumab 100 mg at Week 0, Week 4, and then every 4 or 8 weeks, or placebo with crossover to guselkumab at Week 24. Independent assessors determined dactylitis severity score (DSS; 0‐3/digit; total = 0‐60). Dactylitis resolution (DSS = 0) (prespecified) and at least 20%, at least 50%, and at least 70% DSS improvement from baseline (post hoc) were determined through Week 52 (nonresponder imputation for treatment failure through Week 24 and for missing data through Week 52). ACR50, tender/swollen joints, low disease activity (LDA) as assessed by composite indices, and radiographic progression (DISCOVER‐2 only) were assessed in patients with dactylitis versus without dactylitis resolution at Week 24 and Week 52. Results Patients with dactylitis at baseline (473 of 1118) had more severe joint and skin disease than those without dactylitis (645 of 1118). At Week 52, approximately 75% of guselkumab‐randomized patients with dactylitis at baseline had complete resolution; approximately 80% had at least 70% DSS improvement. Through Week 52, new‐onset dactylitis (DSS ≥1) was uncommon among patients with a DSS of 0 at baseline. Guselkumab‐randomized patients with dactylitis resolution were more likely to achieve ACR50, at least 50% reduction in tender and swollen joints, and LDA at Week 24 and Week 52 than those without resolution. At Week 52, patients with dactylitis resolution had numerically less radiographic progression from baseline (DISCOVER‐2). Conclusion Through 1 year, approximately 75% of guselkumab‐randomized patients had complete resolution of dactylitis; patients exhibiting resolution were more likely to achieve other important clinical outcomes. Given the high burden of dactylitis, resolution may be associated with better long‐term patient outcomes.

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Assessment of Enthesitis in Psoriatic Arthritis

Cited by 18 publications

References 11 publications

What Is Axial Psoriatic Arthritis?

What Is Axial Psoriatic Arthritis?

Prevalence of minimal disease activity in Australian patients with Psoriatic Arthritis: Assessing the outcome of national funding criteria for biologic disease‐modifying antirheumatic drug prescribing

Guselkumab, a Selective Interleukin‐23 p19 Subunit Inhibitor, Resolves Dactylitis in Patients With Active Psoriatic Arthritis: Pooled Results Through Week 52 From Two Phase 3 Studies

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