Development of a preliminary composite disease activity index in psoriatic arthritis

Mumtaz, Aizad; Gallagher, Phil; Kirby, Brian; Waxman, Robin; Coates, Laura C.; J, Douglas Veale; Helliwell, Philip S.; FitzGerald, Oliver

doi:10.1136/ard.2010.129379

Cited by 193 publications

(129 citation statements)

References 25 publications

(23 reference statements)

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“…Different disease activity measures have been proposed as treatment targets, such as the Psoriatic Arthritis Disease Activity Score, the Composite Psoriatic arthritis Disease Activity Index, the Disease activity index for PsA (DAPSA), and minimal disease activity (MDA) (11)(12)(13)(14). Of these measures, both MDA and DAPSA were recently recommended by international experts to be the main targets (15).…”

Section: Introductionmentioning

confidence: 99%

Burden of Psoriatic Arthritis According to Different Definitions of Disease Activity: Comparing Minimal Disease Activity and the Disease Activity Index for Psoriatic Arthritis

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Tchetveriko

et al. 2018

Arthritis Care & Research

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Objective Treat‐to‐target strategies have improved outcomes in rheumatic diseases. In psoriatic arthritis (PsA), the proposed targets are the multidimensional target minimal disease activity (MDA) and the articular target Disease Activity index for PsA (DAPSA). The aim of this study was to compare the disease burden of PsA in patients with low disease activity according to the 2 definitions, MDA and DAPSA low disease activity (DAPSA‐LDA), 1 year after diagnosis. Methods We obtained data on MDA, DAPSA‐LDA and disease burden 1 year after diagnosis for patients included in the Dutch southwest early PsA cohort. Disease burden was assessed in 2 domains: “Body functions,” including the Short Form 36 bodily pain (SF‐36 BP) measure, and “Activity,” including the Health Assessment Questionnaire (HAQ). Results Among the 292 patients included, 48% achieved MDA and 74% achieved DAPSA‐LDA. Average scores for Body functions and Activity were better in patients who achieved MDA and those who achieved DAPSA‐LDA. The scores were significantly better in the 46% of patients who achieved both MDA and DAPSA‐LDA than in the 29% of patients who achieved only DAPSA‐LDA. The average SF‐36 BP score was higher in patients achieving both targets (73.8; 95% confidence interval [95% CI] 71.1‐76.5) than in patients achieving only DAPSA‐LDA (57.6; 95% CI 54.5‐60.8). Similarly, mean HAQ scores measuring Activity were 0.21 (95% CI 0.15‐0.26) and 0.63 (95% CI 0.53‐0.72), respectively. Conclusion Among patients with newly diagnosed PsA, 48% achieved MDA and 74% achieved DAPSA‐LDA after 1 year of receiving usual care. The average disease burden was better in patients who achieved MDA and those who achieved DAPSA‐LDA. Also, patients who achieved only DAPSA‐LDA reported worse outcomes than those who also achieved MDA.

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Section: Introductionmentioning

confidence: 99%

Burden of Psoriatic Arthritis According to Different Definitions of Disease Activity: Comparing Minimal Disease Activity and the Disease Activity Index for Psoriatic Arthritis

Wervers

Vis

Tchetveriko

et al. 2018

Arthritis Care & Research

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“…Further, there is no consensus on the best measure of disease activity in PsA. Studies often refer to the RA-derived American College of Rheumatology (ACR) response criteria and sometimes to the 28-joint Disease Activity Score 7 . Because PsA is a multifaceted disease that displays variability in both presentation and disease course, including not only synovitis but also extraarticular musculoskeletal inflammation (e.g., in the digits, entheses, and spine) and inflammation of the skin and nails, several PsA-specific composite measures of disease activity have been developed 8,9 .…”

Section: Rheumatologymentioning

confidence: 99%

Minimal Disease Activity as a Treatment Target in Psoriatic Arthritis: A Review of the Literature

et al. 2017

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As in other inflammatory rheumatic diseases, the objective of psoriatic arthritis (PsA) treatment is the achievement of a defined target. Recent recommendations propose aiming for remission or low disease activity; however, a consensual definition of remission is lacking. A state of minimal disease activity (MDA) has been established and is defined by low activity assessed by tender/swollen joint counts, tender entheseal points, Psoriasis Area and Severity Index or body surface area, patient pain and global activity visual analog scale, and functional evaluation by Health Assessment Questionnaire. Since its development, MDA has been used increasingly in studies and clinical trials. In this article, the potential use of MDA as a treatment target in PsA is reviewed. The frequencies of MDA achievement with biologic disease-modifying antirheumatic drugs are summarized based on data from registries, observational studies, and clinical trials. Predictors and the prognostic effect of attaining MDA are also evaluated.

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“…An adaptation of the Disease Activity Index for Reactive Arthritis, renamed the Disease Activity Index for Psoriatic Arthritis (DAPSA), was developed from a clinical cohort of PsA patients and validated using PsA clinical trial data (6). A domain-based approach has been proposed with the development of a composite measure known as the Composite Psoriatic Disease Activity Index (CPDAI) (7). In the CPDAI, disease involvement is assessed in up to 5 domains: peripheral joints, skin, entheses, dactylitis, and spinal manifestations.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Composite Measures of Disease Activity in Psoriatic Arthritis Using Data From an Interventional Study With Golimumab

Helliwell

Kavanaugh

2014

Arthritis Care & Research

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Objective. To compare the performance of the Psoriatic Arthritis Disease Activity Score (PASDAS), the Arithmetic Mean of the Desirability Function (AMDF), the Composite Psoriatic Disease Activity Index (CPDAI), and the Disease Activity Index for Psoriatic Arthritis (DAPSA) in the GO-REVEAL data set. The Disease Activity Score using 28 joints (DAS28) was used as a comparator. Methods. The GO-REVEAL study did not allow full computation of all the composite scores (a modified version of CPDAI was used). The performance of the scores at baseline and followup (weeks 14 and 24) was compared using effect sizes. Results. All indices could distinguish response to treatment at 14 and 24 weeks. Effect sizes at 24 weeks for the 50 mg (100 mg) golimumab doses were 2.18 (2.36), 2.08 (2.36), 1.09 (1.41), 1.80 (1.78), and 1.13 (1.18) for PASDAS, AMDF, modified CPDAI, DAS28, and DAPSA, respectively. Comparison of 24-week values across the 3 treatment groups (placebo, golimumab 50 mg, and golimumab 100 mg) by an analysis of covariance using the baseline values as covariates gave the following F statistics: PASDAS 18.3, AMDF 19.6, modified CPDAI 9.4, DAS28 13.6, and DAPSA 7.9; all of these are highly significant. When the analysis was confined to the 2 golimumab treatment groups, there were no significant between-treatment group differences with any of the composite measures. Conclusion. PASDAS and AMDF were better able to distinguish treatment effect, having larger effect sizes at 24 weeks. PASDAS, AMDF, and modified CPDAI better reflected domains such as skin, enthesitis, and dactylitis.

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Development of a preliminary composite disease activity index in psoriatic arthritis

Abstract: CPDAI correlates well with patient and physician global disease activity assessments and is an effective tool that clearly distinguishes those who require a treatment change from those who do not.

Cited by 193 publications

References 25 publications

Burden of Psoriatic Arthritis According to Different Definitions of Disease Activity: Comparing Minimal Disease Activity and the Disease Activity Index for Psoriatic Arthritis

Burden of Psoriatic Arthritis According to Different Definitions of Disease Activity: Comparing Minimal Disease Activity and the Disease Activity Index for Psoriatic Arthritis

Minimal Disease Activity as a Treatment Target in Psoriatic Arthritis: A Review of the Literature

Comparison of Composite Measures of Disease Activity in Psoriatic Arthritis Using Data From an Interventional Study With Golimumab

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