Trajectory of radiographic change over a decade: the effect of transition from conventional synthetic disease-modifying antirheumatic drugs to anti-tumour necrosis factor in patients with psoriatic arthritis

Allard, Andrew; Antony, Anna; Shaddick, Gavin; Jadon, Deepak R.; Cavill, Charlotte; Robinson, Graham; Korendowych, Eleanor; McHugh, Neil; Tillett, William

doi:10.1093/rheumatology/key297

Cited by 13 publications

(13 citation statements)

References 19 publications

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“…In another study that compared several outcome measures for physical function in PsA, the ceiling effect of the HAQ DI in PsA stood high, at 24%, compared with 7.5% for the physical functioning domain of the SF‐36 (13). This ceiling effect makes the HAQ DI inappropriate for modern PsA clinical studies, where physical function is being examined at a higher level of functioning than before the availability of targeted therapeutics (47).…”

Section: Discussionmentioning

confidence: 99%

Comparing the Patient‐Reported Physical Function Outcome Measures in a Real‐Life International Cohort of Patients With Psoriatic Arthritis

Leung

Orbai²,

Wit

et al. 2021

Arthritis Care & Research

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for the Remission/Flare in PsA Study Group Objective. We evaluated the psychometric properties of 3 patient-reported outcome measures to assess the physical function in psoriatic arthritis (PsA). Methods. Data were available for the Health Assessment Questionnaire disability index (HAQ DI), the 12-item Short Form instrument physical component summary (SF-12 PCS), and the Psoriatic Arthritis Impact of Disease instrument functional capacity score (PsAID-FC). Data came from a longitudinal study in 14 countries of consecutive adults with definite PsA with ≥2 years of duration. The score distribution, construct validity, responsiveness, and thresholds of meaning of the patient-reported outcome measures were evaluated. Results. At baseline, 414 subjects (52% male) were analyzed. The mean ± SD age was 52.4 ± 12.5 years and duration of illness was 10.9 ± 8.1 years. Ceiling effects were noted in 31% and 21% of patients for HAQ DI and PsAID-FC, respectively; floor effects were minimal. All 3 patient-reported outcome measures met a priori hypotheses for construct validity. After a median follow-up of 4.1 (interquartile range 2.7) months in 350 patients, 27%, 54%, and 18% of patients reported themselves improved, not changed, and worsened, respectively. Change scores were statistically different for groups for worsening versus no-change for all patient-reported outcome measures. PsAID-FC was more sensitive to change than the other 2 patient-reported outcome measures. Comparing groups with worsening condition to no-change, the standardized response mean square ratios were HAQ DI 29.9, SF-12 PCS 16.7, and PsAID-FC 40.1. Conclusion. HAQ DI, SF-12 PCS, and PsAID-FC are valid measures of physical function for PsA. PsAID-FC, a single question, performed similarly to the other patient-reported outcome measures and may be an additional option to measure PsA-specific physical function.

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Section: Discussionmentioning

confidence: 99%

Comparing the Patient‐Reported Physical Function Outcome Measures in a Real‐Life International Cohort of Patients With Psoriatic Arthritis

Leung

Orbai²,

Wit

et al. 2021

Arthritis Care & Research

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“…[7] Whilst there is some data on osteoproliferation in observational cohorts on biological therapy, no RCTs have directly utilised the Ratingen score. [38] A number of RCTs have assessed the yield of assessing for proliferative features such as osteitis and ankyloses, and have not noted a significant progression in these features over time nor a significant difference between treatment arms. [14,15,21,22,27,[39][40][41][42] These findings, and the impact on feasibility if such features were to be included, suggest that there may be little value in modifications of the mTSS or the mSvDHs to include proliferative change.…”

Section: Discussionmentioning

confidence: 99%

“…Contemporary evidence suggests that peripheral and axial radiographic damage is common and often progressive. [38,49,52,53] However there is significant heterogeneity in the clinical phenotypes of PsA patients, particularly in observational cohorts. This raises the issue of monitoring structural damage in other phenotypes such as oligoarticular large joint PsA and enthesitis.…”

Section: Discussionmentioning

confidence: 99%

Measurement properties of radiographic outcome measures in Psoriatic Arthritis: A systematic review from the GRAPPA-OMERACT initiative

Antony

Holland

D'Agostino

et al. 2021

Seminars in Arthritis and Rheumatism

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“…Historically, in PsA, the first-line treatment was a nonbiologic DMARD, but patterns are changing, with growing evidence that biologics, but not nonbiologics, improve clinical and radiographic outcomes in PsA. 19,[40][41][42][43] These changes likely contributed to the slightly higher rates of biologic DMARDs in PsA than RA as the initial DMARD after diagnosis.…”

Section: ■■ Discussionmentioning

confidence: 99%

Treatment Patterns with Disease-Modifying Antirheumatic Drugs in U.S. Veterans with Newly Diagnosed Rheumatoid Arthritis, Psoriatic Arthritis, or Ankylosing Spondylitis

Walsh

Pei

Penmetsa

et al. 2019

JMCP

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BACKGROUND: Delays in treatment for inflammatory arthritis (IA) are associated with unfavorable outcomes, including impaired quality of life, irreversible joint damage, and disability. OBJECTIVE: To characterize treatment initiation patterns in veterans with newly diagnosed rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ankylosing spondylitis (AS). METHODS: ICD-9/10-CM codes and natural language processing were used to identify incident cases of RA, PsA, or AS between January 1, 2007, and December 31, 2015, in patients enrolled in the Veterans Health Administration. Patterns of treatment initiation and nontreatment with disease-modifying antirheumatic drugs (DMARDs) were assessed in the 12-month follow-up period after the incident diagnosis. Outcomes included the percentage of veterans treated with a DMARD, the mean time to the initial DMARD after diagnosis, and the percentage of veterans who accessed rheumatology care before DMARD initiation. To assess outcomes over time, veterans were grouped by year of initial IA diagnosis. Additionally, outcomes were compared between nonbiologic and biologic DMARDs and among IA subtypes (RA, PsA, and AS). Groups were statistically compared with 95% confidence intervals.RESULTS: The population consisted of 12,118 IA veterans (9,711 RA, 1,472 PsA, and 935 AS), with 91.3% males and a mean age of 63.7 years. The percentage of veterans treated with ≥ 1 DMARD (nonbiologic or biologic) during the 12-month follow-up period increased from 48.8% in 2007 to 66.4% in 2015. In veterans diagnosed with IA in 2015, DMARD treatment was more common for PsA patients (72.9%) and RA patients (68.6%) than for AS patients (28.9%). In the subset treated with a DMARD within 12 months after diagnosis, the mean time to the initial DMARD after diagnosis did not change throughout the observation period (35.5 days for RA, 43.9 days for PsA, and 59.5 days for AS). Rheumatology specialty care was accessed by 87.4% of veterans treated with a nonbiologic DMARD and 92.2% of veterans treated with a biologic DMARD, in patients diagnosed in 2015.CONCLUSIONS: DMARD treatment rates during the initial 12 months after diagnosis increased between 2007 and 2015, but nontreatment remained common, particularly in veterans with AS. The time to treatment after diagnosis was stable over time; it was shortest for RA, intermediate for PsA, and longest for AS. DMARD treatment was uncommon in veterans who did not access rheumatology specialty care.

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Trajectory of radiographic change over a decade: the effect of transition from conventional synthetic disease-modifying antirheumatic drugs to anti-tumour necrosis factor in patients with psoriatic arthritis

Abstract: The trajectory of damage accumulation over a 10-year period in this observational clinical cohort is low overall. The rate of radiographic damage as measured by the mSvdHS slows following commencement of anti-TNF.

Cited by 13 publications

References 19 publications

Comparing the Patient‐Reported Physical Function Outcome Measures in a Real‐Life International Cohort of Patients With Psoriatic Arthritis

Comparing the Patient‐Reported Physical Function Outcome Measures in a Real‐Life International Cohort of Patients With Psoriatic Arthritis

Measurement properties of radiographic outcome measures in Psoriatic Arthritis: A systematic review from the GRAPPA-OMERACT initiative

Treatment Patterns with Disease-Modifying Antirheumatic Drugs in U.S. Veterans with Newly Diagnosed Rheumatoid Arthritis, Psoriatic Arthritis, or Ankylosing Spondylitis

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