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Psoriatic arthritis
Original article
Prediction and benefits of minimal disease activity in patients with psoriatic arthritis and active skin disease in the ADEPT trial
  1. Philip J Mease1,
  2. Arthur Kavanaugh2,
  3. Laura C Coates3,
  4. Iain B McInnes4,
  5. Maja Hojnik5,
  6. Ying Zhang6,
  7. Jaclyn K Anderson6,
  8. Alexander P Dorr6 and
  9. Dafna D Gladman7
  1. 1 Swedish Medical Center and University of Washington, Seattle, Washington, USA
  2. 2 Department of Rheumatology, Allergy and Immunology, University of California San Diego, San Diego, California, USA
  3. 3 Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, University of Leeds, Leeds, UK
  4. 4 Glasgow Biomedical Research Centre, University of Glasgow, Glasgow, UK
  5. 5 AbbVie, Ljubljana, Slovenia
  6. 6 AbbVie Inc, North Chicago, Illinois, USA
  7. 7 Department of Medicine, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Dafna D Gladman; dafna.gladman{at}utoronto.ca

Abstract

Objectives To determine the proportion of patients with psoriatic arthritis in the Adalimumab Effectiveness in Psoriatic Arthritis trial achieving minimal disease activity (MDA) and its individual components at 1 or more visits over 144 weeks, identify baseline predictors of MDA achievement, and evaluate the association of MDA status with independent quality of life (QoL)-related patient-reported outcomes (PROs).

Methods Univariate and multivariate analyses were used to identify the baseline characteristics that predicted achievement of MDA at individual time points (weeks 12 through 144) or sustained MDA (achievement of MDA at 2 consecutive time points 12 weeks apart). The association of independent QoL-related PROs with MDA achievement was evaluated at weeks 24 and 144.

Results In univariate analyses, higher baseline patient assessment of pain, tender joint count (TJC), enthesitis and Health Assessment Questionnaire-Disability Index (HAQ-DI) score were significantly associated with lower likelihood of achieving MDA at later time points. Multivariate analyses confirmed higher baseline HAQ-DI as a significant predictor for failure to achieve MDA at later time points. Achievement of sustained MDA was associated with lower baseline TJC and HAQ-DI score. Achievement of different MDA components appeared to be treatment dependent. MDA achievers had significantly better QoL-related PROs and greater improvements in PROs from baseline to week 24 compared with non-achievers.

Conclusions Higher HAQ-DI score was the most consistent baseline factor that decreased the likelihood of achieving MDA and sustained MDA at later time points. Achieving MDA was associated with better independent QoL-related PROs.

  • Psoriatic Arthritis
  • Anti-TNF
  • TNF-alpha

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/rmdopen-2016-000415

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    Footnotes

    • Contributors PJM, AK, LCC, IBM, MH, APD, JKA and DDG contributed to the design, review and interpretation of data. YZ contributed to the data analyses. In accordance with ICMJE authorship criteria, all authors are responsible for the development of this manuscript, and have reviewed and approved the final version.

    • Funding AbbVie funded the clinical trials (NCT00646386 and NCT00195689).

    • Competing interests PJM has received research grants, consulting fees and/or speaker fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Genentech, Janssen, Merck, Novartis, Pfizer, Sun Pharma and UCB. AK has received grant/research support and/or has provided expert advice to AbbVie, Amgen, AstraZeneca, Bristol-Myers Squibb, Celgene, Centocor-Janssen, Pfizer, Roche and UCB. LCC has received research grants, consulting fees and/or speaker fees from AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Sun Pharma and UCB. IBM has received research grants and consulting fees from AbbVie, Amgen, Janssen, Novartis, Pfizer and UCB. DDG has received grants/consulting fees from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer and UCB. MH, APD, YZ and JKA are employees of AbbVie and may own stock/options.

    • Ethics approval Appropriate Ethics Committee/Institutional review board approval was obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Qualified researchers may request access to the study datasets from AbbVie via the process defined on AbbVie.com under Clinical Trial Data and Information Sharing.