Article Text
PDF
Abstract
Objectives Disease Activity index for PSoriatic Arthritis (DAPSA) (sum score 68/66 tender/swollen joint counts (68TJC/66SJC), patient’s global assessment, pain and C-reactive protein (CRP)) is recommended for clinical assessment of disease activity in patients with psoriatic arthritis (PsA). Ultrasound (US) (grey scale (GS) and power Doppler (PD)) detects inflammation in joints and extra-articular structures. The present objectives were to explore the longitudinal relationships between DAPSA, clinical assessment as well as patient-reported outcome measures (PROMs) with US in patients with PsA initiating biological DMARDs and the associations between DAPSA and US remission.
Methods 47 patients with PsA were examined at baseline and after 3, 6, 9 and 12 months. Assessments included 68TJC/66SJC, examiner’s global assessment (EGA), PROMs, CRP, erythrocyte sedimentation rate (ESR) and US GS and PD (48 joints, 10 flexor tendons, 14 entheses, 4 bursae). Clinical composite scores and PD sum scores (0=remission) were calculated. Longitudinal associations were explored by generalised estimating equations with linear and logistic regression.
Results DAPSA was not longitudinally associated to PD. 66SJC, ESR, 28-joint Disease Activity Score, EGA and CRP were longitudinally associated with PD (p<0.001–0.03), whereas the pain-related components of DAPSA (68TJC and pain) as well as PROMs were not associated. At 6–12 months, remission was achieved in 29%–33 % of the patients for DAPSA and 59%–70 % for PD. The association between DAPSA and PD remission was not significant (p=0.33).
Conclusions DAPSA was not associated with US inflammatory findings which indicates that DAPSA and US may assess different aspects of PsA activity.
- psoriatic arthritis
- ultrasonography
- bDMARDs
- patient perspective
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, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Footnotes
Contributors HBH, PBK, TKK: were responsible for study design. HBH, PBK, BM, JS, SP: were involved in acquisition and/or interpretation of the data. SP: analysed the data and wrote the draft manuscript. All authors critically revised the manuscript and approved the final version.
Funding The data collection was supported by AbbVie in form of study grant to the Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway by Hilde Berner Hammer.
Competing interests HBH has received fees for speaking and/or consulting from AbbVie, BMS, Pfizer, UCB, Roche, MSD, Lilly and Novartis, and received research funding to Diakonhjemmet Hospital from AbbVie, Pfizer and Roche. TKK has received fees for speaking and/or consulting from AbbVie, BMS, Boehringer Ingelheim, Celgene, Celltrion, Eli Lilly, Hospira, Merck-Serono, MSD, Novartis, Orion Pharma, Pfizer, Roche, Sandoz and UCB and received research funding to Diakonhjemmet Hospital from AbbVie, BMS, MSD, Pfizer, Roche and UCB.
Patient consent Obtained.
Ethics approval Norwegian Regional Committee for Medical and Health Research Ethics South East (reference number 2010/2658a).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.