Rheumatology
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PsA is a complex disease, with patients experiencing inflammatory burden across multiple tissues.1​

EULAR recommendations: Remission should be seen as an “abrogation of inflammation”, as the most favourable outcomes are achieved when inflammation is fully controlled.2,3​

To manage PsA, abrogation of inflammation is an important goal across all the different domains of the disease:2,4​

 

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MDA and DAPSA disease activity scores are recommended as valid targets for low disease activity/remission in clinical practice, and are associated with:5–10 ​

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Improved quality of life11,12​

 

 

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Improved physical function13​

 

 

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Reduced structural damage progression13​

 

Disease activity should be regularly assessed across individually involved manifestations.2​

Achieving MDA in PsA is also associated with significant improvements in 6 of the 8 SF-36 domains, including physical functioning, pain and general health.11†​

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Adapted from Coates LC et al. BMC Rheumatol. 2018;2:24.​

Although the use of biologics in PsA has led to success in some domains, a limited number of patients are currently achieving MDA, even with newer therapies.14,15​

 

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What is the impact of patients with PsA achieving MDA, and is MDA a realistic treatment target? ​

 

Explore our resources below to find out the answers to these questions and more today.​​

*p<0.001.11 ​

†Combined data from two phase 3 trials in PsA (SPIRIT-P1 and SPIRIT-P2). MDA responders and non-responders were compared for mean change from baseline on the SF-36. Data for patients in the placebo and both ixekizumab arms comprised the integrated database used for this analysis. Data labels show the difference between MDA responder and non-responder groups.11​

‡Achievement of MDA at Week 12/16/24 with TNFi, IL-12i, IL-12/23i, IL-17i, IL-17Ai and IL-17Fi, or JAKi for studies included in the systematic literature review informing the 2023 EULAR PsA Guidelines.16​

§N=1251 patients.14​

⁋A systematic literature search from 2009–2017 was performed and random effects single-arm meta-analyses were conducted. Cross-sectional and cohort studies were grouped (N=11,254 patients).15

Abbreviations

DAPSA: Disease Activity in PSoriatic Arthritis; EULAR: European Alliance of Associations for Rheumatology; IL: interleukin; IL-12/17/23i: interleukin-12/17/23 inhibitor; JAKi: Janus kinase inhibitor; MDA: minimal disease activity; MSK: musculoskeletal; PsA: psoriatic arthritis;​ SF-36: 36-Item Short Form Survey; TNFi: tumour necrosis factor inhibitor.

References

  1. Raychaudhuri S et al. Arthritis Rheumatol. 2021;73(Suppl 10). Abstract 0452. ​
  2. Gossec L et al. Ann Rheum Dis. 2024;83(6):706–719. ​
  3. McInnes IB Gravallese EM. Nat Rev Immunol. 2021;21(10):680–686.​
  4. Coates LC et al. Nat Rev Rheumatol. 2022;18(8):465–479.​
  5. Smolen JS et al. Clin Exp Rheumatol. 2015;33(5 Suppl 93):S48–S50.​
  6. Coates LC et al. RMD open. 2019;5(2):e001002.​
  7. Gossec L et al. J Rheumatol. 2018;45(1):6–13.​
  8. Wervers K et al. Arthritis Care Res (Hoboken). 2018;70(12):1764–1770.​
  9. Aletaha D et al. Ann Rheum Dis. 2017;76(2):418–421.​
  10. Schoels MM et al. Ann Rheum Dis. 2016;75(5):811–818.​
  11. Coates LC et al. BMC Rheumatol. 2018;2:24. ​
  12. Coates LC et al. Semin Arthritis Rheum. 2020;50(4):709–718. ​
  13. Schneeberger EE et al. Semin Arthritis Rheum. 2023;58:152134.​
  14. Ogdie A et al. Arthritis Rheumatol. 2021;73(Suppl 9). Abstract 1344.​
  15. Zardin-Moraes M et al. J Rheumatol. 2020;47(6):839–846. ​
  16. Kerschbaumer A et al. Ann Rheum Dis. 2024;83(6):760–774.

EU-DC-2400159

 

Date of preparation: February 2025