Disease activity in psoriatic arthritis (PsA): defining remission and treatment success using the DAPSA score
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TLDR
The DAPSA constitutes a disease-specific, validated and feasible tool for PsA assessment and provides criteria for disease activity states and treatment response, based on an international expert survey.Abstract:
Background The Disease Activity Index for Psoriatic Arthritis (DAPSA) is a valid and discriminative tool. Definitions of disease activity states and therapeutic response are still missing. We derived such criteria for the DAPSA. Methods We retrieved 30 patient profiles from an observational database including joint counts, patient pain and global activity ratings and C-reactive protein (CRP) and carried out a survey among experts to classify patients into remission (REM), low (LDA), moderate (MDA) or high (HDA) disease activity. Based on the distributions of DAPSA in each of these expert-assigned states we defined the cutpoints between groups. We performed similar analyses evaluating a clinical score (cDAPSA), omitting CRP. To define minor, moderate and major treatment response, we used Cohen9s Kappa statistics and analysed agreement of DAPSA percentage change with ACR20/50/70-response in three randomised controlled trials. Results Our survey yielded a response rate of 75% (n=33). Mean DAPSA differed significantly between patients classified as REM, LDA, MDA or HDA (p 4 and ≤14 for LDA, >14 and ≤28 for MDA and >28 for HDA. We observed best agreement with ACR20/50/70-response at DAPSA changes of 50/75/85%, reflecting minor, moderate and major improvement. Conclusions The DAPSA constitutes a disease-specific, validated and feasible tool for PsA assessment. In this study, we provide criteria for disease activity states and treatment response. They are based on an international expert survey, and show good performance in clinical trials and observational data.read more
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Journal ArticleDOI
European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update.
Laure Gossec,Josef S Smolen,Sofia Ramiro,M. de Wit,Maurizio Cutolo,Maxime Dougados,Paul Emery,Robert Landewé,Sue Oliver,Daniel Aletaha,Neil Betteridge,Jürgen Braun,G.-R. Burmester,Juan D. Cañete,Nemanja Damjanov,Oliver FitzGerald,Emma Haglund,P S Helliwell,Tore K Kvien,Rik Lories,Thomas A. Luger,Mara Maccarone,Helena Marzo-Ortega,Dennis McGonagle,Iain B. McInnes,I. Olivieri,Karel Pavelka,Georg Schett,Joachim Sieper,F. Van den Bosch,Douglas J. Veale,Jürgen Wollenhaupt,Angela Zink,D. van der Heijde +33 more
TL;DR: These recommendations provide stakeholders with an updated consensus on the pharmacological treatment of PsA and strategies to reach optimal outcomes in PsA, based on a combination of evidence and expert opinion.
Journal ArticleDOI
Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force
Josef S. Smolen,Monika Schöls,Jürgen Braun,Maxime Dougados,Oliver FitzGerald,Dafna D. Gladman,Arthur Kavanaugh,Robert Landewé,Philip J. Mease,Joachim Sieper,Tanja Stamm,Maarten de Wit,Daniel Aletaha,Xenofon Baraliakos,Neil Betteridge,Filip Van den Bosch,Laura C. Coates,Paul Emery,Lianne S. Gensler,Laure Gossec,Philip S. Helliwell,Merryn Jongkees,Tore K Kvien,Robert D. Inman,Iain B. McInnes,Mara Maccarone,Pedro Machado,Anna Molto,Alexis Ogdie,Denis Poddubnyy,Christopher T. Ritchlin,Martin Rudwaleit,Adrian Tanew,Bing Thio,Douglas J. Veale,Kurt de Vlam,Désirée van der Heijde +36 more
TL;DR: There was broad agreement, now better supported by data than in 2012, that remission/inactive disease and, alternatively, low/minimal disease activity are the principal targets for the treatment of PsA.
Journal ArticleDOI
Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis.
Jasvinder A. Singh,Gordon H. Guyatt,Alexis Ogdie,Dafna D. Gladman,Chad L. Deal,Atul Deodhar,Maureen Dubreuil,Jonathan Dunham,M. Elaine Husni,Sarah Kenny,Jennifer Kwan-Morley,Janice Lin,Paula Marchetta,Philip J. Mease,Joseph F. Merola,Julie Miner,Christopher T. Ritchlin,Bernadette C. Siaton,Benjamin J Smith,Abby S. Van Voorhees,Anna Helena Jonsson,Amit Aakash Shah,Nancy Sullivan,Marat Turgunbaev,Laura C. Coates,Alice B. Gottlieb,Marina Magrey,W. Benjamin Nowell,Ana Maria Orbai,Soumya M. Reddy,Jose U. Scher,Evan Siegel,Michael Siegel,Jessica A. Walsh,Amy S. Turner,James Reston +35 more
TL;DR: The 2018 ACR/NPF guideline as mentioned in this paper provides evidence-based guidelines for the pharmacologic and non-pharmacologic treatment of psoriatic arthritis (PsA) using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology.
Journal ArticleDOI
2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis
Jasvinder A. Singh,Gordon H. Guyatt,Alexis Ogdie,Dafna D. Gladman,Chad L. Deal,Atul Deodhar,Maureen Dubreuil,Jonathan Dunham,M. Elaine Husni,Sarah Kenny,Jennifer Kwan-Morley,Janice Lin,Paula Marchetta,Philip J. Mease,Joseph F. Merola,Julie Miner,Christopher T. Ritchlin,Bernadette C. Siaton,Benjamin J Smith,Abby S. Van Voorhees,Anna Helena Jonsson,Amit Aakash Shah,Nancy Sullivan,Marat Turgunbaev,Laura C. Coates,Alice B. Gottlieb,Marina Magrey,W. Benjamin Nowell,Ana Maria Orbai,Soumya M. Reddy,Jose U. Scher,Evan Siegel,Michael Siegel,Jessica A. Walsh,Amy S. Turner,James Reston +35 more
TL;DR: To develop an evidence‐based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology and the National Psoriasis Foundation (NPF).
Journal ArticleDOI
Group for Research and Assessment of Psoriasis and Psoriatic Arthritis/Outcome Measures in Rheumatology Consensus-Based Recommendations and Research Agenda for Use of Composite Measures and Treatment Targets in Psoriatic Arthritis.
Laura C. Coates,Oliver FitzGerald,Joseph F. Merola,Josef S Smolen,Leonieke J J van Mens,Heidi Bertheussen,Wolf-Henning Boehncke,Kristina Callis Duffin,Willemina Campbell,Maarten de Wit,Dafna D. Gladman,Alice B. Gottlieb,Jana James,Arthur Kavanaugh,Lars Erik Kristensen,Tore K Kvien,Thomas A. Luger,Neil McHugh,Philip J. Mease,Peter Nash,Alexis Ogdie,Cheryl F. Rosen,Vibeke Strand,William Tillett,Douglas J. Veale,Philip S. Helliwell +25 more
TL;DR: A meeting was convened by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) and Outcome Measures in Rheumatology (OMERACT) to further the development of consensus among physicians and patients regarding composite disease activity measures and targets in psoriatic arthritis (PsA).
References
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Journal ArticleDOI
Modified disease activity scores that include twenty-eight-joint counts : development and validation in a prospective longitudinal study of patients with rheumatoid arthritis
M.L.L. Prevoo,M.A. van 't Hof,H.H. Kuper,M.A. van Leeuwen,L. B. A. Van De Putte,P.L.C.M. van Riel +5 more
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Journal Article
A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index.
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TL;DR: It is important to note that patients included in recent drug trials resemble patients followed prospectively in a clinic, and patients with PsA who present with polyarticular disease are at risk for disease progression.
Journal ArticleDOI
Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score
Daniel Aletaha,Valerie Nell,Tanja Stamm,Martin Uffmann,Stephan Pflugbeil,Klaus P Machold,Josef S Smolen +6 more
TL;DR: A purely clinical score is a valid measure of disease activity and will have its greatest merits in clinical practice rather than research, where APRs are usually always available.
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