Journal ArticleDOI
The development of candidate composite disease activity and responder indices for psoriatic arthritis (GRACE project)
Philip S. Helliwell,Philip S. Helliwell,Oliver FitzGerald,Jaap Fransen,Dafna D. Gladman,Gerald G Kreuger,Kristina Callis-Duffin,Neil McHugh,Philip J. Mease,Vibeke Strand,Robin Waxman,Valderílio Feijó Azevedo,Adriana Beltran Ostos,Sueli Carneiro,Alberto Cauli,Luis R Espinoza,John A. Flynn,Nada Hassan,Paul J. Healy,Eduardo Kerzberg,Yun Jong Lee,Ennio Lubrano,Antonio Marchesoni,Helena Marzo-Ortega,Giovanni Porru,Elvia G. Moreta,Peter Nash,Helena Raffayova,Roberto Ranza,Siba P. Raychaudhuri,Euthalia Roussou,Raphael Scarpa,Yeong Wook Song,Enrique R. Soriano,Paul P. Tak,Ilona Ujfalussy,Kurt de Vlam,Jessica A. Walsh +37 more
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TLDR
Two new composite measures to assess disease activity in PsA have been developed by multiple linear regression and empirically, utilising physician-defined cut-offs for disease activity, and area under the receiver operating curves (AUC) were generally smaller.Abstract:
Objective To develop new composite disease activity indices for psoriatic arthritis (PsA). Methods Data from routine clinic visits at multiple centres were collected in a systematic manner. Data included all domains identified as important in randomised controlled trials in PsA. Decisions to change treatment were used as surrogates for high disease activity. New indices were developed by multiple linear regression (psoriatic arthritis disease activity score: PASDAS) and empirically, utilising physician-defined cut-offs for disease activity (arithmetic mean of desirability functions: AMDF). These were compared with existing composite measures: Composite Psoriatic arthritis Disease Activity Index (CPDAI), Disease Activity for PSoriatic Arthritis (DAPSA), and Disease Activity Score for rheumatoid arthritis (DAS28). Results 161/503 (32%) subjects had treatment changes. Although all measures performed well, compared with existing indices, PASDAS was better able to discriminate between high and low disease activity (area under receiver operating curves (ROC)) curve with 95% CI: PASDAS 0.773 (0.723, 0.822); AMDF 0.730 (0.680, 0.780); CPDAI 0.719 (0.668, 0.770); DAPSA 0.710 (0.654, 0.766); DAS28 0.736 (0.680, 0.792). All measures were able to discriminate between disease activity states in patients with oligoarthritis, although area under the receiver operating curves (AUC) were generally smaller. In patients with severe skin disease (psoriasis area and severity index >10) both nonparametric and AUC curve statistics were nonsignificant for all measures. Conclusions Two new composite measures to assess disease activity in PsA have been developed. Further testing in other datasets, including comparison with existing measures, is required to validate these instruments.read more
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Journal ArticleDOI
Radiographic Progression in Psoriatic Arthritis Achieving a Good Response to Treatment: Data Using Newer Composite Indices of Disease Activity
TL;DR: To compare radiographic outcomes according to the magnitude of the response utilizing 3 new psoriatic composite disease activity measures, the PASDAS, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis Composite Exercise, and the Disease Activity in PsA are compared.
Journal ArticleDOI
Subcutaneous anti-TNF alfa induced sustained minimal disease activity and remission in psoriatic arthritis patients: a retrospective study.
TL;DR: In this retrospective study, sustained MDA was achieved in 43.2% of patients treated with TNFα blockers and sustained remission was achieve in a consistent number of patients, configuring this as an achievable target for PsA patients.
Journal ArticleDOI
Performance of composite measures used in a trial of etanercept and methotrexate as monotherapy or in combination in psoriatic arthritis.
Laura C. Coates,Joseph F. Merola,Philip J. Mease,Alexis Ogdie,Dafna D. Gladman,Vibeke Strand,Leonieke J J van Mens,Lyrica Liu,Priscilla K Yen,David H. Collier,Gregory Kricorian,James B. Chung,Philip S. Helliwell +12 more
TL;DR: PASDAS was the most sensitive continuous composite measure examined with results that mirrored the protocol-defined primary and key secondary outcomes and may better quantify change in PsA disease burden.
Journal ArticleDOI
Need for Improvement in Current Treatment of Psoriatic Arthritis: Study of an Outpatient Clinic Population.
Brigitte Michelsen,Andreas P. Diamantopoulos,Hege Kilander Høiberg,D.M. Soldal,Arthur Kavanaugh,Glenn Haugeberg +5 more
TL;DR: There is still a need for improvement in today’s treatment of PsA, as musculoskeletal inflammatory involvement was more prominent than psoriatic skin involvement and patient satisfaction and PASI and DLQI were low.
Journal ArticleDOI
Treating Psoriatic Arthritis to Target: Defining the Psoriatic Arthritis Disease Activity Score That Reflects a State of Minimal Disease Activity.
TL;DR: This study has externally validated PASDAS cutoff scores previously proposed to differentiate between low, moderate, and high disease activity and identified a point that maximized the sensitivity and specificity for MDA.
References
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