PASDAS best reflects disease activity, treatment response in psoriatic arthritis
medwireNews: A comparison of different composite measures suggests that PASDAS has the strongest ability to predict disease activity and treatment response in patients with oligoarticular or polyarticular psoriatic arthritis (PsA).
Speaking at the online British Society for Rheumatology 2021 Annual Conference, Laura Tucker (University of Oxford, UK) explained that “progress has been made in the development of multiple composite measures of disease activity” in recent years, but “there remains poor agreement on the optimal measure to use in clinical practice, and as a consequence these measures have not been routinely implemented.”
Moreover, “research to date has focused on the polyarticular subtype of psoriatic arthritis, despite oligoarticular disease accounting for almost 50% of cases presenting in clinical practice,” she added.
Tucker and colleagues used data from the GRACE study to compare the ability of five composite indices – CPDAI, DAPSA, DAS28-CRP, GRACE, and PASDAS – to predict patient- and physician-defined disease control and whether treatment escalation was required in a cohort of 271 PsA patients from routine clinical practice. In all, 56% of study participants had oligoarthritis and the remaining 44% had polyarthritis.
All composite measures were able to distinguish patients with active disease from those with inactive disease irrespective of whether patients had oligoarticular or polyarticular PsA, but PASDAS had the greatest predictive ability, said Tucker.
Specifically, when the patient definition was used as the reference, the difference in Z-score between patients with and without disease control ranged from 6.24 for CPDAI to 7.67 for PASDAS in patients with oligoarthritis and from 3.98 for CPDAI to 6.05 for PASDAS in patients with polyarthritis. When physician-reported disease control was used as the reference, these differences ranged from 4.97 for DAS28-CRP to 7.48 for PASDAS in the oligoarthritis group and from 3.45 for DAPSA to 5.97 for PASDAS in the polyarthritis group.
In accordance with these findings, PASDAS also had the greatest ability to predict treatment changes in both patient subgroups.
“Interestingly, DAPSA scores did not correlate with treatment change in the polyarthritis group,” noted Tucker.
She concluded that PASDAS was “shown to be the most effective measure of treatment response and disease activity, suggesting it has the greatest clinical and research utility in the future.”
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