Study: Are Biological Drugs Better for PsA Than Conventional Treatment?

Patients with psoriatic arthritis (PsA) who take biological disease-modifying anti-rheumatic drugs (bDMARD) are more likely to reach minimal disease activity (MDA) and remission faster than with conventional synthetic DMARD (csDMARD), according to a new study.

For their study, the researchers assessed a total of 109 patients with PsA using the classification criteria for psoriatic arthritis (CASPAR) criteria. Overall, 79 patients were treated with bDMARD, while the remaining 30 received csDMARD. Patients were treated at baseline and had more than 6 months of follow-up data.
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Patients were analyzed using the Disease Activity Index for Psoriatic Arthritis (DAPSA), clinical DAPSA (cDAPSA), Psoriatic Arthritis Disease Activity Score (PASDAS), MDA 5/7, and MDA 7/7. Achievement of remission was indicated by DAPSA and cDAPSA scores of 4 or lower, MDA 7/7, and PASDAS of 1.9 or lower, while MDA and low disease activity (LDA) criteria were indicated by MDA 5/7, DAPSA scores of 14 or lower, cDAPSA scores of 13 or lower, and PASDAS below 3.2.

Results showed that of all the participants in the study, 28 achieved cDAPSA remission, 23 reached DAPSA remission, 19 had MDA 7/7, and 13 had PASDAS at or below 1.9. Additionally, 54 had MDA 5/7, 80 reached DAPSA LDA, 79 reached cDAPSA LDA, and 38 achieved PASDAS LDA.

The researchers noted that patients who received bDMARD demonstrated much lower median DAPSA, cDAPSA, and PASDAS scores than patients treated with csDMARD.

“Patients with PsA receiving bDMARD are more likely to achieve a status of MDA and remission when compared with csDMARD,” the researchers concluded. “PASDAS [of 1.9 or lower] and MDA 7/7 seem to be stringent remission criteria.”

—Christina Vogt

Reference:

Lubrano E, De Socio A, Perrotta FM. Comparison of composite indices tailored for psoriatic arthritis treated with csDMARD and bDMARD: a cross-sectional analysis of a longitudinal cohort. J Rheumatol. 2017;44(6). doi:10.3899/jrheum.170112.