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EditorialEditorial

Treatment Continuation Guidance in Psoriatic Arthritis Clinical Care

Ana-Maria Orbai
The Journal of Rheumatology November 2020, 47 (11) 1600-1602; DOI: https://doi.org/10.3899/jrheum.200423
Ana-Maria Orbai
1A.M. Orbai, MD, MHS, Assistant Professor of Medicine, Director of Psoriatic Arthritis Program, Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, Maryland, USA.
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  • For correspondence: aorbai1{at}jhmi.edu
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Article Figures & Data

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    Table 1.

    Summary of treatment targets proposed by Cãnete, et al1.

    Presence of Damage and/or DisabilityNo Damage, No Disability, No Mild/moderate PsoriasisDamage and/or Disability and Multiple Failed bDMARD
    SubtypePeripheralAxialPeripheralAxial
    Primary bDMARD continuation criteriaDAPSA ≤ 14 and ΔPsAID ≤ (−3)ASDAS ≤ 2.1 and ΔPsAID ≤ (−3)DAPSA ≤ 14ASDAS ≤ 2.1
    Primary T2T goalDAPSA ≤ 4 MDAASDAS ≤ 1.3DAPSA ≤ 4 MDAASDAS ≤ 1.3
    Alternative bDMARD continuation criteriaDAPSA ≤ 4*ASDAS ≤ 1.3*ΔDAPSA ≤ (−85%) and PsAID ≤ 4ΔASDAS ≤ (−1.1) and PsAID ≤ 4
    Alternative T2T goalDAPSA ≤ 14ASDAS ≤ 2.1DAPSA ≤ 14ASDAS ≤ 2.1
    • ↵* Alternative target allowed in this category if there is 1 bDMARD failure. bDMARD: biological disease-modifying antirheumatic drugs; DAPSA: Disease Activity in Psoriatic Arthritis; PsAID: Psoriatic Arthritis Impact of Disease; ASDAS: Ankylosing Spondylitis Disease Activity Score; T2T: treat to target; MDA: moderate disease activity.

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    Table 2.

    Parallel between the psoriatic arthritis (PsA) core outcome set (COS) and the proposed effectiveness targets.

    PsA COSPeripheralAxial
    DAPSAPsAIDASDAS
    Arthritis68 tender/66 swollen joint counts——
    Dactylitis———
    Enthesitis———
    Spondyloarthritis——BASDAI – Duration morning stiffness
    Psoriasis—PsAID – Psoriasis—
    Nail psoriasis———
    PainPain VASPsAID – PainBASDAI – Spinal pain BASDAI – Peripheral pain
    Patient globalPatient global assessment VAS—Patient global assessment
    Physical function—PsAID – Functional capacity—
    Fatigue—PsAID – Fatigue—
    Life effect/HRQOLPsAID total score
    Systemic inflammationCRP—CRP
    • DAPSA: Disease Activity in Psoriatic Arthritis; PsAID: Psoriatic Arthritis Impact of Disease; ASDAS: Ankylosing Spondylitis Disease Activity Score; BASDAI: Bath Ankylosing Spondylitis Disease Activity Index; VAS: visual analog scale; HRQOL: health-related quality of life; CRP: C-reactive protein.

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The Journal of Rheumatology
Vol. 47, Issue 11
1 Nov 2020
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Treatment Continuation Guidance in Psoriatic Arthritis Clinical Care
Ana-Maria Orbai
The Journal of Rheumatology Nov 2020, 47 (11) 1600-1602; DOI: 10.3899/jrheum.200423

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Treatment Continuation Guidance in Psoriatic Arthritis Clinical Care
Ana-Maria Orbai
The Journal of Rheumatology Nov 2020, 47 (11) 1600-1602; DOI: 10.3899/jrheum.200423
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