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Research ArticlePsoriatic Arthritis

Expert Consensus on a Set of Outcomes to Assess the Effectiveness of Biologic Treatment in Psoriatic Arthritis: The MERECES Study

Juan D. Cañete, Joan M. Nolla, Ruben Queiro, Miguel J. Rodríguez, Miguel Ruiz and Luis Lizán for the MERECES Working Group
The Journal of Rheumatology November 2020, 47 (11) 1637-1643; DOI: https://doi.org/10.3899/jrheum.191056
Juan D. Cañete
1J.D. Cañete, MD, PhD, Arthritis Unit, Rheumatology Department, Hospital Clínic and IDIBAPS, Barcelona;
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  • ORCID record for Juan D. Cañete
  • For correspondence: jcanete@clinic.cat
Joan M. Nolla
2J.M. Nolla, MD, PhD, Department of Rheumatology, Hospital Universitario de Bellvitge IDIBELL, L’Hospitalet de Llobregat, Barcelona;
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Ruben Queiro
3R. Queiro, MD, PhD, Department of Rheumatology, Hospital Universitario Central de Asturias, Oviedo;
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Miguel J. Rodríguez
4M.J. Rodríguez, MD, Management Unit, Hospital Universitario de Cabueñes, Gijón;
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Miguel Ruiz
5M. Ruiz, PhD, Department of Social Psychology and Methodology, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid;
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Luis Lizán
6L. Lizán, MD, PhD, Outcomes’10 and Universidad Jaime I, Castellón, Spain.LL works for an independent research organization (Outcomes’10, S.L.) that has received fees for its contribution to the development and coordination of the project and to the writing of this manuscript.
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Abstract

Objective. To reach a consensus on the instruments to be used in clinical practice to evaluate the effectiveness of biological disease-modifying antirheumatic drug (bDMARD) treatment in patients with psoriatic arthritis (PsA) in the short to medium term (3–6 mos), and to establish the minimum health outcomes for treatment continuation.

Methods. A 2-round Delphi questionnaire was developed based on both the information gathered in the literature review and 4 discussion groups. The suitability and feasibility of the proposed sets of instruments were assessed on a 7-point Likert scale. Consensus was established when at least 75% of healthcare professionals (HCP) reached agreement. To define a minimum health outcome to continue treatment, a combination of 4 disease activity states and 3 health-related quality of life states were defined for 3 hypothetical patient profiles. HCP were given a dichotomous choice (yes/no) to respond to whether they would continue treatment in each case.

Results. The second round was completed by 106 HCP. Consensus was reached on the use of (1) Disease Activity in Psoriatic Arthritis + Psoriatic Arthritis Impact of Disease (PsAID12) or minimal disease activity + PsAID12 + C-reactive protein, in peripheral PsA; and (2) Ankylosing Spondylitis Disease Activity Score + PsAID12, in axial PsA. Health outcomes considered sufficient to continue treatment were stricter for bDMARD-naive patients than for patients who failed several bDMARD.

Conclusion. To the best of our knowledge, this is the first multidisciplinary consensus on a set of outcomes for the evaluation of bDMARD effectiveness in PsA, in routine clinical practice.

Key Indexing Terms:
  • antirheumatic agents
  • consensus
  • Delphi technique
  • patient-reported outcome measures
  • psoriatic arthritis
  • treatment outcome

Footnotes

  • The project was supported by UCB Pharma.

  • Accepted for publication January 16, 2020.
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Expert Consensus on a Set of Outcomes to Assess the Effectiveness of Biologic Treatment in Psoriatic Arthritis: The MERECES Study
Juan D. Cañete, Joan M. Nolla, Ruben Queiro, Miguel J. Rodríguez, Miguel Ruiz, Luis Lizán
The Journal of Rheumatology Nov 2020, 47 (11) 1637-1643; DOI: 10.3899/jrheum.191056

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Expert Consensus on a Set of Outcomes to Assess the Effectiveness of Biologic Treatment in Psoriatic Arthritis: The MERECES Study
Juan D. Cañete, Joan M. Nolla, Ruben Queiro, Miguel J. Rodríguez, Miguel Ruiz, Luis Lizán
The Journal of Rheumatology Nov 2020, 47 (11) 1637-1643; DOI: 10.3899/jrheum.191056
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Keywords

ANTIRHEUMATIC AGENTS
CONSENSUS
DELPHI TECHNIQUE
PATIENT-REPORTED OUTCOME MEASURES
PSORIATIC ARTHRITIS
TREATMENT OUTCOME

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Keywords

  • antirheumatic agents
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  • Delphi technique
  • patient-reported outcome measures
  • psoriatic arthritis
  • treatment outcome

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