Article Figures & Data
Figures
- Figure 1.
A. ROC curve for PASDAS with MDA state (5/7) as the discriminator. The value of PASDAS when Youden index was maximized (0.80) was 3.2. At this point, the sensitivity was 88% (95% CI 80–93), the specificity was 92% (95% CI 84–96), and the AUC was 0.96 (95% CI 0.94–0.99). B. ROC curve for PASDAS with MDA 6/7 state as the discriminator. The value of PASDAS when Youden index was maximized (0.74) was 2.6. At this point, the sensitivity was 88% (95% CI 82–93), the specificity was 86% (95% CI 74–93), and the AUC was 0.92 (95% CI 0.88–0.96). C. ROC curve for PASDAS with MDA 7/7 state as the discriminator. The value of PASDAS when Youden index was maximized (0.70) was 2.1. At this point, the sensitivity was 89% (95% CI 83–93), the specificity was 81% (95% CI 60–92), and the AUC was 0.91 (95% CI 0.86–0.96). ROC: receiver-operating characteristic; AUC: area under the curve; PASDAS: Psoriatic Arthritis Disease Activity Score; MDA: minimal disease activity.
Tables
Characteristics PsA, n = 178 Sex, n (%) Female 82 (46.1) Male 96 (53.9) Age, yrs 56.8 (12.8) Age at PsA diagnosis, yrs 39.1 (13.6) Disease duration from PsA diagnosis, yrs 17.6 (12.7) Swollen joint count (0–66) 0.71 (2.03) Swollen joint count, median (range) 0 (0–19) Tender joint count (0–68) 2.21 (4.88) Tender joint count, median (range) 0 (0–31) Patients with oligoarticular PsA, n (%) 28 (15.73) Patients with axial disease (NY criteria), n (%) 67 (37.64) PASI (0–72) 1.64 (3.95) Leeds Enthesitis Index (0–6) 0.13 (0.49) CRP, mg/l 5.08 (6.88) HAQ-DI (0–3) 0.53 (0.59) SF-36 PCS (0–100) 40.10 (12.39) SF-36 MCS (0–100) 48.93 (10.75) No. digits with dactylitis 0.03 (0.22) Patient pain VAS (0–100 mm) 37.81 (27.02) Patient global disease activity VAS (0–100 mm) 34.97 (25.57) Physician global disease activity VAS (0–100 mm) 18.93 (14.00) PASDAS 3.29 (1.29) MDA 5/7, n (%) 85 (47.8) Patients treated with conventional DMARD, n (%) 114 (64.04) Patients treated with methotrexate, n (%) 87 (8.88) Patients treated with biologic agents, n (%) 89 (50.0) Values are mean (SD) unless otherwise specified. PsA: psoriatic arthritis; NY: New York; CRP: C-reactive protein; HAQ-DI: Health Assessment Questionnaire–Disability Index; SF-36: Medical Outcomes Survey Short Form-36 questionnaire; PCS: physical component summary score; MCS: mental component summary score; VAS: visual analog scale; PASDAS: Psoriatic Arthritis Disease Activity Score; PASI: Psoriasis Area Severity Index; DMARD: disease-modifying antirheumatic drug; MDA: minimal disease activity.
Criteria N = 178, n (%) Composite criteria MDA 5/7 85 (47.8) MDA 6/7 50 (28.1) MDA 7/7 21 (11.8) Individual criteria Tender joint count ≤ 1 125 (70.2) Swollen joint count ≤ 1 151 (84.8) PASI ≤ 1 97 (54.5) Patient pain VAS ≤ 15 46 (25.8) Patient global activity VAS ≤ 20 75 (42.1) HAQ ≤ 0.5 112 (62.9) Tender entheseal points ≤ 1 166 (93.2) MDA: minimal disease activity; HAQ: Health Assessment Questionnaire; VAS: visual analog scale; PASI: Psoriasis Area Severity Index.
Escalation Type/Reason n Type of treatment escalation Increase in dosage or frequency 21 Switch medications within same drug class 8 Adding or switching to another drug class(es) 17 Intraarticular steroid injection 8 Reason for escalation Skin disease 5 Joint disease 38 Skin and joint disease 4 Forty-seven patients in total required escalation of treatment, with some requiring more than 1 type of treatment escalation.
- Table 4.
Proportion of patients requiring treatment escalation by disease activity category as defined by published PASDAS cutoffs.
Variables PASDAS Low Disease Activity Moderate Disease Activity High Disease Activity No. patients 86 86 6 No. requiring treatment escalation 7 36 4 Proportion 0.081 0.42 0.67 PASDAS: Psoriatic Arthritis Disease Activity Score.
