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Research ArticlePsoriatic Arthritis

Prevalence of Psoriatic Arthritis Patients Achieving Minimal Disease Activity in Real-world Studies and Randomized Clinical Trials: Systematic Review with Metaanalysis

Mariele Zardin-Moraes, André Luis Ferreira Azeredo da Silva, Carla Saldanha, Charles Lubianca Kohem, Laura C. Coates, Lilian Rodrigues Henrique, Penélope Esther Palominos and Rafael Mendonça da Silva Chakr
The Journal of Rheumatology June 2020, 47 (6) 839-846; DOI: https://doi.org/10.3899/jrheum.190677
Mariele Zardin-Moraes
From the Rheumatology Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
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André Luis Ferreira Azeredo da Silva
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Carla Saldanha
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Charles Lubianca Kohem
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Laura C. Coates
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Lilian Rodrigues Henrique
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Penélope Esther Palominos
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Rafael Mendonça da Silva Chakr
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  • For correspondence: rchakr@hcpa.edu.br
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Abstract

Objective. To estimate the frequency of patients with psoriatic arthritis (PsA) achieving minimal disease activity (MDA) status in real-world studies and randomized controlled trials (RCT).

Methods. A systematic literature search for 2009–2017 was performed in PubMed, Embase, Cochrane Library, and LILACS. Study selection and data extraction were performed by 2 independent researchers. Random-effects single-arm metaanalyses were performed and heterogeneity was assessed using I2.

Results. A total of 405 records were identified and 45 studies were analyzed: 39 (86.7%) observational studies and 6 (13.3%) RCT; they included 12,469 patients. The overall prevalence of MDA in cross-sectional studies was 35% (95% CI 30%–41%, I2 = 94%), varying from 17% (95% CI 7%–34%) in patients taking synthetic disease-modifying antirheumatic drugs (DMARD) to 57% (95% CI 41%–71%) in those taking biological DMARD. Prevalence of MDA in cohort studies increased with longer followup time, ranging from 25% (95% CI 15%–40%) with 3- to 4-month followup to 42% (95% CI 38%–45%) with > 24-month followup. Patients with PsA receiving biological DMARD in a real-world context and RCT had similar prevalence of MDA at 6-month followup: 30% (95% CI 21%–41%, I2 = 85%) versus 32% (95% CI 26%–39%, I2 = 79%), respectively.

Conclusion. Patients with PsA included in real-world studies had similar prevalence of MDA compared to those in controlled clinical trials. This finding suggests that MDA is a useful treatment target for PsA in the real-world setting.

Key Indexing Terms:
  • PSORIATIC ARTHRITIS
  • RANDOMIZED CONTROLLED TRIALS
  • OBSERVATIONAL STUDIES

Footnotes

  • Supported by Fundo de Incentivo à Pesquisa e Eventos do Hospital de Clínicas de Porto Alegre.

  • Accepted for publication September 18, 2019.
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The Journal of Rheumatology
Vol. 47, Issue 6
1 Jun 2020
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Prevalence of Psoriatic Arthritis Patients Achieving Minimal Disease Activity in Real-world Studies and Randomized Clinical Trials: Systematic Review with Metaanalysis
Mariele Zardin-Moraes, André Luis Ferreira Azeredo da Silva, Carla Saldanha, Charles Lubianca Kohem, Laura C. Coates, Lilian Rodrigues Henrique, Penélope Esther Palominos, Rafael Mendonça da Silva Chakr
The Journal of Rheumatology Jun 2020, 47 (6) 839-846; DOI: 10.3899/jrheum.190677

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Prevalence of Psoriatic Arthritis Patients Achieving Minimal Disease Activity in Real-world Studies and Randomized Clinical Trials: Systematic Review with Metaanalysis
Mariele Zardin-Moraes, André Luis Ferreira Azeredo da Silva, Carla Saldanha, Charles Lubianca Kohem, Laura C. Coates, Lilian Rodrigues Henrique, Penélope Esther Palominos, Rafael Mendonça da Silva Chakr
The Journal of Rheumatology Jun 2020, 47 (6) 839-846; DOI: 10.3899/jrheum.190677
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Keywords

PSORIATIC ARTHRITIS
RANDOMIZED CONTROLLED TRIALS
OBSERVATIONAL STUDIES

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