title: Early treatment of psoriatic arthritis is associated with improved patient-reported outcomes: findings from the etanercept PRESTA trial.
abstract: OBJECTIVE
  The present paper aims to investigate the effect of psoriatic arthritis (PsA) disease duration on the outcome of treatment with etanercept (ETN) in patients with PsA who also have moderate-to-severe psoriasis.
  
  
  METHODS
  Patients from the PRESTA trial who received ≥1 ETN 50 mg once weekly (QW) dose and had ≥1 post-baseline value were evaluated. Baseline and after-treatment changes were compared between patients with PsA ≤2 years versus PsA >2 years in efficacy measures (physician global assessment [PGA] arthritis, swollen joint count and Psoriasis Area and Severity Index [PASI]) and patient reported outcomes (PROs; joint pain, arthritis activity, Euro-Qol [EQ-5D] utility and visual analogue score [VAS]) using linear regression analysis.
  
  
  RESULTS
  Baseline efficacy measures were similar between the PsA ≤2 years (n=103) and PsA >2 years (n=269) groups, with the exception of PGA arthritis (p=0.006). At week 24, improvements in efficacy measures were observed in both groups but were significantly greater for PGA arthritis in the PsA ≤2 years group (p=0.03). Quality of life (QoL), measured using PROs, was generally lower at baseline in patients with PsA >2 years. Clinically meaningful improvements were seen in QoL with ETN treatment in both groups, but the change from baseline scores at week 24 were significantly higher in PsA ≤2 years group for joint pain (p=0.007), arthritis activity (p=0.01), EQ-5D utility (p=0.046) and EQ-5D VAS (p=0.04) responses.
  
  
  CONCLUSIONS
  PsA patients responded to ETN 50 mg QW treatment irrespective of disease duration; however, patients with shorter PsA duration had greater improvements in arthritis scores and several PRO measures.
authors.affiliation: Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Bruce
authors.initials: B
authors.lastname: Kirkham
authors.affiliation: Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Kurt
authors.initials: K
authors.lastname: de Vlam
authors.affiliation: Quintiles, Collegeville, PA, USA.
authors.forename: Wenzhi
authors.initials: W
authors.lastname: Li
authors.affiliation: Pfizer Inc, Collegeville, PA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Boggs
authors.affiliation: Pfizer Europe, Rome, Italy.
authors.forename: Lotus
authors.initials: L
authors.lastname: Mallbris
authors.affiliation: Pfizer Europe, Rome, Italy.
authors.forename: Henk W
authors.initials: HW
authors.lastname: Nab
authors.affiliation: Pfizer Europe, Rome, Italy.
authors.forename: Miriam
authors.initials: M
authors.lastname: Tarallo
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D016009:Chi-Square Distribution; D000068800:Etanercept; D005260:Female; D006304:Health Status; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects / Q000627:therapeutic use*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011788:Quality of Life; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept