title: Comparison between full and tapered dosages of biologic therapies in psoriatic arthritis patients: clinical and ultrasound assessment.
abstract: The primary objective of this study was to describe and compare clinical and musculoskeletal (MS) ultrasound (US) features between psoriatic arthritis (PsA) patients treated with full and tapered dosage of biologic (b) disease-modified antirheumatic drugs (DMARDs). The secondary objective was to compare clinical and MSUS features between PsA patients treated with bDMARDs with and without concomitant synthetic (s) DMARDs. We evaluated 102 patients with PsA treated with bDMARDs. The bDMARD dosage tapering had been made in patients with a maintained remission or minimal disease activity (MDA) according to their attending rheumatologist and with the patient acceptance. The bDMARD tapering consisted of the following: increase the interval between doses for subcutaneous bDMARDs or reduction of the dose for intravenous bDMARDs. The clinical evaluation consisted of a dermatologic and rheumatologic assessment of disease activity. The presence of B-mode and Doppler synovitis, tenosynovitis, enthesopathy, and paratenonitis was investigated by a rheumatologist blinded to drug dosage, clinical assessments, and laboratory results. Seventy-four (72.5 %) patients received full dosage of bDMARDs and 28 (27.5 %) received tapered dosage. The duration with biologic therapy and with current biologic therapy was significantly higher in patients with tapered dosages (p = 0.008 and p = 0.001, respectively). We found no significant differences between clinical, laboratory, and US variables, both for BM and CD between patients with full and tapered dosage and between patients with and without concomitant sDMARD. Clinical assessment, MSUS variables, and MDA status are similar in patients receiving full and tapered dosage of bDMARDs.
authors: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain, iustinajanta@yahoo.com.
authors: Iustina
authors: I
authors: Janta
authors: Lina
authors: L
authors: Martínez-Estupiñán
authors: Lara
authors: L
authors: Valor
authors: María
authors: M
authors: Montoro
authors: Ofelia
authors: O
authors: Baniandres Rodriguez
authors: Ignacio
authors: I
authors: Hernández Aragüés
authors: Natalia
authors: N
authors: Bello
authors: Diana
authors: D
authors: Hernández-Flórez
authors: Michelle
authors: M
authors: Hinojosa
authors: Julia
authors: J
authors: Martínez-Barrio
authors: Juan Carlos
authors: JC
authors: Nieto-González
authors: Juan Gabriel
authors: JG
authors: Ovalles-Bonilla
authors: Carlos Manuel
authors: CM
authors: González
authors: Francisco Javier
authors: FJ
authors: López-Longo
authors: Indalecio
authors: I
authors: Monteagudo
authors: Esperanza
authors: E
authors: Naredo
authors: Luis
authors: L
authors: Carreño
mesh_terms: D000068879:Adalimumab / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D015535:Arthritis, Psoriatic / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001688:Biological Products / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D004551:Elbow Joint / Q000000981:diagnostic imaging; D000068800:Etanercept / Q000008:administration & dosage; D005260:Female; D033023:Foot Joints / Q000000981:diagnostic imaging; D050823:Hand Joints / Q000000981:diagnostic imaging; D006801:Humans; D000069285:Infliximab / Q000008:administration & dosage; D007719:Knee Joint / Q000000981:diagnostic imaging; D060046:Maintenance Chemotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013585:Synovitis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013717:Tenosynovitis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D001688:Biological Products; C529000:golimumab; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept
references: Ann Rheum Dis. 2007 Aug;66(8):1038-42
references: 17213251
references: Ann Rheum Dis. 2002 Oct;61(10 ):905-10
references: 12228161
references: J Rheumatol. 1994 Dec;21(12):2281-5
references: 7699629
references: Ann Rheum Dis. 2009 Jun;68(6):777-83
references: 19297344
references: Reumatol Clin. 2011 May-Jun;7(3):179-88
references: 21794810
references: Arthritis Rheum. 1999 Jun;42(6):1232-45
references: 10366117
references: Arthritis Rheum. 2001 Sep;44(9):2018-23
references: 11592362
references: Arthritis Rheum. 2003 Feb;48(2):523-33
references: 12571863
references: Ann Rheum Dis. 2011 Jan;70(1):25-31
references: 21109520
references: Rheumatology (Oxford). 2010 Apr;49(4):697-705
references: 20056769
references: Arthritis Care Res (Hoboken). 2014 Mar;66(3):432-9
references: 24022986
references: Arthritis Rheum. 2008 Aug;58(8):2248-56
references: 18668537
references: Ann Rheum Dis. 2011 Feb;70(2):315-9
references: 21068104
references: Ann Rheum Dis. 2007 Aug;66(8):1015-9
references: 17158138
references: Arthritis Rheum. 2003 Apr;48(4):955-62
references: 12687537
references: Ann Rheum Dis. 2014 Aug;73(8):1529-36
references: 23740228
references: J Rheumatol. 2003 May;30(5):966-71
references: 12734890
references: Ann Rheum Dis. 2003 Feb;62(2):127-32
references: 12525381
references: Arthritis Res Ther. 2010;12(3):R94
references: 20482783
references: Ann Rheum Dis. 2014 Mar;73(3):492-509
references: 24161836
references: Ann Rheum Dis. 2010 Jan;69(1):48-53
references: 19147615
references: Arthritis Care Res (Hoboken). 2010 Jul;62(7):965-9
references: 20589696
references: Arthritis Rheum. 2004 Jul;50(7):2103-12
references: 15248207
references: Ann Rheum Dis. 2010 Aug;69(8):1441-7
references: 20525844
references: Dermatologica. 1978;157(4):238-44
references: 357213
references: Ann Rheum Dis. 2012 Nov;71(11):1849-54
references: 22504561
references: Ann Rheum Dis. 2013 Aug;72 (8):1328-34
references: 22984169
references: Biologics. 2012;6:201-6
references: 22904612
references: Ann Rheum Dis. 2005 Mar;64 Suppl 2:ii18-23; discussion ii24-5
references: 15708928
references: Ann Rheum Dis. 2014 Apr;73(4):678-83
references: 23475981
references: Arthritis Rheum. 1995 Jan;38(1):38-43
references: 7818569
references: Ann Rheum Dis. 2011 Feb;70(2):272-7
references: 21115550
references: Ann Rheum Dis. 2005 Mar;64 Suppl 2:ii14-7
references: 15708927
references: Ann Rheum Dis. 2012 Jan;71(1):4-12
references: 21953336
references: Ann Rheum Dis. 2005 Mar;64(3):375-81
references: 15708891
references: Ann Rheum Dis. 2004 Apr;63(4):382-5
references: 15020331
references: J Rheumatol. 2005 Dec;32(12 ):2485-7
references: 16331793
references: Scand J Rheumatol. 2000;29(1):52-5
references: 10722258
references: Arthritis Rheum. 2006 Aug;54(8):2665-73
references: 16871531
references: Ann Rheum Dis. 2015 Apr;74(4):655-60
references: 24336010
references: Ann Rheum Dis. 2010 Sep;69(9):1636-42
references: 20421345
references: J Rheumatol. 1994 Dec;21(12):2286-91
references: 7699630