title: Radiographic Progression of Patients With Psoriatic Arthritis Who Achieve Minimal Disease Activity in Response to Golimumab Therapy: Results Through 5 Years of a Randomized, Placebo-Controlled Study.
abstract: OBJECTIVE
  To evaluate long-term outcomes in psoriatic arthritis (PsA) patients who achieved or did not achieve minimal disease activity (MDA) through 5 years of golimumab treatment in the GO-REVEAL trial.
  
  
  METHODS
  The GO-REVEAL trial was a phase III, randomized, double-blind trial with placebo-control through week 24 followed by an open-label extension of golimumab 50/100 mg treatment up to 5 years. In these post-hoc analyses, MDA was defined by the presence of ≥5 of 7 PsA outcome measures (≤1 swollen joint, ≤1 tender joint, Psoriasis Area and Severity Index [PASI] ≤1, patient pain score ≤15, patient global disease activity score ≤20 [range 0-100], Health Assessment Questionnaire disability index [HAQ DI] ≤0.5, and ≤1 tender enthesis point).
  
  
  RESULTS
  Treatment with golimumab yielded significantly higher MDA response rates versus patients randomized to placebo at week 14 (23.5% versus 1.0%; P < 0.0001), week 24 (28.1% versus 7.7%; P < 0.0001), and week 52 (42.4% versus 30.2%; P = 0.037). MDA was achieved at least once by ∼50% of golimumab-treated patients overall. Irrespective of treatment randomization, achievement of MDA at ≥3 and ≥4 consecutive visits was associated with significantly less radiographic progression and more improvement in MDA components allowing specific assessment of physical function (HAQ DI) and overall disease activity (patient global assessment of disease activity) at week 256 versus patients not achieving MDA. Logistic regression analyses indicated that a 1-unit higher baseline HAQ DI score yielded a significantly lower likelihood of achieving MDA at ≥3 (odds ratio 0.514 [95% confidence interval 0.321-0.824]; P = 0.006) and ≥4 (odds ratio 0.480 [95% confidence interval 0.290-0.795]; P = 0.004) consecutive visits.
  
  
  CONCLUSIONS
  Among golimumab-treated PsA patients, better long-term functional improvement, patient global assessment, and radiographic outcomes were observed when patients achieved persistent MDA.
authors.affiliation: University of California, San Diego, La Jolla.
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
authors.affiliation: Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Désirée
authors.initials: D
authors.lastname: van der Heijde
authors.affiliation: Janssen Research & Development, Spring House, Pennsylvania.
authors.forename: Anna
authors.initials: A
authors.lastname: Beutler
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Dafna
authors.initials: D
authors.lastname: Gladman
authors.affiliation: Swedish Medical Center, Seattle, Washington, and University of Washington, Seattle.
authors.forename: Philip
authors.initials: P
authors.lastname: Mease
authors.affiliation: University of Utah, Salt Lake City.
authors.forename: Gerald G
authors.initials: GG
authors.lastname: Krueger
authors.affiliation: University of Glasgow, Glasgow, UK.
authors.forename: Iain B
authors.initials: IB
authors.lastname: McInnes
authors.affiliation: Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Helliwell
authors.affiliation: Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Coates
authors.affiliation: Janssen Research & Development, Spring House, Pennsylvania.
authors.forename: Stephen
authors.initials: S
authors.lastname: Xu
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D018450:Disease Progression; D006801:Humans; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; C529000:golimumab