title: Minimal Disease Activity and Remission in Psoriatic Arthritis Patients Treated with Anti-TNF-α Drugs.
abstract: OBJECTIVE
  A state of remission is the target of therapy in chronic arthritis. The aim of the present study was to assess the rate of minimal disease activity (MDA) and remission in patients with psoriatic arthritis (PsA) treated with tumor necrosis factor (TNF-α) blockers. Disease characteristics and predictors of MDA were also evaluated.
  
  
  METHODS
  Patients fulfilling the ClASsification for Psoriatic ARthritis (CASPAR) criteria and treated with TNF-α blockers adalimumab, etanercept, or golimumab were enrolled and prospectively followed every 4 months for 1 year in a clinical practice setting. Patients were considered in MDA when they met at least 5/7 of the criteria previously defined. Other remission criteria evaluated were 28-joint Disease Activity Score-C-reactive protein (DAS28-CRP) < 2.6 and Disease Activity in Psoriatic Arthritis (DAPSA) score ≤ 3.3. Patients achieving MDA were compared to non-MDA to identify outcome predictor factors.
  
  
  RESULTS
  Of the 75 patients treated with TNF-α blockers, at baseline no patients were in MDA or had a DAPSA score ≤ 3.3, while 25 (21.3%) had a DAS28-CRP score < 2.6. Five patients (6%) discontinued treatment because of side effects or inefficacy during followup. After 12 months, MDA was achieved in 46 patients (61.3%). No difference was found among the 3 anti-TNF-α drugs. Predictors for MDA were found to be male sex, high CRP, high erythrocyte sedimentation rate, and low Health Assessment Questionnaire.
  
  
  CONCLUSIONS
  In our prospective observational study, based on a clinical practice setting, MDA was achieved in 61.3% of patients treated with TNF-α blockers, identifying this as an achievable target for patients with PsA. Predictors of remission were also identified.
authors.affiliation: From the Academic Rheumatology Unit, Department of Medicine and Health Science Vincenzo Tiberio, University of Molise, Campobasso; Rheumatology Unit, Orthopedic Institute G. Pini, Milan, Italy.F.M. Perrotta, MD, PhD, fellow in Translational and Clinical Medicine, Academic Rheumatology Unit, Department of Medicine and Health Science Vincenzo Tiberio, University of Molise; A. Marchesoni, MD, Consultant Rheumatologist, Rheumatology Unit, Orthopedic Institute G. Pini; E. Lubrano, MD, PhD, Aggregate Professor of Rheumatology and Consultant Rheumatologist, Academic Rheumatology Unit, Department of Medicine and Health Science Vincenzo Tiberio, University of Molise.
authors.forename: Fabio Massimo
authors.initials: FM
authors.lastname: Perrotta
authors.affiliation: From the Academic Rheumatology Unit, Department of Medicine and Health Science Vincenzo Tiberio, University of Molise, Campobasso; Rheumatology Unit, Orthopedic Institute G. Pini, Milan, Italy.F.M. Perrotta, MD, PhD, fellow in Translational and Clinical Medicine, Academic Rheumatology Unit, Department of Medicine and Health Science Vincenzo Tiberio, University of Molise; A. Marchesoni, MD, Consultant Rheumatologist, Rheumatology Unit, Orthopedic Institute G. Pini; E. Lubrano, MD, PhD, Aggregate Professor of Rheumatology and Consultant Rheumatologist, Academic Rheumatology Unit, Department of Medicine and Health Science Vincenzo Tiberio, University of Molise.
authors.forename: Antonio
authors.initials: A
authors.lastname: Marchesoni
authors.affiliation: From the Academic Rheumatology Unit, Department of Medicine and Health Science Vincenzo Tiberio, University of Molise, Campobasso; Rheumatology Unit, Orthopedic Institute G. Pini, Milan, Italy.F.M. Perrotta, MD, PhD, fellow in Translational and Clinical Medicine, Academic Rheumatology Unit, Department of Medicine and Health Science Vincenzo Tiberio, University of Molise; A. Marchesoni, MD, Consultant Rheumatologist, Rheumatology Unit, Orthopedic Institute G. Pini; E. Lubrano, MD, PhD, Aggregate Professor of Rheumatology and Consultant Rheumatologist, Academic Rheumatology Unit, Department of Medicine and Health Science Vincenzo Tiberio, University of Molise. enniolubrano@hotmail.com.
authors.forename: Ennio
authors.initials: E
authors.lastname: Lubrano
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy*; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D000068800:Etanercept / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012074:Remission Induction; D012720:Severity of Illness Index; D012460:Sulfasalazine / Q000627:therapeutic use; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007155:Immunologic Factors; D014409:Tumor Necrosis Factor-alpha; D012460:Sulfasalazine; D016572:Cyclosporine; C529000:golimumab; D000068879:Adalimumab; D000068800:Etanercept; D008727:Methotrexate
keywords: ANTI–TUMOR NECROSIS FACTOR; MINIMAL DISEASE ACTIVITY; PSORIATIC ARTHRITIS; REMISSION