title: Minimal disease activity and impact of disease in psoriatic arthritis: a Spanish cross-sectional multicenter study.
abstract: Patients with psoriatic arthritis (PsA) experience functional impairment and reduced quality of life, and thus patient global assessment in PsA is explained mainly by the physical, but also by the psychological, aspect of the disease. To assess the prevalence of minimal disease activity (MDA) in Spanish patients with PsA, we examined their characteristics and the association between MDA and the impact of the disease as assessed by the PsA Impact of Disease (PsAID) questionnaire.
  
  
  
  A cross-sectional multicenter study was carried out in patients who fulfilled the Classification for Psoriatic Arthritis (CASPAR) criteria with at least 1 year of disease duration, and who were treated with biological or conventional synthetic (cs) disease-modifying anti-rheumatic drugs (DMARDs) according to routine clinical practice in Spain. Patients were considered in MDA if they met at least 5/7 of the MDA criteria. The association between MDA and the recently developed PsAID questionnaire was also recorded.
  
  
  
  Of 227 patients included, 133 (58.6%) were in the MDA state (52% with antitumor necrosis factor (anti-TNF)α monotherapy, 24% with csDMARD monotherapy, and 24% with anti-TNFα in combination with csDMARD). Using multivariate logistic regression analysis, male gender (odds ratio (OR) 2.74, p = 0.001), a sedentary lifestyle (OR 3.13, p = 0.002), familial history of PsA (OR 0.38, p = 0.036), C-reactive protein (CRP) level (OR 0.92, p = 0.010), and use of corticoids (OR 0.33, p = 0.007) were considered features related to MDA. MDA patients had a significantly lower impact of the disease according to PsAID (mean total score (SD): MDA 3.3 (3.1) vs. non-MDA 7.1 (5.2); p < 0.001).
  
  
  
  Nearly 60% of Spanish PsA patients achieve MDA in routine clinical practice. MDA remains one of the most useful therapeutic targets for PsA since patients who reached this state also had a significantly lower impact of disease according to PsAID.
authors.affiliation: Department of Rheumatology, HU, Central de Asturias, Av. Roma, s/n, 33011, Oviedo, Asturias, Spain. rubenque7@yahoo.es.
authors.forename: Rubén
authors.initials: R
authors.lastname: Queiro
authors.affiliation: Department of Rheumatology, HU, Clinic and IDIBAPS, C/Villarroel, 170-08036, Barcelona, Spain.
authors.forename: Juan D
authors.initials: JD
authors.lastname: Cañete
authors.affiliation: Department of Rheumatology, HU, Parque Natural de las Batuecas 17, Cabrerizos, Salamanca, Cp 37193, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Montilla
authors.affiliation: Department of Rheumatology HU, Virgen del Puerto, Paraje Valcorchero s/n, 10600, Plasencia, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Abad
authors.affiliation: Medical Department, Pfizer, Avenida de Europa, 20 B, 28108, Alcobendas, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Montoro
authors.affiliation: Medical Department, Pfizer, Avenida de Europa, 20 B, 28108, Alcobendas, Madrid, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Gómez
authors.affiliation: Medical Department, Pfizer, Avenida de Europa, 20 B, 28108, Alcobendas, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Cábez
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012074:Remission Induction; D012720:Severity of Illness Index; D013030:Spain; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents
keywords: Minimal disease activity; PsAID; Psoriatic arthritis; Therapeutic objective