Journal article
Residual disease associated with suboptimal treatment response in patients with psoriatic arthritis: a systematic review of real world evidence
- Abstract:
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Objective: This systematic literature review aimed to identify and summarise real-world observational studies reporting the type, prevalence and/or severity of residual symptoms and disease in adults with psoriatic arthritis (PsA) who have received treatment and been assessed against remission or low disease activity targets.
Methods: Patients had received treatment and been assessed with treat-to-target metrics including minimal disease activity (MDA), Disease Activity Index in PsA (DAPSA) and others. MEDLINE, Embase® and the Cochrane Database of Systematic Reviews (CDSR) were searched using search terms for PsA, treatment targets and observational studies. Screening of search results was completed by two independent reviewers; studies were included if they reported relevant residual disease outcomes in adults with PsA who had received one or more pharmacological treatments for PsA in a real-world setting. Non-observational studies were excluded. Information from included studies was extracted into a prespecified grid by a single reviewer and checked by a second reviewer.
Results: Database searching yielded 2,328 articles; 42 publications (27 unique studies) were included. 23 studies reported outcomes for MDA assessed patients, 14 studies reported outcomes for DAPSA assessed patients. Physician- and patient reported residual disease was less frequent and/or severe in patients reaching targets, but often not absent, including when patients achieved very low disease activity (VLDA) or remission. For example, studies reported 0–8% patients in DAPSA (or clinical DAPSA) remission had >1 tender joint, 25–39% had PASI >1, and 0–10% had patient reported pain >15. Residual disease was usually less frequent and/or severe among patients achieving MDA-assessed targets versus DAPSAassessed targets, especially for skin outcomes.
Conclusion: The findings demonstrate a need for further optimisation of care for patients with PsA.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 1.8MB, Terms of use)
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- Publisher copy:
- 10.1007/s40744-022-00443-y
Authors
- Publisher:
- Springer
- Journal:
- Rheumatology and Therapy More from this journal
- Volume:
- 9
- Pages:
- 803–821
- Publication date:
- 2022-04-12
- Acceptance date:
- 2022-03-14
- DOI:
- EISSN:
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2198-6576
- Language:
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English
- Keywords:
- Pubs id:
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1246332
- Local pid:
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pubs:1246332
- Deposit date:
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2022-03-18
Terms of use
- Copyright holder:
- Coates et al
- Copyright date:
- 2022
- Rights statement:
- © The Author(s) 2022. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.
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