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Treatment‐to‐Target With Apremilast in Psoriatic Arthritis: The Probability of Achieving Targets and Comprehensive Control of Disease Manifestations
Author(s) -
Mease Philip J.,
Gladman Dafna D.,
Ogdie Alexis,
Coates Laura C.,
Behrens Frank,
Kavanaugh Arthur,
McInnes Iain,
Queiro Rubén,
Guerette Benoit,
Brunori Michele,
Teng Lichen,
Smolen Josef S.
Publication year - 2020
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.24134
Subject(s) - apremilast , medicine , psoriatic arthritis , disease , arthritis , physical therapy
Objective The present study was undertaken to evaluate the probability of achieving the Clinical Disease Activity Index for Psoriatic Arthritis ( cDAPSA ) treatment targets of remission or low disease activity ( LDA ) with apremilast based on disease activity categories and corresponding responses in arthritis and other domains of psoriatic arthritis (PsA) not included in the cDAPSA . Methods Pooled analyses from the Psoriatic Arthritis Long‐term Assessment of Clinical Efficacy studies 1, 2, and 3 were performed. Probability analyses assessing the likelihood of achieving cDAPSA treatment targets by week 52 were performed using multiple imputation for discontinuations and missing values. Longitudinal analyses were performed in patients grouped by cDAPSA category at week 52. Results Among 494 patients in the probability analyses, 46.9% with moderate disease activity and 24.9% with high disease activity at baseline achieved treatment targets (remission or LDA ) by week 52. For patients with moderate disease activity at baseline, small improvements ( cDAPSA reductions ≥30%) by week 16 were associated with achieving targets. Patients achieving remission or LDA by week 16 had high probabilities of remaining at treatment targets at week 52. Of 375 patients with cDAPSA components available at week 52, achieving targets with apremilast was associated with continuous disease activity improvements and no or mild arthritis and other PsA manifestations. Conclusion The probability of achieving treatment targets (remission or LDA ) at week 52 was greater for patients with moderate versus high disease activity at baseline. At a mean level, partial improvements by week 16 were associated with achieving treatment targets. Patients receiving apremilast who achieved cDAPSA targets by week 52 also had no or mild arthritis or other PsA manifestations.