Who Achieves Minimal and Very Low Disease Activity in Psoriatic Arthritis? An Analysis of the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry.

Abstract

To evaluate the achievement of minimal disease activity (MDA) and very low disease activity (VLDA) in patients with psoriatic arthritis (PsA) treated in a real-world clinical setting with biologic/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). This study included patients with a diagnosis of PsA treated with an approved b/tsDMARD who were enrolled in the CorEvitas PsA/Spondyloarthritis (SpA) Registry (March 2013 - September 2023). MDA/VLDA achievement was assessed at the follow-up registry visit, 6 (range: 5-9) months post-index (b/tsDMARD initiation). At the follow-up registry visit, 17.68% (370/2,093) and 7.51% (187/2,491) of patients achieved MDA and VLDA, respectively. Baseline characteristics including female sex, higher baseline fatigue and pain scores, and previous treatment with b/tsDMARDs were associated with a lower likelihood of achieving MDA/VLDA. Higher European Quality of Life 5-Dimension 3- Level (EQ-5D-3L) scores and b/tsDMARD monotherapy treatment were associated with a higher likelihood of achieving MDA. Among MDA/VLDA non-achievers, 23.10% (398/1,723) and 10.24% (236/2,304) missed MDA/VLDA achievement by 1 criterion, respectively. At the follow-up registry visit, pain was the most commonly unmet criterion across the overall MDA non-achiever (95.41%) and VLDA nonachiever (87.02%) cohorts. Other commonly unmet criteria were the Patient Global Assessment of arthritis and psoriasis (MDA non-achievers: 89.32%; VLDA non-achievers: 75.87%) and Health Assessment Questionnaire-Disability Index (MDA non-achievers: 80.91%; VLDA nonachievers: 67.01%). Despite receiving b/tsDMARD treatment for PsA, most patients did not achieve MDA or VLDA, with the most commonly unmet criteria being pain and other patient-reported outcomes. These findings indicate opportunities to improve PsA management.