Frank Behrens1,2, Lothar Meier3,4, Jörg C Prinz3,4, Jürgen Jobst3,4, Ralph Lippe3,4, Peter-Andreas Löschmann3,4, Hanns-Martin Lorenz3,4. 1. From the CIRI/Rheumatology and Fraunhofer Institute IME, Translational Medicine and Pharmacology, Goethe University, Frankfurt; Rheuma Praxis Hofheim, Hofheim am Taunus; Department of Dermatology, Ludwig-Maximilians-University of Munich, Munich; Pfizer Pharma GmbH, Berlin, Germany; Universitätsklinikum Heidelberg, Heidelberg, and ACURA Center for Rheumatic Diseases, Baden-Baden, Germany. Frank.Behrens@ime.fraunhofer.de. 2. F. Behrens, MD, CIRI/Rheumatology and Fraunhofer Institute IME, Translational Medicine and Pharmacology, Goethe University; L. Meier, MD, Rheuma Praxis Hofheim; J.C. Prinz, MD, Professor and Vice Chair, Department of Dermatology, Ludwig-Maximilian-University of Munich; J. Jobst, PhD, Pfizer Pharma GmbH; R. Lippe, MD, Pfizer Pharma GmbH; P.A. Löschmann, MD, Pfizer Pharma GmbH; H.M. Lorenz, MD, Professor of Medicine, Universitätsklinikum Heidelberg and ACURA Center for Rheumatic Diseases. Frank.Behrens@ime.fraunhofer.de. 3. From the CIRI/Rheumatology and Fraunhofer Institute IME, Translational Medicine and Pharmacology, Goethe University, Frankfurt; Rheuma Praxis Hofheim, Hofheim am Taunus; Department of Dermatology, Ludwig-Maximilians-University of Munich, Munich; Pfizer Pharma GmbH, Berlin, Germany; Universitätsklinikum Heidelberg, Heidelberg, and ACURA Center for Rheumatic Diseases, Baden-Baden, Germany. 4. F. Behrens, MD, CIRI/Rheumatology and Fraunhofer Institute IME, Translational Medicine and Pharmacology, Goethe University; L. Meier, MD, Rheuma Praxis Hofheim; J.C. Prinz, MD, Professor and Vice Chair, Department of Dermatology, Ludwig-Maximilian-University of Munich; J. Jobst, PhD, Pfizer Pharma GmbH; R. Lippe, MD, Pfizer Pharma GmbH; P.A. Löschmann, MD, Pfizer Pharma GmbH; H.M. Lorenz, MD, Professor of Medicine, Universitätsklinikum Heidelberg and ACURA Center for Rheumatic Diseases.
Abstract
OBJECTIVE: To evaluate patients with psoriatic arthritis (PsA) receiving etanercept (ETN) monotherapy or ETN plus conventional synthetic disease-modifying antirheumatic drugs (csDMARD) to determine the proportion achieving a clinically meaningful response in arthritis, psoriasis, and quality of life simultaneously. METHODS: A prospective, multicenter, 52-week observational study in patients with active PsA evaluated treatment with ETN in clinical practice (ClinicalTrials.gov: NCT00293722). This analysis assessed simultaneous achievement of 3 treatment targets: low disease activity (LDA) based on 28-joint count Disease Activity Score (DAS28); body surface area (BSA) involvement ≤ 3%; and a score > 45 on the Medical Outcomes Study Short Form-12 (SF-12) physical component summary. RESULTS: Of 579 patients, 380 received ETN monotherapy and 199 received combination ETN plus csDMARD. At 52 weeks, data for all 3 disease domains were available for 251 patients receiving monotherapy and 151 receiving combination therapy. In the monotherapy and combination therapy groups, 61 (24.3%) and 37 (24.5%) patients, respectively, achieved all 3 treatment targets simultaneously. A significantly greater proportion of patients receiving monotherapy versus combination therapy achieved SF-12 > 45 (43.0% vs 31.8%; p < 0.05) and DAS28 LDA (72.5% vs 62.3%; p < 0.05). Conversely, BSA ≤ 3% was reached by a significantly greater proportion receiving combination therapy (75.5% vs 56.6%; p < 0.001). However, baseline BSA involvement was higher for the monotherapy group. CONCLUSION: While nearly half the patients achieved arthritis and psoriasis treatment targets simultaneously and one-fourth reached all 3 treatment targets, combining ETN and csDMARD did not substantially improve clinical response compared with ETN monotherapy in this real-world PsA patient population.
OBJECTIVE: To evaluate patients with psoriatic arthritis (PsA) receiving etanercept (ETN) monotherapy or ETN plus conventional synthetic disease-modifying antirheumatic drugs (csDMARD) to determine the proportion achieving a clinically meaningful response in arthritis, psoriasis, and quality of life simultaneously. METHODS: A prospective, multicenter, 52-week observational study in patients with active PsA evaluated treatment with ETN in clinical practice (ClinicalTrials.gov: NCT00293722). This analysis assessed simultaneous achievement of 3 treatment targets: low disease activity (LDA) based on 28-joint count Disease Activity Score (DAS28); body surface area (BSA) involvement ≤ 3%; and a score > 45 on the Medical Outcomes Study Short Form-12 (SF-12) physical component summary. RESULTS: Of 579 patients, 380 received ETN monotherapy and 199 received combination ETN plus csDMARD. At 52 weeks, data for all 3 disease domains were available for 251 patients receiving monotherapy and 151 receiving combination therapy. In the monotherapy and combination therapy groups, 61 (24.3%) and 37 (24.5%) patients, respectively, achieved all 3 treatment targets simultaneously. A significantly greater proportion of patients receiving monotherapy versus combination therapy achieved SF-12 > 45 (43.0% vs 31.8%; p < 0.05) and DAS28 LDA (72.5% vs 62.3%; p < 0.05). Conversely, BSA ≤ 3% was reached by a significantly greater proportion receiving combination therapy (75.5% vs 56.6%; p < 0.001). However, baseline BSA involvement was higher for the monotherapy group. CONCLUSION: While nearly half the patients achieved arthritis and psoriasis treatment targets simultaneously and one-fourth reached all 3 treatment targets, combining ETN and csDMARD did not substantially improve clinical response compared with ETN monotherapy in this real-world PsA patient population.
Entities:
Keywords:
DERMATOLOGY; ETANERCEPT; MUSCULOSKELETAL DISEASE; PSORIATIC ARTHRITIS; QUALITY OF LIFE