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Open Access Highly Accessed Research article

Remission in psoriatic arthritis: is it possible and how can it be predicted?

Tajvur P Saber12, CT Ng12, Guillaume Renard12, Bernadette M Lynch12, Eliza Pontifex12, Ceara AE Walsh12, Alexia Grier12, Marian Molloy12, Barry Bresnihan12, Oliver FitzGerald12, Ursula Fearon12 and Douglas J Veale12*

Author Affiliations

1 Department of Rheumatology, Dublin Academic Medical Centre, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland

2 The Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland

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Arthritis Research & Therapy 2010, 12:R94  doi:10.1186/ar3021


See related editorial by Sokka and Mäkinen, http://arthritis-research.com/content/12/4/129

Published: 18 May 2010

Abstract

Introduction

Since remission is now possible in psoriatic arthritis (PsA) we wished to examine remission rates in PsA patients following anti tumour necrosis factor alpha (TNFα) therapy and to examine possible predictors of response.

Methods

Analysis of a prospective patient cohort attending a biologic clinic, between November 2004 and March 2008, was performed prior to commencing therapy and at regular intervals. Baseline clinical characteristics including demographics, previous disease-modifying antirheumatic drug (DMARD) response, tender and swollen joint counts, early morning stiffness, pain visual analogue score, patient global assessment, C reactive protein (CRP) and health assessment questionnaire (HAQ) were collected.

Results

A total of 473 patients (152 PsA; 321 rheumatoid arthritis (RA)) were analyzed. At 12 months remission, defined according to the disease activity score using 28 joint count and CRP (DAS28-CRP), was achieved in 58% of PsA patients compared to 44% of RA patients, significant improvement in outcome measures were noted in both groups (P < 0.05). Analysis of a subgroup of PsA and RA patients matched for DAS28-CRP at baseline also showed higher numbers of PsA patients achieving remission. Linear regression analysis identified the HAQ at baseline as the best predictor of remission in PsA patients (P < 0.001).

Conclusions

DAS28 remission is possible in PsA patients at one year following anti-TNF therapy, at higher rates than in RA patients and is predicted by baseline HAQ.