Subcutaneous anti-TNF alfa induced sustained minimal disease activity and remission in psoriatic arthritis patients: a retrospective study

Objective: The aim of the present study was to assess the rate of sustained Minimal Disease Activity (MDA) and remission in a group of psoriatic arthritis (PsA) patients treated with TNF alpha blockers. Methods: We perform a retrospective study on our database of PsA patients treated with adalimumab, etanercept and golimumab, with a minimum of 12 months of follow up. Patients were considered in sustained MDA when they met at least 5/7 of the criteria previously defined for at least 12 months of follow up. DAS28-CRP < 2.6, DAPSA score <= 4 and patient global assessment (PGA) <= 20 mm were also evaluated as remission criteria. Concordance between the remission criteria and MDA was also performed. Results: Of the 81 patients treated with TNF alpha blockers, at baseline no patients were in MDA or had a DAPSA score <= 4, while 17 (20.9%) had a DAS28-CRP score < 2.6. PGA <= 20 was recorded in 6 patients (7%). Sustained MDA was achieved in 35 (43.2%) patients while sustained DAPSA, DAS28-CRP and PGA remission were obtained respectively in 19.7%, 35.8% and 44.4% of patients. No difference was found between the three anti-TNF alpha in respect to the probability of achieve MDA. Conclusions: In this retrospective study, sustained MDA was achieved in 43.2% of patients treated with TNF alpha blockers. Moreover, sustained remission was achieved in a consistent number of patients, configuring this as an achievable target for PsA patients.