Background Early detection and treatment of inflammatory involvement in patients with Psoriatic arthritis (PsA) is essential to prevent chronic disability
Objectives To investigate the clinical remission at two years obtained with traditional DMARDs and antiTNF alpha in patients with early psoriatic arthritis (ePsA)
Methods 43 patients (16 male and 27 female) with early PsA (ePsA), defined as inflammatory joint symptoms and signs with a duration <1 year at diagnosis and diagnosed according to the Classification Criteria for Psoriatic Arthritis (CASPAR) (1), with persistent disease after three months since diagnosis and treated with DMARDS (traditional and antiTNF alpha) and cox2 inhibitors, were studied, at two years of follow up (since onset of treatment), with inflammatory markers (ESR, CRP), clinical investigation (MASES, 66/68 joint count, BASMI, pain at palpation of sacroiliac joints) and questionnaires (pain and fatigue visual analogical scale -VAS-, HAQ modified for spondiloarthritis, BASFI and BASDAI). We defined clinical remission as the complete negativity of all parameters persistent for almost six months.
Results At two years, 12/43 patients (27,9%) presented a complete clinical remission at (mean) 10,6 months (range 6 - 24 months), persistent for successive six months, of whom 5/12 (41,6%) suspended DMARDS and were treated only with cox2 inhibitors, without relapse after six months. The clinical characteristics and treatments of ePsA are shown in table 1. Patients with complete remission had no axial disease and had a higher percentage of entheseal involvement in comparison to the ePsA with partial response.
Conclusions Early treatment of ePsA induces clinical remission in an high percentage of patients with entheseal and peripheral involvement.
Taylor W, Gladman D, Helliwell Ph, Marchesoni A, Mease Ph, Mielants H, and the CASPAR Study Group. Classification criteria for psoriatic arthritis. Development of new criteria from a large international study. Arthritis Rheum 2006;54:2665-73
Disclosure of Interest None Declared
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