Objectives To compare the efficacy of adalimumab, etanercept, and infliximab therapy in psoriatic arthritis (PsA) patients with oligoarticular or polyarticular subset
Methods We enrolled in a prospective, not-randomized, open-label study 349 PsA patients with peripheral disease, 234 with polyarticular and 115 with oligoarticular subset, beginning a treatment with adalimumab, etanercept, or infliximab. At baseline, 6 months, and 12 months, disease activity indices, (DAS28, Disease Activity Score on 28 joints, SDAI, simplified disease activity index, sum of TJC tender joint count, SJC swollen joint count, CRP C-reactive protein, and PzGA Patient Global Assessment), and disability HAQ (Health Assessment Questionnaire) were calculated. The rates of disease remission were compared among the three TNF-ablockers at 6 and 12 months. Baseline predictors of disease remission and functional improvement (reduction of HAQ ≥0.5) were analyzed by multivariate regression models
Results After 12 months the percentage of patients on clinical remission (SDAI ≤3.3) was significantly higher in infliximab or etanercept than adalimumab group (p<0.05), both in oligoarticular and polyarticular subset. Infliximab induced the widest decrease of TJC and the best “good” EULAR response in polyarthritis and oligoarthritis patients, respectively. Baseline predictors of disease remission were low DAS28, low HAQ, sex male, and glucocorticoids therapy in polyarthritis. The best predictor of functional improvement (ΔHAQ ≥0.5) was high HAQ in both subsets.
Conclusions Our study provides evidence that anti-TNFa drugs may differently perform in PsA and that separate analysis of the clinical subsets of the disease may improve our knowledge of the management of PsA
Disclosure of Interest None Declared