Objectives To analyse clinical and sonographic differences between patients with rheumatoid arthritis and psoriatic arthritis with clinical remission or low disease activity on anti-TNF therapy.
Methods Subanalysis of the 12 months follow-up prospective study INMUNOREMAR. Patients diagnosed with rheumatoid arthritis or polyarticular psoriatic arthritis in clinical remission or low disease activity by DAS28 on anti-TNF therapy (etanercept, adalimumab or infliximab) were included. Clinical, epidemiological, demographic and serological data at baseline were analysed. Ultrasound scans of both knees and hands (wrists, metacarpophalangeal [MCP], proximal interphalangeal [PIP] flexor and extensor tendons of the hand) were made. We quantified synovial hypertrophy (grades 0-3) and power Doppler signal (grades 0-3) in all patients and a global synovitis score was calculated. Data at study entry are presented.
Results 100 patients (46 RA and 54 PsA, mean age (SD) 58.2 (11.4) years, disease duration 15.9 (8.8) years) were included. 50 patients were on etanercept, 35 adalimumab and 15 infliximab. 51 patients (39 PsA) were on monotherapy and 46 (31 PsA) were on anti-TNF dose-reduction. 48 patients had power Doppler signal and 45 met criteria for ultrasound-active synovitis (synovial hypertrophy + Power Doppler signal). Patients with psoriatic arthritis had significantly-less disease activity (p=0.0001 for DAS28-VSG) and fewer sonographic findings (Table 1): only 14 patients with PsA met criteria for active synovitis (31 for RA, p=0.0001).
Conclusions Among patients with clinical remission or low disease activity and anti-TNF therapy, PsA patients had significantly less clinical and sonographic activity.
Disclosure of Interest : None declared