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02.42 Description of a series of patients with psoriatic arthritis treatment with biological therapy
  1. Raquel Hernández1,
  2. Julia Uceda1,
  3. Carmen Almeida2,
  4. Jose L. Marenco1
  1. 1Reumatology, Valme Hospital, Seville, Spain
  2. 2Bioestadistica, Valme Hospital, Seville, Spain

Abstract

Introduction Psoriatic arthritis (PSA) is a chronic inflammatory joint disease associated with the presence of cutaneous psoriasis.

Objective The main aim was to describe the characteristics of a series of patients from the southern hospital area of Seville (Hospital Virgen de Valme) with PSA diagnosis in treatment with biological therapies (TB)

Material and methods Retrospective observational study of 25 patients diagnosed with APS with peripheral affection according to CASPAR criteria, in treatment with TB registered in the database of the UGC of Rheumatology of the hospital Virgen de Valme. Description of baseline sociodemographic characteristics, age, sex, APs form, cutaneous involvement, and indicated biological therapies.

Results A total of 25 patients have been reviewed.

Of these, 68% were men, compared to 32% women. The mean age at present is 48 years, and the mean age at diagnosis is 37 years. Or this 92% has cutaneous involvement and 12% of nail involvement.

The clinical profiles were : 40% has polyarticular afecction, 36% oligoarticular, 12% axial, 8% axial and peripheral, and 4% involvement of the distal interphalangeal. WE don´t have a mutilante form.

The TB most used as first line of treatment was Etanercept in 36%, followed by Infliximab in 32%, and Adalimumab (16%). In the 2nd line of treatment, we again find Etanercept as the most used drug followed by Adalimumab, which was the most used also in 3rd line.

Exceptionally, we observed a single patient with highly refractory psoriatic arthritis treated with Abatacept in the fourth line and currently being treated with Ustekinumab in the 5th line. (After 6 months of treatment it has a NAT=0 and NAD=0 and a cutaneous involvement with a BSA <3%)

Finally we found the 84% of the patients were responders to the 1 st biological therapy measured by a DAS28 <2.6 (almost remission) or, failing that, a DAS28 <3.2 (low activity) and/or an MAE.

Conclusion In our sample we found a predominance of male involvement in the most aggressive forms. Peripheral involvement is the most frequent, coinciding with the patterns described in the literature and most of the patients had cutaneous symptoms. TB in general is effective in archieved high response rates after the first biological in real clinical practice conditions.

Finally, the newly accepted therapies, anti-IL 17 and IL 12–23 drugs extend the therapeutic arsenal with data on efficacy and safety in real clinical practice.

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