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“Given the complex nature of PsA, patients should also be involved in defining their treatment goals, as every patient may have different perspectives on the target for therapy and the means to achieve it.”
Although definition of remission may vary in patients with psoriatic arthritis (PsA), patient-reported remission was most notably linked to the lessening of psoriasis symptoms, according to a study published in Springer.1
“Previous efforts have utilized multidomain measures such as minimal disease activity that assess the status of joints, skin, and function to determine current level of PsA disease activity,” investigators stated. “Given the complex nature of PsA, patients should also be involved in defining their treatment goals, as every patient may have different perspectives on the target for therapy and the means to achieve it.”
A cross-sectional study utilizing an online surey of 1570 participants with psoriatic disease was conducted by the National Psoriasis Foundation. Data collected included a provider diagnosis of PsA and/or psoriasis (PsO), comorbidities, the impact of PsA and disease activity, and demographics. Those who had a PsA diagnosis were asked if they believed that their disease was in remission and, if so, the length of their remission.
Patients with PsO reported the severity of their symptoms using the Patient Report of Extent of Psoriasis Involvement (PREPI). Those with mild cases (3% or less body surface impacted) were also asked if they felt their disease was in remission.
PsA disease activity and impact was assessed using the 9-question Psoriatic Arthritis Impact of Disease (PsAID-9) instrument as well a global PsA-related quality of life questionnaire. PsAID-9 scores of ≤ 4, representing patient-acceptable symptom state (PASS), were considered to be acceptable disease state.
Of the 834 participants with PsA included in the study, 144 (21.6%) reported that their PsA was in remission, with an average remission of 43 months. Within the cohort, 76 (4.8%) patients with PsA never experienced skin involvement at all. For patients in remission, 78.4% (n = 116) were currently using a treatment for PsA and most (76.7%) were using a biologic treatment for PsA within the past 12 months.
A multivariate logistic regression model demonstrated that patient-reported PsA remission was independently linked to experiencing an acceptable disease state, PsO remission, lower impact of PsA on global quality of life, and patients who reported non-White race. However, age, sex, body mass index, and use of biologics in the past 12 months were not associated with patient-reported PsA remission.
The study was limited by using an online survey as investigators believe web-based surveys may be affected by age and race. Additionally, generalizability may be hindered as individuals who contact the National Psoriasis Foundation may differ from general patients with psoriasis as they tend to be older, more affluent, have more significant disease, and be more knowledgeable about treating psoriatic disease in comparison with the general population.
“We evaluated the clinical and demographic factors associated with patient-perceived PsA remission through the use of a cross-sectional survey,” investigators concluded. “Low disease activity and impact (low PSAID score) was associated with remission status. Furthermore, perceived psoriasis remission, quality of life, and non-white race were also significantly associated with patient-reported PsA remission. Ultimately, our study highlights that PsA remission status is multifactorial and patient-dependent.”
Gondo G, Mosca M, Hong J, et al. Demographic and Clinical Factors Associated with Patient-Reported Remission in Psoriatic Arthritis. Dermatol Ther (Heidelb). 2022;12(8):1885-1895. doi:10.1007/s13555-022-00770-6