In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective Analysis
With the availability of effective treatment with targeted synthetic and biologic disease-modifying anti-rheumatic drugs (ts/bDMARDs) for psoriatic arthritis (PsA), it is crucial to identify predictors of access to this treatment since disease onset. We retrospectively enrolled patients with periphe...
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doaj-363f3ab64b7c49d6b8cee5158f7a5f6b2021-07-15T15:39:05ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-01102834283410.3390/jcm10132834In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective AnalysisGarifallia Sakellariou0Silvana Quaglini1Serena Bugatti2Francesca Bobbio-Pallavicini3Vittorio Gabba4Carlomaurizio Montecucco5Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, ItalyDepartment of Electrical, Computer and Biomedical Engineering, University of Pavia, 27100 Pavia, ItalyDepartment of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, ItalyDivision of Rheumatology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, ItalyDepartment of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, ItalyDepartment of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, ItalyWith the availability of effective treatment with targeted synthetic and biologic disease-modifying anti-rheumatic drugs (ts/bDMARDs) for psoriatic arthritis (PsA), it is crucial to identify predictors of access to this treatment since disease onset. We retrospectively enrolled patients with peripheral PsA, assessed in an early arthritis clinic from 2005 to 2020. The main baseline demographic, clinical and ultrasonographic (assessment of bilateral wrist and metacarpophalangeal joints) features were evaluated through descriptive statistics and tested as predictors by univariate and multivariate Cox models. The outcome of interest was the indication for ts/bDMARDs within 2 years from diagnosis. We included 238 patients with PsA, with a mean (sd) age of 51.04 (13.98) years; 90 (37.8%) were male, and the median (IQR) symptom duration was 6.12 (3.29–12.25) months. In univariate analyses, C-reactive protein (RR, 95% CI 1.204 (1.065,1.362)), Visual Analogue Scale (VAS) pain (1.027 (1.005,1.048)), the number of tender joints on 28 joints (1.087 (1.025, 1.153)), and a synovial power Doppler (PD) score > 1 (3.63 (1.307, 10.08)) emerged as significant predictors. C-reactive protein, VAS pain and PD confirmed their predictive value also in multivariate models. These results provide preliminary evidence on the features that might characterize patients with early peripheral PsA requiring more intensive monitoring and treatment escalation.https://www.mdpi.com/2077-0383/10/13/2834psoriatic arthritisearly arthritisdisease-modifying anti-rheumatic drugspredictors |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Garifallia Sakellariou Silvana Quaglini Serena Bugatti Francesca Bobbio-Pallavicini Vittorio Gabba Carlomaurizio Montecucco |
spellingShingle |
Garifallia Sakellariou Silvana Quaglini Serena Bugatti Francesca Bobbio-Pallavicini Vittorio Gabba Carlomaurizio Montecucco In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective Analysis Journal of Clinical Medicine psoriatic arthritis early arthritis disease-modifying anti-rheumatic drugs predictors |
author_facet |
Garifallia Sakellariou Silvana Quaglini Serena Bugatti Francesca Bobbio-Pallavicini Vittorio Gabba Carlomaurizio Montecucco |
author_sort |
Garifallia Sakellariou |
title |
In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective Analysis |
title_short |
In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective Analysis |
title_full |
In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective Analysis |
title_fullStr |
In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective Analysis |
title_full_unstemmed |
In Patients with Early Peripheral Psoriatic Arthritis Baseline C-Reactive Protein, Pain and Ultrasound-Detected Synovitis Predict Subsequent Treatment with ts/bDMARDs. A Retrospective Analysis |
title_sort |
in patients with early peripheral psoriatic arthritis baseline c-reactive protein, pain and ultrasound-detected synovitis predict subsequent treatment with ts/bdmards. a retrospective analysis |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-06-01 |
description |
With the availability of effective treatment with targeted synthetic and biologic disease-modifying anti-rheumatic drugs (ts/bDMARDs) for psoriatic arthritis (PsA), it is crucial to identify predictors of access to this treatment since disease onset. We retrospectively enrolled patients with peripheral PsA, assessed in an early arthritis clinic from 2005 to 2020. The main baseline demographic, clinical and ultrasonographic (assessment of bilateral wrist and metacarpophalangeal joints) features were evaluated through descriptive statistics and tested as predictors by univariate and multivariate Cox models. The outcome of interest was the indication for ts/bDMARDs within 2 years from diagnosis. We included 238 patients with PsA, with a mean (sd) age of 51.04 (13.98) years; 90 (37.8%) were male, and the median (IQR) symptom duration was 6.12 (3.29–12.25) months. In univariate analyses, C-reactive protein (RR, 95% CI 1.204 (1.065,1.362)), Visual Analogue Scale (VAS) pain (1.027 (1.005,1.048)), the number of tender joints on 28 joints (1.087 (1.025, 1.153)), and a synovial power Doppler (PD) score > 1 (3.63 (1.307, 10.08)) emerged as significant predictors. C-reactive protein, VAS pain and PD confirmed their predictive value also in multivariate models. These results provide preliminary evidence on the features that might characterize patients with early peripheral PsA requiring more intensive monitoring and treatment escalation. |
topic |
psoriatic arthritis early arthritis disease-modifying anti-rheumatic drugs predictors |
url |
https://www.mdpi.com/2077-0383/10/13/2834 |
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