Anti-tumor necrosis factor-α effective in psoriatic arthritis

Patients with psoriatic arthritis (PsA) undergoing their first treatment with tumor necrosis factor-α (TNA-α) inhibitor showed a high adherence to therapy and a good response, according to a recent Danish study in Arthritis & Rheumatism.

Investigators used a nationwide rheumatologic database to identify 764 PsA patients who were treated with TNA-α inhibitors.  In the first 6 months of treatment, the patients' clinical responses were evaluated according to the American College of Rheumatology’s 20% (ACR20), 50% (ACR50), or 70% (ACR70) improvement criteria or to the “good response” of the European League Against Rheumatism (EULAR). Drug adherence and clinical response predictors were also assessed.

Of the 764 patients, 320 received adalimumab, 260 infliximab, and 184 etanercept. The average duration of drug adherence was 2.9 years; 70% of patients remained adherent for 1 year and 57% for 2 years. Male gender, baseline C-reactive protein (CRP) level greater than 10 mg/L, concomitant methotrexate use, and low patient health visual analog score at baseline were associated with longer adherence to therapy.  Improvement in the ACR20, ACR50, ACR70, and EULAR good response was 59%, 45%, 24%, and 54%, respectively. A CRP level greater than 10 mg/L was predictive of improved responses in all categories.

"This analysis of 764 patients with PsA in a nationwide prospective registry documents that TNA-α inhibitors decrease the disease activity in patients with PsA in clinical practice," the investigators concluded.