Early treatment of psoriatic arthritis is associated with improved patient-reported outcomes: findings from the etanercept PRESTA trial

Clin Exp Rheumatol. Jan-Feb 2015;33(1):11-9. Epub 2014 Dec 22.

Abstract

Objectives: The present paper aims to investigate the effect of psoriatic arthritis (PsA) disease duration on the outcome of treatment with etanercept (ETN) in patients with PsA who also have moderate-to-severe psoriasis.

Methods: Patients from the PRESTA trial who received ≥1 ETN 50 mg once weekly (QW) dose and had ≥1 post-baseline value were evaluated. Baseline and after-treatment changes were compared between patients with PsA ≤2 years versus PsA >2 years in efficacy measures (physician global assessment [PGA] arthritis, swollen joint count and Psoriasis Area and Severity Index [PASI]) and patient reported outcomes (PROs; joint pain, arthritis activity, Euro-Qol [EQ-5D] utility and visual analogue score [VAS]) using linear regression analysis.

Results: Baseline efficacy measures were similar between the PsA ≤2 years (n=103) and PsA >2 years (n=269) groups, with the exception of PGA arthritis (p=0.006). At week 24, improvements in efficacy measures were observed in both groups but were significantly greater for PGA arthritis in the PsA ≤2 years group (p=0.03). Quality of life (QoL), measured using PROs, was generally lower at baseline in patients with PsA >2 years. Clinically meaningful improvements were seen in QoL with ETN treatment in both groups, but the change from baseline scores at week 24 were significantly higher in PsA ≤2 years group for joint pain (p=0.007), arthritis activity (p=0.01), EQ-5D utility (p=0.046) and EQ-5D VAS (p=0.04) responses.

Conclusions: PsA patients responded to ETN 50 mg QW treatment irrespective of disease duration; however, patients with shorter PsA duration had greater improvements in arthritis scores and several PRO measures.

Trial registration: ClinicalTrials.gov NCT00245960.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Arthritis, Psoriatic / diagnosis
  • Arthritis, Psoriatic / drug therapy*
  • Arthritis, Psoriatic / physiopathology
  • Arthritis, Psoriatic / psychology
  • Chi-Square Distribution
  • Etanercept
  • Female
  • Health Status
  • Humans
  • Immunoglobulin G / adverse effects
  • Immunoglobulin G / therapeutic use*
  • Linear Models
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Quality of Life
  • Receptors, Tumor Necrosis Factor / therapeutic use*
  • Remission Induction
  • Severity of Illness Index
  • Time Factors
  • Time-to-Treatment*
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • Etanercept

Associated data

  • ClinicalTrials.gov/NCT00245960