Disease activity states of the DAPSA, a psoriatic arthritis specific instrument, are valid against functional status and structural progression

Aletaha, Daniel; Alasti, Farideh; Smolen, JS

doi:10.1136/annrheumdis-2016-209511

Cited by 77 publications

(55 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are a variety of disease assessments for PsA. DAPSA, cDAPSA, and MDA are composite indices and have been validated and promoted for use in estimating disease activity for PsA by the international task force . In the multivariable regression analysis of the present study, two disease activity indices (cDAPSA and DAPSA) and HAQ were significantly associated with HU after adjusting for age.…”

Section: Discussionmentioning

confidence: 59%

“…The target of treatment of PsA in the 2017 update of recommendations by an international task force is clinical remission or minimal disease activity . Patients with clinical remission had the best function and the fewest radiographic outcomes . The validated measures of PsA including Disease Activity Index for Psoriatic Arthritis (DAPSA), the clinical DAPSA (cDAPSA), and the minimal disease activity (MDA) have been suggested to measure the target of treatment.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Disease activity and functional status associated with health‐related quality of life and patient‐acceptable symptom state in patients with psoriatic arthritis in Thailand: A cross‐sectional study

et al. 2019

View full text Add to dashboard Cite

Aim:To identify factors associated with the EuroQol-5 Dimensions-5 levels (EQ-5D-5L) and patient acceptable symptom state (PASS) and to estimate health utility (HU) in Thai patients with psoriatic arthritis (PsA). Methods:A cross-sectional study of consecutive PsA patients visiting Siriraj Hospital was performed between 31 May, 2012 and 31 March, 2016. Data of patient demographics, HU outcomes (Thai EQ-5D-5L), disease activity (Disease Activity Index for Psoriatic Arthritis [DAPSA], the Clinical DAPSA [cDAPSA], the minimal disease activity [MDA]), and the Health Assessment Questionnaire (HAQ) were collected.Regression analyses were used to explore factors associated with each EQ-5D domain, HU, and PASS. Results:Of 129 PsA patients, the mean age was 47.6 years; 53.5% were male. The mean HU was 0.76. Univariable analysis showed lower disease activity and less impaired function were significantly associated with higher HU and no to mild problem in each EQ-5D domain. Multivariable analysis showed HAQ and disease activity indices (cDAPSA, DAPSA, MDA) adjusting for age, had good goodness-of-fit to HU (adjusted R 2 : 0.63-0.65). Patients answering "yes" to PASS had significantly longer disease duration of PsA, higher HU, lower disease activity, less disability, and were more often married than those answering "no" to PASS. Pain problem was the most important association to PASS adjusting for other domains and age. Conclusions:Disease activity and functional status in PsA patients were significant factors related to HU and PASS. To improve quality of life, the goal of treatment should be achieving remission, improving function, and controlling pain. K E Y W O R D ScDAPSA, EQ-5D-5L, MDA, PASS, psoriatic arthritis | 701 CHIOWCHANWISAWAKIT eT Al.

show abstract

Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Disease activity and functional status associated with health‐related quality of life and patient‐acceptable symptom state in patients with psoriatic arthritis in Thailand: A cross‐sectional study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Investigators in other studies did assess the burden of disease in patients fulfilling only 1 of the targets compared with those not fulfilling that target. It was shown in those studies that patients achieving the target had better scores for patient-reported outcomes compared with patients in whom the target was not achieved (28)(29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

Burden of Psoriatic Arthritis According to Different Definitions of Disease Activity: Comparing Minimal Disease Activity and the Disease Activity Index for Psoriatic Arthritis

Wervers

Vis

Tchetveriko

et al. 2018

Arthritis Care & Research

View full text Add to dashboard Cite

Objective Treat‐to‐target strategies have improved outcomes in rheumatic diseases. In psoriatic arthritis (PsA), the proposed targets are the multidimensional target minimal disease activity (MDA) and the articular target Disease Activity index for PsA (DAPSA). The aim of this study was to compare the disease burden of PsA in patients with low disease activity according to the 2 definitions, MDA and DAPSA low disease activity (DAPSA‐LDA), 1 year after diagnosis. Methods We obtained data on MDA, DAPSA‐LDA and disease burden 1 year after diagnosis for patients included in the Dutch southwest early PsA cohort. Disease burden was assessed in 2 domains: “Body functions,” including the Short Form 36 bodily pain (SF‐36 BP) measure, and “Activity,” including the Health Assessment Questionnaire (HAQ). Results Among the 292 patients included, 48% achieved MDA and 74% achieved DAPSA‐LDA. Average scores for Body functions and Activity were better in patients who achieved MDA and those who achieved DAPSA‐LDA. The scores were significantly better in the 46% of patients who achieved both MDA and DAPSA‐LDA than in the 29% of patients who achieved only DAPSA‐LDA. The average SF‐36 BP score was higher in patients achieving both targets (73.8; 95% confidence interval [95% CI] 71.1‐76.5) than in patients achieving only DAPSA‐LDA (57.6; 95% CI 54.5‐60.8). Similarly, mean HAQ scores measuring Activity were 0.21 (95% CI 0.15‐0.26) and 0.63 (95% CI 0.53‐0.72), respectively. Conclusion Among patients with newly diagnosed PsA, 48% achieved MDA and 74% achieved DAPSA‐LDA after 1 year of receiving usual care. The average disease burden was better in patients who achieved MDA and those who achieved DAPSA‐LDA. Also, patients who achieved only DAPSA‐LDA reported worse outcomes than those who also achieved MDA.

show abstract

“…A fundamental question that remains is how to identify the most appropriate instruments to monitor disease activity in patients with PsA who may have multiple manifestations in clinical practice. In this regard, treatment‐to‐target and American College of Rheumatology recommendations for PsA support the use of the Disease Activity Index for Psoriatic Arthritis (DAPSA) as a valid instrument to monitor the achievement of treatment targets among other treatment targets . A potential, inherent limitation associated with the DAPSA relates to its focus on articular features.…”

Section: Introductionmentioning

confidence: 99%

Treatment‐to‐Target With Apremilast in Psoriatic Arthritis: The Probability of Achieving Targets and Comprehensive Control of Disease Manifestations

Mease

Gladman

Ogdie

et al. 2020

Arthritis Care & Research

View full text Add to dashboard Cite

Objective The present study was undertaken to evaluate the probability of achieving the Clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA) treatment targets of remission or low disease activity (LDA) with apremilast based on disease activity categories and corresponding responses in arthritis and other domains of psoriatic arthritis (PsA) not included in the cDAPSA. Methods Pooled analyses from the Psoriatic Arthritis Long‐term Assessment of Clinical Efficacy studies 1, 2, and 3 were performed. Probability analyses assessing the likelihood of achieving cDAPSA treatment targets by week 52 were performed using multiple imputation for discontinuations and missing values. Longitudinal analyses were performed in patients grouped by cDAPSA category at week 52. Results Among 494 patients in the probability analyses, 46.9% with moderate disease activity and 24.9% with high disease activity at baseline achieved treatment targets (remission or LDA) by week 52. For patients with moderate disease activity at baseline, small improvements (cDAPSA reductions ≥30%) by week 16 were associated with achieving targets. Patients achieving remission or LDA by week 16 had high probabilities of remaining at treatment targets at week 52. Of 375 patients with cDAPSA components available at week 52, achieving targets with apremilast was associated with continuous disease activity improvements and no or mild arthritis and other PsA manifestations. Conclusion The probability of achieving treatment targets (remission or LDA) at week 52 was greater for patients with moderate versus high disease activity at baseline. At a mean level, partial improvements by week 16 were associated with achieving treatment targets. Patients receiving apremilast who achieved cDAPSA targets by week 52 also had no or mild arthritis or other PsA manifestations.

show abstract

Disease activity states of the DAPSA, a psoriatic arthritis specific instrument, are valid against functional status and structural progression

Abstract: IMPACT 2: NCT02152254; GO-REVEAL: NCT00265096.

Cited by 77 publications

References 14 publications

Disease activity and functional status associated with health‐related quality of life and patient‐acceptable symptom state in patients with psoriatic arthritis in Thailand: A cross‐sectional study

Disease activity and functional status associated with health‐related quality of life and patient‐acceptable symptom state in patients with psoriatic arthritis in Thailand: A cross‐sectional study

Burden of Psoriatic Arthritis According to Different Definitions of Disease Activity: Comparing Minimal Disease Activity and the Disease Activity Index for Psoriatic Arthritis

Treatment‐to‐Target With Apremilast in Psoriatic Arthritis: The Probability of Achieving Targets and Comprehensive Control of Disease Manifestations

Contact Info

Product

Resources

About