Results of one-year treat-to-target strategy in early psoriatic arthritis: data of an open-label REMARCA study

Tv, Korotaeva; Loginova, E.; Ts, Getiya; El, Nasonov

doi:10.26442/terarkh201890522-29

Cited by 10 publications

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“…In the TICOPA study, almost 40% of patients in the tight control, treat-to-target arm, were in minimal disease activity at 48 weeks, compared with 25% in the standard of care arm. Similar experiences have been reported in an open-label study [ 130 ].…”

Section: Resultssupporting

confidence: 88%

Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

et al. 2021

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To establish practical recommendations for the management of patients with psoriatic arthritis (PsA) with particular clinical situations that might lead to doubts in the pharmacological decision-making. A group of six expert rheumatologists on PsA identified particular clinical situations in PsA. Then, a systematic literature review (SLR) was performed to analyse the efficacy and safety of csDMARDs, b/tsDMARDs in PsA. In a nominal group meeting, the results of the SLR were discussed and a set of recommendations were proposed for a Delphi process. A total of 65 rheumatologists were invited to participate in the Delphi. Agreement was defined if ≥ 70% of the participants voted ≥ 7 (from 1, totally disagree to 10, totally agree). For each recommendation, the level of evidence and grade of recommendation was established based on the Oxford Evidence-Based Medicine categorisation. Particular clinical situations included monoarthritis, axial disease, or non-musculoskeletal manifestations. The SLR finally comprised 131 articles. A total of 16 recommendations were generated, all but 1 reached consensus. According to them, it is crucial to carefully analyse the impact of individual manifestations on patients (disability, quality of life, etc.), but also to recognise the impact of each drug singularities on selected clinical phenotypes to adopt the most appropriate treatment strategy. Early diagnosis and treatment to target approach, along with a close risk management, is also necessary. These recommendations are intended to complement gaps in national and international guidelines by helping health professionals address and manage particular clinical situations in PsA.

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Section: Resultssupporting

confidence: 88%

Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

et al. 2021

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“…Согласно [56,57]. Напротив, в открытом исследовании РЕМАРКА показана эффективность МТ в подкожной форме в дозе до 20-25 мг/нед при раннем ПсА (рПсА): минимальная активность болезни после 1 года терапии была отмечена у 65,9% больных [58].…”

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“…Следует отметить, что парадигма лечения ПсА претерпела существенное изменение в связи не только с внедрением в клиническую практику таргетных ГИБП, но и с выработкой новой стратегии ведения больных -«Лечение до достижения цели» («Treat-to-target» -T2T),направленной на достижение ремиссии или минимальной активности болезни [56,58].…”

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“…Согласно стратегии «Лечение до достижения цели», рекомендуется оценивать эффективность лечения каждые 3-6 мес и при необходимости осуществлять коррекцию терапии [56,69]. Полученные данные согласуются с основными ре-зультатами открытого рандомизированного многоцентрового исследования TICOPA [58,70]. В целом полученные к настоящему времени данные свидетельствуют об эффективности стратегии Т2Т у больных рПсА с применением ГИБП и МТ.…”

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Psoriatic arthritis: pathogenetic features and innovative therapies

Лила¹,

Насонов

Коротаева³

2019

Naučno-praktičeskaâ revmatologiâ

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The paper considers the modern concepts of the etiology and pathogenesis of psoriatic arthritis (PsA). The latter is currently indicated as a T-cell-mediated disease that is based on the activation of cellular immunity, followed by the hyperproduction and imbalance of key pro- and anti-inflammatory cytokines, such as tumor necrosis factor-α (TNF- α), interleukin-1β (IL-1β), IL-6, IL-12/23, and IL-17. The paper presents the basic principles of diagnosis and clinical manifestations of the disease and notes the importance of screening questionnaires, the use of which allows specialists to diagnose PsA early, by actively identifying articular complaints, the characteristic clinical and radiological signs of damage to the joint, spine, and entheses. It is pointed out that the key target of pharmacotherapy for PsA is to achieve remission or minimal activity of the main clinical manifestations of the disease, to slow down or prevent its radiographic progression, to increase the length and quality of life in patients, and to reduce the risk of comorbidities. The authors characterize the major groups of used drugs: nonsteroidal anti-inflammatory drugs, conventional and targeted synthetic disease-modifying antirheumatic drugs, and biological drugs (inhibitors of TNF-α, IL-12/23, and IL-17). The key Treat-to-target principles of patient management are considered; it is noted that strict control over disease activity and treatment results provides suppression of all major clinical manifestations of PsA. The paper also shows the basic principles of the creation and further development of the All-Russian Registry of PsA patients, which makes it possible to optimize management decision-making on the provision of high-tech medical care and drugs for this cohort of patients.

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“…В связи с внедрением в практику ревматолога стратегии «Лечение до достижения цели» -Treat-to-Target (Т2Т), предусматривающей динамичный контроль за активностью болезни и, при необходимости, усиление терапии каждые 3-6 мес [3], растет число пациентов, которым на ранней стадии болезни назначаются ГИБП. Применение ГИБП при раннем ПсА позволяет быстро достичь ремиссии или минимальной активности болезни (МАБ) [3,4]. Однако остается неясным, как долго следует продолжать лечение ГИБП после достижения ремиссии или МАБ, особенно учитывая высокую стоимость терапии, а также риск неблагоприятных лекарственных реакций, включая длительную иммуносупрессию.…”

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The duration of remission and minimal disease activity after initiation and discontinuation of biological agents in patients with early psoriatic arthritis (data from the all-russian psoriatic arthritis registry)

Логинова¹,

Коротаева²,

Глухова³

et al. 2019

Naučno-praktičeskaâ revmatologiâ

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Results of one-year treat-to-target strategy in early psoriatic arthritis: data of an open-label REMARCA study

Cited by 10 publications

References 0 publications

Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

Psoriatic arthritis: pathogenetic features and innovative therapies

The duration of remission and minimal disease activity after initiation and discontinuation of biological agents in patients with early psoriatic arthritis (data from the all-russian psoriatic arthritis registry)

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