The burden of progression of psoriatic arthritis. All-Russian register data

Korsakova, Y.; Loginova, E.; Коротаева, Т. В.; Gubar, E.; Глухова, С. И.; Vasilenko, E.; Насонов, Е. Л.

doi:10.26442/00403660.2022.05.201506

Terapevticheskii arkhiv

2022

DOI: 10.26442/00403660.2022.05.201506

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The burden of progression of psoriatic arthritis. All-Russian register data

Y. Korsakova

E. Loginova

Т. В. Коротаева

et al.

Abstract: Background. Psoriatic arthritis (PsA) is a complex immune-mediated disease in which a third of patients with psoriasis (PsO) have a inflammatory lesion of both the musculoskeletal system (peripheral joints and axial structures) and extra-articular manifestations (dactylitis, enthesitis, nail PsO, uveitis and inflammatory bowel disease). Aim. To assess the burden of PsA progression in real practice according to the Russian register of PsA patients. Materials and methods. Seven hundred thirty seven … Show more

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Cited by 7 publications

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Guselkumab in Biologic-Naïve Patients with Active Psoriatic Arthritis in Russia: A Post Hoc Analysis of the DISCOVER-1 and -2 Randomized Clinical Trials

Mease,

Korotaeva,

Shesternya

et al. 2024

Rheumatol Ther

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Introduction There are limited data on the use of advanced therapies to treat psoriatic arthritis (PsA) in Russia. Guselkumab, an interleukin (IL)-23p19-subunit inhibitor, demonstrated efficacy in patients with PsA in the phase 3 DISCOVER-1 and -2, and COSMOS trials. This analysis evaluated the efficacy and safety of guselkumab in patients with PsA in Russia. Methods This post hoc analysis of DISCOVER-1 and -2 included 1002 biologic-naïve patients with active PsA from Russia ( n = 317) and the rest of the world (RoW; n = 685). Patients received guselkumab 100 mg every 4 weeks (Q4W), or at week 0 and 4 then Q8W, or placebo then guselkumab Q4W at week 24 (Russian: n = 119, 88, and 110, respectively; RoW: n = 216, 246, and 223, respectively). Outcomes through week 52 were pooled (DISCOVER-1 and -2); outcomes from week 52 to 100 represent DISCOVER-2 only. Results In patients from Russia, ≥ 20% improvement in the American College of Rheumatology (ACR20) criteria response rates were higher with guselkumab vs. placebo at week 24, increased through week 52, and were consistent across all guselkumab-treated groups at week 100. Similar trends were generally observed for ACR50, ≥ 90% improvement in Psoriasis Area and Severity Index (PASI90), achievement of Disease Activity in Psoriatic Arthritis (DAPSA) low disease activity/remission and minimal disease activity, enthesitis and dactylitis resolution, ≥ 0.35 improvement in Health Assessment Questionnaire–Disability Index (HAQ-DI) score, improvement in patient-reported pain, and measures in patients with axial PsA (including Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Ankylosing Spondylitis Disease Activity Score [ASDAS], and patient-reported spinal pain). Efficacy responses were similar between patients from Russia and the RoW across all endpoints and timepoints. The safety profile of guselkumab in patients from Russia was consistent with previous findings. Conclusion This analysis demonstrated that the safety and efficacy profiles of guselkumab across all PsA domains and patient-reported outcomes in patients from Russia were similar to those in patients from the RoW. Trial Registration Numbers NCT03162796 and NCT03158285. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-024-00713-x.

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Guselkumab in Biologic-Naïve Patients with Active Psoriatic Arthritis in Russia: A Post Hoc Analysis of the DISCOVER-1 and -2 Randomized Clinical Trials

Mease,

Korotaeva,

Shesternya

et al. 2024

Rheumatol Ther

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Results of a non-interventional observational multicenter study of the management of patients with axial psoriatic arthritis in real-life clinical practice (NiSaXPA)

Korotaeva,

Gubar,

Loginova

et al. 2023

Sovremennaâ revmatologiâ

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Psoriatic arthritis (PsA) is a chronic immunoinflammatory disease of the joints, spine and entheses from the group of spondyloarthritis, which is usually observed in patients with psoriasis. In recent years, the axial form of PsA (axPsA) has been actively researched. However, there is insufficient data on approaches to the diagnosis and treatment of patients with axPsA in real-life clinical practice. This article presents the results of an interim analysis of data from a non-interventional multicenter observational study on the treatment of patients with axPsA in real-life clinical practice (NiSaXPA) in Russian centers.Objective: to identify patients with axPsA, their characteristics and describe treatment tactics in real-life clinical practice.Material and methods. Patients with PsA who met the inclusion criteria were prospectively followed up during routine visits to a rheumatologist. Participants' axial radiographs were uploaded to a database in order for it to be confirmed the presence or absence of axPsA by two independent experts, a rheumatologist and a radiologist. Patients with a confirmed axPsA diagnosis participated in a further data collection phase (Visit 2, week 24).Results and discussion. Six hundred patients were enrolled into the study. At the time of analysis, 386 (64.3%) of them (209 men and 177 women) were screened for axPsA. The diagnosis of axPsA was confirmed in 241 (62.4%) cases; these patients formed the Per Protocol (PP) population. The mean age of patients with axPsA in the PP population was 46.30±12.6 years and the body mass index (BMI) was 27.4±5.2 kg/m2 . In 14.9% of patients, the duration of psoriasis was less than 1–5 years, in 21.5% – 5–10 years and in 63.6% – more than 10 years. The duration of PsA symptoms was less than 1–5 years in 31.2 % of patients, 5–10 years in 31.6 % and more than 10 years in 37.2 %. Low disease activity (BASDAI ˂ 4) was achieved in 33.3 % of patients with axPsA at visit 1 and in 64.3 % at visit 2; the BASDAI index declined on average from 4.67±1.95 to 3.31±1.89 points.In real-life clinical practice, patients were most frequently prescribed non-steroidal anti-inflammatory drugs (NSAIDs) – 88.7% and 71.7% (visits 1 and 2, respectively), and synthetic disease-modifying antirheumatic drugs (sDMARDs) –79.1% and 70.7%, respectively; therapy with biologic disease-modifying antirheumatic drugs (bDMARDs) was initiated in 40.2% and 60.6% of patients, respectively.Conclusion. The results of the interim analysis of this observational study showed that in 87.2% of patients who met the CASPAR criteria for PsA there was a suspicion of axial manifestations of PsA on the primary care level. However, only 62.4% of them had a confirmed diagnosis of axPsA on centralized expert assessment, which may indicate a possible overdiagnosis of axial lesions in real-life practice and emphasizes the importance of collaboration between a rheumatologist and a radiologist when analyzing the results of imaging studies. 33.3% of patients with axPsA had low disease activity according to BASDAI at baseline and 64.3% after 24 weeks, meaning that the disease was only adequately controlled in one third of cases despite therapy; the number of these patients doubled after a change in therapy. In real-world clinical practice, patients with axPsA are most commonly prescribed drugs from the NSAID and sDMARD groups; the frequency of use of biologic drugs varied between 40.2 and 60.6% by the end of the observation period.

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Search for predictors of achieving minimal disease activity during tofacitinib therapy in patients with psoriatic arthritis

Vorobyova,

Korotaeva,

Glukhova

et al. 2023

Sovremennaâ revmatologiâ

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Objective: to search predictors of achieving minimal disease activity (MDA) during therapy in patients with psoriatic arthritis (PsA).Materials and methods. The study included 41 patients, predominantly men (58.9 %), with a confirmed PsA diagnosis and a disease duration of at least 6 months. In all cases, the diagnosis fulfilled the CASPAR criteria. The mean age of the patients at the time of enrolment in the study was 43.0±10.1 years, the duration of PsA was 7.7±7.1 years, the duration of psoriasis was 18.6±10.4 years, and the DAPSA index was 44.2±17.1. All patients were prescribed tofacitinib at a dose of 5 mg twice daily, followed by a possible dose increase to 10 mg twice daily. In addition to a general clinical examination and a standard rheumatological examination, the level of secreted DKK-1 protein and health-related quality of life (HRQoL, using a special PsAID-12 questionnaire) were determined. Multivariate stepwise discriminant analysis was used to search for predictors for the achievement of MDA in patients with PsA and to calculate the coefficients.Results and discussion. Based on the results obtained, a predictor for the achievement of MDA (PMDA) was developed: PMDA=-1.165 × number of inflamed entheses + DKK-1 level (pmol/l) + 3.086 × PsAID-12 “Skin lesions” scale value (if this indicator was ≤3 points, it was assigned a value of 1, if it was >3 points – 0) + 2.568 × PsAID-12 “Pain” scale (if this indicator was ≤6 points, it was assigned a value of 1, if it was >6 points – 0).The ROC analysis, which reflects the prognostic significance of this index, showed AUC (area under the curve) of 0.803 (95% confidence interval 0.739–0.867; p=0.02). PMDA=3.89 was chosen as the cut-off value; the sensitivity of this indicator was 91 %, the specificity – 79 %. Therefore with a PMDA ≥3.89, the probability of the patient achieving a MDA after 3 months is high; with a PMDA ˂ 3.89, it is low.Conclusion. We identified factors influencing the achievement of MDA in patients with PsA and developed a mathematical model. It allows timely assessment of the quality of treatment and its correction if necessary, thereby slowing disease progression.

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The burden of progression of psoriatic arthritis. All-Russian register data

Cited by 7 publications

References 23 publications

Guselkumab in Biologic-Naïve Patients with Active Psoriatic Arthritis in Russia: A Post Hoc Analysis of the DISCOVER-1 and -2 Randomized Clinical Trials

Guselkumab in Biologic-Naïve Patients with Active Psoriatic Arthritis in Russia: A Post Hoc Analysis of the DISCOVER-1 and -2 Randomized Clinical Trials

Results of a non-interventional observational multicenter study of the management of patients with axial psoriatic arthritis in real-life clinical practice (NiSaXPA)

Search for predictors of achieving minimal disease activity during tofacitinib therapy in patients with psoriatic arthritis

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