Prevalence and Predictors of Achieving Sustained Remission in Psoriatic Arthritis : A Swedish Nationwide Registry Study
Palsson, Olafur LU
; Einarsson, Jon T.
LU
; Wallman, Johan K.
LU
; Love, Thorvardur J.
; Gudbjornsson, Bjorn
and Kapetanovic, Meliha C.
LU
(2025)
In The Journal of rheumatology
52(10).
p.997-1004
- Abstract
OBJECTIVE: To estimate the prevalence and predictors of sustained remission (SR) in patients with psoriatic arthritis (PsA) receiving biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in Sweden. METHODS: All patients with PsA initiating b/tsDMARDs and who were registered in the national Swedish Rheumatology Quality Register (SRQ) from April 1999 to December 2019 were included. Data on disease/treatment characteristics at first b/tsDMARD (baseline) initiation and all subsequent visits were extracted from the SRQ. Remission was defined as Disease Activity Score in 28 joints based on C-reactive protein (DAS28-CRP) ≤ 2.6, Disease Activity Index for Psoriatic Arthritis in 28 joints (DAPSA28) ≤ 4 or the... (More)
OBJECTIVE: To estimate the prevalence and predictors of sustained remission (SR) in patients with psoriatic arthritis (PsA) receiving biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in Sweden. METHODS: All patients with PsA initiating b/tsDMARDs and who were registered in the national Swedish Rheumatology Quality Register (SRQ) from April 1999 to December 2019 were included. Data on disease/treatment characteristics at first b/tsDMARD (baseline) initiation and all subsequent visits were extracted from the SRQ. Remission was defined as Disease Activity Score in 28 joints based on C-reactive protein (DAS28-CRP) ≤ 2.6, Disease Activity Index for Psoriatic Arthritis in 28 joints (DAPSA28) ≤ 4 or the physician global assessment of disease activity (PGA) on a scale of 0 to 4 (remission = 0), and SR when these criteria persisted during ≥ 2 consecutive visits for ≥ 6 months. Baseline predictors of SR were explored using logistic regression analysis. RESULTS: Data on 4669 patients with PsA with 48,773 visits were available. Eighty-one percent of patients achieved DAS28-CRP remission ever, and 54% achieved SR at least once. The corresponding percentages for DAPSA28 were 46% and 24% and for PGA were 69% and 38% for ever reaching remission and SR, respectively. Male sex was a positive predictor of reaching SR when measured by DAPSA28 and PGA but not by DAS28-CRP. Fewer swollen joints at baseline predicted SR according to all 3 remission criteria. CONCLUSION: A considerable proportion of patients with PsA receiving various b/tsDMARDs never achieved remission, and approximately half never achieved SR in this Swedish nationwide registry study. Fewer swollen joints at first b/tsDMARD initiation increases the likelihood of SR, regardless of remission criteria used. There was still a sex difference when measured with DAPSA28 and PGA, with men being more likely to reach SR.
(Less)
- author
- Palsson, Olafur
LU
; Einarsson, Jon T.
LU
; Wallman, Johan K.
LU
; Love, Thorvardur J.
; Gudbjornsson, Bjorn
and Kapetanovic, Meliha C.
LU
- organization
- publishing date
- 2025-10
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- biologic treatments, psoriatic arthritis, remission, sustained remission
- in
- The Journal of rheumatology
- volume
- 52
- issue
- 10
- pages
- 8 pages
- publisher
- Journal of Rheumatology
- external identifiers
-
- scopus:105017655766
- pmid:40374512
- ISSN
- 0315-162X
- DOI
- 10.3899/jrheum.2024-1250
- language
- English
- LU publication?
- yes
- id
- 704f1eb4-baff-447c-894a-aa8526cc24e0
- date added to LUP
- 2025-11-25 15:02:58
- date last changed
- 2025-11-25 15:03:17
@article{704f1eb4-baff-447c-894a-aa8526cc24e0,
abstract = {{<p>OBJECTIVE: To estimate the prevalence and predictors of sustained remission (SR) in patients with psoriatic arthritis (PsA) receiving biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in Sweden. METHODS: All patients with PsA initiating b/tsDMARDs and who were registered in the national Swedish Rheumatology Quality Register (SRQ) from April 1999 to December 2019 were included. Data on disease/treatment characteristics at first b/tsDMARD (baseline) initiation and all subsequent visits were extracted from the SRQ. Remission was defined as Disease Activity Score in 28 joints based on C-reactive protein (DAS28-CRP) ≤ 2.6, Disease Activity Index for Psoriatic Arthritis in 28 joints (DAPSA28) ≤ 4 or the physician global assessment of disease activity (PGA) on a scale of 0 to 4 (remission = 0), and SR when these criteria persisted during ≥ 2 consecutive visits for ≥ 6 months. Baseline predictors of SR were explored using logistic regression analysis. RESULTS: Data on 4669 patients with PsA with 48,773 visits were available. Eighty-one percent of patients achieved DAS28-CRP remission ever, and 54% achieved SR at least once. The corresponding percentages for DAPSA28 were 46% and 24% and for PGA were 69% and 38% for ever reaching remission and SR, respectively. Male sex was a positive predictor of reaching SR when measured by DAPSA28 and PGA but not by DAS28-CRP. Fewer swollen joints at baseline predicted SR according to all 3 remission criteria. CONCLUSION: A considerable proportion of patients with PsA receiving various b/tsDMARDs never achieved remission, and approximately half never achieved SR in this Swedish nationwide registry study. Fewer swollen joints at first b/tsDMARD initiation increases the likelihood of SR, regardless of remission criteria used. There was still a sex difference when measured with DAPSA28 and PGA, with men being more likely to reach SR.</p>}},
author = {{Palsson, Olafur and Einarsson, Jon T. and Wallman, Johan K. and Love, Thorvardur J. and Gudbjornsson, Bjorn and Kapetanovic, Meliha C.}},
issn = {{0315-162X}},
keywords = {{biologic treatments; psoriatic arthritis; remission; sustained remission}},
language = {{eng}},
number = {{10}},
pages = {{997--1004}},
publisher = {{Journal of Rheumatology}},
series = {{The Journal of rheumatology}},
title = {{Prevalence and Predictors of Achieving Sustained Remission in Psoriatic Arthritis : A Swedish Nationwide Registry Study}},
url = {{http://dx.doi.org/10.3899/jrheum.2024-1250}},
doi = {{10.3899/jrheum.2024-1250}},
volume = {{52}},
year = {{2025}},
}