Baseline disease activity predicts achievement of cDAPSA treatment goals with apremilast: Phase 3 results in DMARD-naive psoriatic arthritis patients

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J Rheumatol. April 15, 2022: jrheum.210906. doi: 10.3899/jrheum.210906. Online ahead of print.


OBJECTIVE: Likelihood of achieving Clinical Psoriatic Disease Activity Index (cDAPSA) treatment goals (remission [REM]low disease activity [LDA]) was assessed following apremilast monotherapy in disease-modifying antirheumatic drug (DMARD)-naïve patients with psoriatic arthritis (PS) based on baseline disease activity.

METHODS: This post hoc probability analysis of PALACE 4, a Phase 3, multicentre, randomized, placebo-controlled study, evaluated crossover between cDAPSA categories at week 52, included treatment-naïve patients DMARDs receiving apremilast 30 mg twice daily with baseline cDAPSA data available. Changes in articular/extra-articular manifestations were assessed in patients with cDAPSA components at week 52. Achievement of cDAPSA treatment goal was assessed in a subgroup with extra-articular manifestations. initial joints of PSA (cutaneous involvement, enthesitis, dactylitis).

RESULTS: Of the 175 apremilast-treated patients in the probability analysis, 66.3% had high disease activity (HDA) and 31.4% moderate disease activity (ModDA) at baseline. Approximately twice as many patients on ModDA at baseline achieved REM/LDA at week 52 compared to those on HDA (61.7% vs. 28.2%). Achievement of cDAPSA treatment goals was associated with reductions in articular (swollen/painful joints) and extra-articular (skin involvement, enthesitis, dactylitis, functional disability) disease activity. Similar rates of treatment goal achievement were observed in the subgroup with ≥ 1 extra-articular PsA event (n=126; ModDA: 66.7%, HDA: 32.2%).

CONCLUSION: Patients treated with apremilast with baseline ModDA had a higher likelihood of achieving cDAPSA treatment goals than patients with HDA. Resolution/near resolution of articular/extra-articular manifestations of PsA was achieved by patients on REM/LDA at week 52. Consistent achievement of treatment goals was observed in patients with 1 or more extra-articular manifestations. joints of the active PR.

PMID:35428720 | DOI:10.3899/jrheum.210906

About Antoine L. Cassell

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