The disease activity states of the DAPSA (a psoriatic arthritis-specific instrument) stands valid against functional status and structural progression

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The disease activity states of the DAPSA (a psoriatic arthritis-specific instrument) stands valid against functional status and structural progression

People affected by psoriasis are susceptible to psoriatic arthritis (PsA) which is indicated by red patches of the skin topped with silvery scales. In many people, psoriasis evolve first, and they are later diagnosed with psoriatic arthritis, but the joint problems can occasionally occur before the skin lesions appear.  Recently, the disease activity states were progressed for the Disease Activity index for PSoriatic Arthritis (DAPSA).   Aletaha D., et. al., studied that whether the different DAPSA disease activity states are connected with different degrees of functional impairment and different extents of joint damage progression in patients suffering from PsA.

Data were retrieved from two significant trials of tumour necrosis factor inhibitors (TNFi)  in PsA (IMPACT II and GO-REVEAL). At 6 months, patients were recognized in DAPSA remission (REM, ≤4), and low, moderate or high disease activity (LDA, ≤14; MDA, ≤28; HDA, >28). The functional scores (Health Assessment Questionnaire Disability Index, HAQ and physical component scale of the Short Form-36, PCS), and 1-year structural progression (PsA-modified Sharp/van der Heijde Score) were distinguished across these groups.

Three hundred and ten patients from GO-REVEAL and one hundred thirty patients from IMPACT II, with a mean (SD) baseline DAPSA of 48.8 (26.4) and 44.6 (17.9) were recognized, respectively.

Inflation in the HAQ scores across patients groups in the four DAPSA disease activity states was observed, although PCS curtailed (p<0.001 for both). As per the mean progression in the combined cohort, −0.47 for REM, −0.28 for LDA, −0.14 for MDA and 0.51 for HDA (p<0.001) scores were revealed. This relationship proved effective in the individual trial cohorts, and in the subgroups of patients treated with TNFi or placebo. In multiple analyses, the increased DAPSA scores were notably and independently related to the probability of structural progression.

Therefore, it was concluded that the disease activity states of the PsA specific DAPSA score are highly justifiable for future use as endpoints in clinical trials or as targets in clinical practice.

Source:

Annals of Rheumatic Diseases

Link to the source:

http://ard.bmj.com/content/76/2/418.short?rss=1

The original title of the article:

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

Authors

D Aletaha et. al.

SearchTags: 
Exploratory, Psoriatic Arthritis, Skin, Joints
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