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Background: Despite achieving Low Disease Activity (LDA) states, patients with SpondyloArthritis (SpA) may have considerable residual disease. Sparse data is currently available from Asia.
Objectives: We aimed to evaluate the burden of residual disease in patients with axial SpondyloArthritis (axSpA) or Psoriatic Arthritis (PsA) who achieved LDA.
Methods: We used data from a registry of SpA from an outpatient setting in a tertiary hospital in Singapore. For axSpA, LDA was defined as Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) <4/10. For PsA, LDA was defined by achieving 5/7 cutoffs in the Minimal Disease Activity (MDA) or clinical Disease Activity index for Psoriatic Arthritis (cDAPSA) ≤13.
Results: From 262 cases of axSpA (21% women; mean ± standard deviation (SD) age 42 ± 14 years), 58% of patients achieved LDA states. While from 142 cases of PsA (49% women; mean ± SD age 51 ± 14 years), 38% and 63% achieved MDA and cDAPSA LDA, respectively. Both axSpA and PsA patients with LDA had pain scores range from 17.2 to 25.7/100 and fatigue scores from 3.3 to 3.5/10. (
Residual disease burden in patients with axSpA and PsA who have achieved LDA
| axSpA | PsA | ||
|---|---|---|---|
| LDA (n=153 ) | LDA by MDA (n=54 ) | LDA by cDAPSA (n=90 ) | |
| Age, years ¥ | 42.2 (14.0) | 52.5 (13.2) | 52.5 (13.2) |
| Female, n (%) | 26 (17.0) | 30 (55.6) | 45 (50.0) |
| TJC ¥ | 0.1 (0.3) | 0.8 (1.0) | 1.0 (1.4) |
| SJC ¥ | 0.1 (0.3) | 0.7 (1.3) | 0.9 (1.3) |
| VAS-pain (0-100) ¥ | 25.7 (19.0) | 17.2 (17.8) | 20.8 (16.7) |
| BASDAI (0-10) ¥ | 2.3 (1.0) | 2.4 (1.6) | 2.7 (1.7) |
| BASDAI fatigue (0-10) ¥ | 3.5 (2.2) | 3.3 (2.3) | 3.4 (2.3) |
| PtGA (0-100) ¥ | 27.8 (19.5) | 20.9 (17.9) | 23.5 (17.6) |
| Dactylitis (0-20) ¥ | – | 0.3 (0.5) | 0.5 (0.9) |
| LEI (0-6) ¥ | – | 0.1 (0.4) | 0.2 (0.5) |
| HAQ (0-3) ¥ | 0.1 (0.1) | 0.1 (0.2) | 0.2 (0.4) |
| HAQ < 0.5, n (%) | 149 (97.4) | 52 (96.3) | 77 (85.6) |
| SF-36 PCS ¥ | 46.8 (9.9) | 45.8 (11.5) | 45.1 (11.7) |
| SF-36 MCS ¥ | 46.4 (11.2) | 46.1 (11.3) | 45.6 (10.6) |
axSpA, axial Spondyloarthritis; PsA, Psoriatic Arthritis; LDA, Low Disease Activity; MDA, Minimal Disease Activity; cDAPSA, clinical Disease Activity index for Psoriatic Arthritis; TJC, tender joint count; SJC, swollen joint count; VAS, Visual Analog Scale; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; PtGA, patient’s global assessment; LEI, Leeds Enthesitis Index; HAQ, Health Assessment Questionnaire; SF-36, Short-Form 36; SF-36 PCS, norm-based Physical Component Summary (mean=50, SD=10); SF-36 MCS, norm-based Mental Component Summary (mean=50, SD=10)
¥ mean (SD)
Conclusion: Despite being in LDA, axSpA and PsA patients experienced substantial pain, fatigue and poorer functional health and mental well-being.
Disclosure of Interests: Venice Liu: None declared, Warren Fong Consultant of: Abbvie, Janssen, Novartis, Speakers bureau: Abbvie, Janssen, Novartis, Yu Heng Kwan: None declared, Ying Ying Leung Speakers bureau: Novartis, Janssen, Eli Lilly