FRI0453 DOES DISCORDANCE BETWEEN BASELINE PATIENT’S AND EVALUATOR’S GLOBAL ASSESSMENT OF DISEASE ACTIVITY IMPACT RETENTION AND REMISSION RATES OF TNF INHIBITORS IN PATIENTS WITH PSORIATIC ARTHRITIS? DATA FROM THE EUROSPA RESEARCH COLLABORATION

Abstract

Background Discordance between baseline patient’s and evaluator’s global assessment of disease activity is common1 and may reduce the likelihood of remission following tumor necrosis factor inhibitor (TNFi) treatment in patients with psoriatic arthritis (PsA).2 However, the impact of such discordance on retention rates of TNFi in PsA patients remains unexplored. Objectives To explore the impact of discordance, defined as patient’s minus evaluator’s global assessment (ΔPEG), on retention rates and remission rates (DAS28(3)CRP (which does not include patient’s global) and DAS28(4)CRP (which includes patient’s global)) in PsA patients initiating their first TNFi treatment. We used pooled data from the European Spondyloarthritis Research Collaboration (EuroSpA). Methods TNFi naive PsA patients from 11 European registries in EuroSpA were included. Kaplan-Meier analyses were used to estimate TNFi retention rates after 6/12/24 months, with comparison between baseline ΔPEG quartiles using the log rank test, stratified by gender. Remission rates were compared between different ΔPEG quartiles with Chi-square test, stratified by gender. Results A total of 5422 PsA patients were included. Mean (SD) age for women(n=2988)/men(n=2867) were 49.3(12.5)/47.4(11.7) years, disease duration 6.6(7.3)/6.7(7.2) years, median(25-75 percentiles) baseline ΔPEG 17(0-38)/10(0-30) mm. Retention rates and DAS28(4)CRP but not DAS28(3)CRP remission rates were lower for higher quartiles of baseline ΔPEG (table, figure). Conclusion High baseline discordance (ΔPEG) was associated with lower TNFi retention rates and with DAS28(4)CRP but not DAS28(3)CRP remission rates after 6, 12 and 24 months’ follow-up in both male and female PsA patients. The choice of remission criteria in the follow-up of PsA patients may affect important treatment decisions, and may be of particular impact in patients with high baseline ΔPEG.