Prior Conventional Disease-modifying Antirheumatic Drugs Research Articles

A window of opportunity for abatacept in RA: is disease duration an independent predictor of low disease activity/remission in clinical practice?

The objective of the study was to examine whether disease duration independently predicts treatment response among biologic-naïve patients with rheumatoid arthritis (RA) initiating abatacept in clinical practice. Using the Corrona RA registry (February 2006–January 2015), biologic-naïve patients with RA initiating abatacept with 12-month (±3 months) follow-up and assessment of disease activity (Clinical Disease Activity Index [CDAI]) at initiation and at 12 months were identified. The primary outcome was mean change in CDAI (ΔCDAI) from baseline to 12 months. Secondary outcomes at 12 months included achievement of low disease activity (LDA; CDAI ≤10 in patients with moderate/high disease activity at initiation) and remission (CDAI ≤2.8 in patients with low, moderate or high disease activity at initiation). Linear and logistic regression analyses were performed to examine the relationship between disease duration and response to abatacept. There were 281 biologic-naïve patients with RA initiating abatacept (disease duration 0–2 years, n = 107; 3–5 years, n = 45; 6–10 years, n = 50; >10 years, n = 79). Increased disease duration was associated with older age (p = 0.047), and the median number of prior conventional disease-modifying antirheumatic drugs used was lowest in the 0- to 2-year duration group (p < 0.001). Mean ΔCDAI (SE) ranged from −10.22 (1.19) for 0–2 years to −4.63 (1.38) for >10 years. In adjusted analyses, shorter disease duration was significantly associated with greater mean ΔCDAI (p = 0.015) and greater likelihood of achieving LDA (p = 0.048). In biologic-naïve patients with RA initiating abatacept, earlier disease (shorter disease duration) was associated with greater ΔCDAI and likelihood of achieving LDA.

SAT0392 Work Productivity Improvement Associated with Apremilast, an Oral Phosphodiesterase 4 Inhibitor, in Patients with Psoriatic Arthritis: Results of A Phase 3, Randomized, Controlled Trial

BackgroundApremilast (APR), an oral phosphodiesterase 4 inhibitor, works intracellularly to regulate inflammatory mediators. The Work Limitations Questionnaire (WLQ) is a reliable tool for assessing work productivity in patients with chronic...

OP0078 Apremilast, an Oral Phosphodiesterase 4 Inhibitor, is Associated with Long-Term (52-WEEK) Improvement in Measures of Disease Activity in Patients with Psoriatic Arthritis: Results from 3 Phase 3, Randomized, Controlled Trials

BackgroundApremilast (APR), an oral phosphodiesterase 4 inhibitor, works intracellularly to regulate inflammatory mediators. The PALACE 1, 2, and 3 trials compared the efficacy and safety of APR with placebo (PBO)...

PMS4 - Impact Of Apremilast On Physical Function In Patients With Psoriatic Arthritis

The PALACE 1 study compared the efficacy and safety of apremilast (APR) with placebo in patients with active psoriatic arthritis despite prior conventional disease-modifying antirheumatic drugs (DMARDs) and/or biologics. The objective of the study was to assess the impact of APR therapy on physical functioning in patients enrolled in the PALACE 1 study. Patients were randomized 1:1:1 to placebo, APR 20 mg BID (APR20), or APR 30 mg BID (APR30) stratified by baseline DMARD use (yes/no). Treatment efficacy was assessed at Week 16 based on the full analysis set population. Physical function, a pre-specified secondary end point, was measured in patients using the 36-item Short-Form Health Survey version 2 (SF-36v2) Physical Function (PF) domain, SF-36v2 physical component summary (PCS), and Health Assessment Questionnaire-Disability Index (HAQ-DI) scores. 504 patients were randomized (49.4%: male; mean age: 50.4 years). At Week 16, the physical function change from baseline was significantly improved with APR30 vs. placebo, as measured by the SF-36v2 PF (4.23 vs. 1.81; P=0.006), SF-36v2 PCS (4.59 vs. 2.39; P=0.0097), and HAQ-DI (-0.244 vs. -0.086; P=0.0017) scores. APR20 was associated with a significant improvement in the HAQ-DI score (-0.198 vs. -0.086; P=0.025), but not in the SF-36v2 PF (3.5 vs. 1.81; P=0.050) and SF-36v2 PCS (3.53 vs. 2.39; P=0.175) scores at Week 16. While both APR30 and APR20 showed a benefit in disability over 16 weeks, APR30 is consistently effective as measured by the improvement compared with placebo in the SF-36v2 PF, SF-36v2 PCS, and HAQ-DI scores in patients with active psoriatic arthritis.