How Do You Measure Disease Activity In Your Psoriatic Arthritis ... · 2020. 11. 2. · PtGA...
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PtGA Dactylitis Spine Skin Enthesitis Joint PhysGA HAQ CRP HRQoL Pain MDA / VLDA CRITERIA 14 State of disease activity MDA (5/7 outcome measures) VLDA (7/7 outcome measures) AXIAL DISEASE Associated with likelihood of psoriasis disease activity and greater effect on quality of life. 1 NAIL DISEASE Associated with functional impairment. 3 DACTYLITIS Index finger and fourth toe are often affected. 10 ENTHESITIS Differentiates PsA from other forms of arthritis. 12 CONSIDER THE TOTALITY OF PSORIATIC DISEASE Different composite measures emphasize different components of the disease. A comprehensive assessment evaluates all manifestations / domains of the disease. 14 LISTEN TO THE PATIENT Patient-reported outcomes, HRQoL measures, and the impact of comorbidities are essential components of a patient-centered approach. 14 DAPSA SCORE 14,15 Measure of disease activity LDA (score of 4<LDA≤14) Remission (score of ≤4) ABBREVIATIONS: BSA: body surface area; CRP: c-reactive protein; DAPSA: disease activity in PsA; HAQ: health assessment questionnaire; HRQoL: health-related quality of life; LDA: low disease activity; MDA: minimal disease activity; PhysGA, physician global assessment; PsA: psoriatic arthritis; PtGA: patient’s global assessment of disease activity; VLDA: very low disease activity. REFERENCES: (1) Mease PJ, et al. J Rheumatol. 2018 [Epub ahead of print]. (2) Coates LC, et al. Arthritis Rheumatol. 2016;68:1060-71. (3) Williamson L, et al. Rheumatology. 2004;43:790-4. (4) Sandre MK, et al. Semin Arthritis Rheum. 2014;44:162-9. (5) Ogdie A, et al. Rheum Dis Clin North Am. 2015;41:545-68. (6) Acosta Felquer ML, et al. Clin Exp Rheumatol. 2015;33:S26-30. (7) Mease PJ, et al. J Am Acad Dermatol. 2013;69:729-35. (8) Mease PJ, et al. J Rheumatol. 2017;44:1151-8. (9) Mease PJ, et al. Drugs. 2014;74:423-41. (10) Brockbank J, et al. Ann Rheum Dis. 2005;64:188-90. (11) Wong PC, et al. Int J Rheumatol. 2012:839425. (12) Kaeley GS, et al. Semin Arthritis Rheum. 2018;48:35-43. (13) Coates LC, et al. Arthritis Care Res. 2010;62:965-9. (14) Coates LC, et al. Arthritis Rheumatol. 2018;70:345-55. (15) Smolen JS, et al. Clin Exp Rheumatol. 2015;33:S48-50. USA-916-80421 * Target measures vary in terms of the domains assessed and scoring methods used, and should ideally include musculoskeletal disease, skin disease, and disease impact/ HRQoL. 14 KEY CLINICAL DOMAINS PsA MANIFESTS DIFFERENTLY FROM PATIENT TO PATIENT, ACROSS MULTIPLE DOMAINS 1,2 How Do You Measure Disease Activity In Your Psoriatic Arthritis Patients? OPTIMIZING PATIENT SUCCESS Given multiple means of scoring PsA disease activity, two principles are paramount: 13,14 POTENTIAL PsA TARGET MEASURES* Both DAPSA and MDA / VLDA are simple to perform in routine clinical practice. 14 A CONSTELLATION OF INPUTS 14 PREVALENCE (among diagnosed PsA patients) PSORIASIS About 30% of psoriasis patients develop PsA; majority of PsA patients have BSA ≤3%. 7,8 PERIPHERAL ARTHRITIS Joint involvement ranges from oligo- ( ≤4 joints) to polyarthritis (>4 joints), is usually asymmetrical, and involves large and/or small joints. 6 7–32 % 5 ~75–84% 9 32–97% 4 35–50% 12 16–48% 11 ~40% (oligo) 6 ~60% (poly) 6 MDA / VLDA DAPSA DAPSA and MDA / VLDA Neither DAPSA or MDA / VLDA
Transcript of How Do You Measure Disease Activity In Your Psoriatic Arthritis ... · 2020. 11. 2. · PtGA...
PtGA
Dactylitis
Spine
Skin Enthesitis
Joint
PhysGA
HAQ
CRP
HRQoL
Pain
MDA / VLDA CRITERIA14
State of disease activity
MDA (5/7 outcome measures)VLDA (7/7 outcome measures)
AXIAL DISEASEAssociated with likelihood of psoriasis disease activity and greater effect on quality of life.1
NAIL DISEASEAssociated with functional impairment.3
DACTYLITIS Index finger and fourth toe are often affected.10
ENTHESITISDifferentiates PsA from other forms of arthritis.12
CONSIDER THE TOTALITY OF PSORIATIC DISEASEDifferent composite measures emphasize different components of the disease. A comprehensive assessment evaluates all manifestations / domains of the disease.14
LISTEN TO THE PATIENTPatient-reported outcomes, HRQoL measures, and the impact of comorbidities are essential components of a patient-centered approach.14
DAPSA SCORE14,15
Measure of disease activity
LDA (score of 4<LDA≤14)Remission (score of ≤4)
ABBREVIATIONS: BSA: body surface area; CRP: c-reactive protein; DAPSA: disease activity in PsA; HAQ: health assessment questionnaire; HRQoL: health-related quality of life;
LDA: low disease activity; MDA: minimal disease activity; PhysGA, physician global assessment; PsA: psoriatic arthritis; PtGA: patient’s global assessment of disease activity; VLDA:
very low disease activity.
REFERENCES: (1) Mease PJ, et al. J Rheumatol. 2018 [Epub ahead of print]. (2) Coates LC, et al. Arthritis Rheumatol. 2016;68:1060-71. (3) Williamson L, et al. Rheumatology.
2004;43:790-4. (4) Sandre MK, et al. Semin Arthritis Rheum. 2014;44:162-9. (5) Ogdie A, et al. Rheum Dis Clin North Am. 2015;41:545-68. (6) Acosta Felquer ML, et al. Clin Exp
Rheumatol. 2015;33:S26-30. (7) Mease PJ, et al. J Am Acad Dermatol. 2013;69:729-35. (8) Mease PJ, et al. J Rheumatol. 2017;44:1151-8. (9) Mease PJ, et al. Drugs.
2014;74:423-41. (10) Brockbank J, et al. Ann Rheum Dis. 2005;64:188-90. (11) Wong PC, et al. Int J Rheumatol. 2012:839425. (12) Kaeley GS, et al. Semin Arthritis Rheum.
2018;48:35-43. (13) Coates LC, et al. Arthritis Care Res. 2010;62:965-9. (14) Coates LC, et al. Arthritis Rheumatol. 2018;70:345-55. (15) Smolen JS, et al. Clin Exp Rheumatol.
2015;33:S48-50.
USA-916-80421
* Target measures vary in terms of the domains assessed and scoring methods used, and should ideally include musculoskeletal disease, skin disease, and disease impact/ HRQoL.14
KEY CLINICAL DOMAINS
PsA MANIFESTS DIFFERENTLY FROM PATIENT TO PATIENT, ACROSS MULTIPLE DOMAINS1,2
How Do You Measure Disease Activity In Your Psoriatic Arthritis Patients?
OPTIMIZING PATIENT SUCCESS
Given multiple means of scoring PsA disease activity, two principles are paramount:13,14
POTENTIAL PsA TARGET MEASURES*
Both DAPSA and MDA / VLDA are simple to perform in routine clinical practice.14
A CONSTELLATION OF INPUTS14
PREVALENCE (among diagnosed PsA patients)
PSORIASISAbout 30% of psoriasis patients develop PsA; majority of PsA patients have BSA ≤3%.7,8
PERIPHERAL ARTHRITISJoint involvement ranges from oligo- (≤4 joints) to polyarthritis (>4 joints), is usually asymmetrical, and involves large and/or small joints.6
7–32%5
~75–84%9
32–97%4
35–50%12
16–48%11
~40% (oligo)6
~60% (poly)6
MDA / VLDADAPSA DAPSA and MDA / VLDA Neither DAPSA or MDA / VLDA
PtGA
Dactylitis
Spine
Skin Enthesitis
Joint
PhysGA
HAQ
CRP
HRQoL
Pain
MDA / VLDA CRITERIA14
State of disease activity
MDA (5/7 outcome measures)VLDA (7/7 outcome measures)
AXIAL DISEASEAssociated with likelihood of psoriasis disease activity and greater effect on quality of life.1
NAIL DISEASEAssociated with functional impairment.3
DACTYLITIS Index finger and fourth toe are often affected.10
ENTHESITISDifferentiates PsA from other forms of arthritis.12
CONSIDER THE TOTALITY OF PSORIATIC DISEASEDifferent composite measures emphasize different components of the disease. A comprehensive assessment evaluates all manifestations / domains of the disease.14
LISTEN TO THE PATIENTPatient-reported outcomes, HRQoL measures, and the impact of comorbidities are essential components of a patient-centered approach.14
DAPSA SCORE14,15
Measure of disease activity
LDA (score of 4<LDA≤14)Remission (score of ≤4)
ABBREVIATIONS: BSA: body surface area; CRP: c-reactive protein; DAPSA: disease activity in PsA; HAQ: health assessment questionnaire; HRQoL: health-related quality of life;
LDA: low disease activity; MDA: minimal disease activity; PhysGA, physician global assessment; PsA: psoriatic arthritis; PtGA: patient’s global assessment of disease activity; VLDA:
very low disease activity.
REFERENCES: (1) Mease PJ, et al. J Rheumatol. 2018 [Epub ahead of print]. (2) Coates LC, et al. Arthritis Rheumatol. 2016;68:1060-71. (3) Williamson L, et al. Rheumatology.
2004;43:790-4. (4) Sandre MK, et al. Semin Arthritis Rheum. 2014;44:162-9. (5) Ogdie A, et al. Rheum Dis Clin North Am. 2015;41:545-68. (6) Acosta Felquer ML, et al. Clin Exp
Rheumatol. 2015;33:S26-30. (7) Mease PJ, et al. J Am Acad Dermatol. 2013;69:729-35. (8) Mease PJ, et al. J Rheumatol. 2017;44:1151-8. (9) Mease PJ, et al. Drugs.
2014;74:423-41. (10) Brockbank J, et al. Ann Rheum Dis. 2005;64:188-90. (11) Wong PC, et al. Int J Rheumatol. 2012:839425. (12) Kaeley GS, et al. Semin Arthritis Rheum.
2018;48:35-43. (13) Coates LC, et al. Arthritis Care Res. 2010;62:965-9. (14) Coates LC, et al. Arthritis Rheumatol. 2018;70:345-55. (15) Smolen JS, et al. Clin Exp Rheumatol.
2015;33:S48-50.
USA-916-80421
* Target measures vary in terms of the domains assessed and scoring methods used, and should ideally include musculoskeletal disease, skin disease, and disease impact/ HRQoL.14
KEY CLINICAL DOMAINS
PsA MANIFESTS DIFFERENTLY FROM PATIENT TO PATIENT, ACROSS MULTIPLE DOMAINS1,2
How Do You Measure Disease Activity In Your Psoriatic Arthritis Patients?
OPTIMIZING PATIENT SUCCESS
Given multiple means of scoring PsA disease activity, two principles are paramount:13,14
POTENTIAL PsA TARGET MEASURES*
Both DAPSA and MDA / VLDA are simple to perform in routine clinical practice.14
A CONSTELLATION OF INPUTS14
PREVALENCE (among diagnosed PsA patients)
PSORIASISAbout 30% of psoriasis patients develop PsA; majority of PsA patients have BSA ≤3%.7,8
PERIPHERAL ARTHRITISJoint involvement ranges from oligo- (≤4 joints) to polyarthritis (>4 joints), is usually asymmetrical, and involves large and/or small joints.6
7–32%5
~75–84%9
32–97%4
35–50%12
16–48%11
~40% (oligo)6
~60% (poly)6
MDA / VLDADAPSA DAPSA and MDA / VLDA Neither DAPSA or MDA / VLDA
