Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.


Are Clinical and Radiologic Outcomes the Same for Patients with Moderate Vs. Severe Disease Activity at Baseline in Patients with Psoriatic Arthritis?Post-Hoc Analysis of ADEPT

Mease1,  Philip, Kavanaugh2,  Arthur, Perdok3,  Renee, Kupper4,  Hartmut, Lavie5,  Frédéric

Seattle Rheumatology Associates and Swedish Medical Center. Seattle, WA,
University of California San Diego, La Jolla, CA,
Abbott Laboratories, Abbott Park, IL,
Abbott GmbH & Co. KG, Ludwigshafen, Germany,
Abbott Laboratories, Rungis, France

Purpose:

Patients (pts) in psoriatic arthritis (PsA) trials usually have severe disease activity at baseline, yet most pts in clinical practice have more moderate disease. This post-hoc analysis compared clinical and radiographic responses to placebo (PBO) and adalimumab (ADA) for pts with moderate vs. severe PsA.

Methods:

Observed clinical data at Weeks 2, 12, 24, and 48 and radiographic data at Weeks 24 and 48 of the ADEPT study were analyzed.1 Pts were classified by the 28-joint Disease Activity Score (DAS28) as having moderate (<5.1) or severe (>=5.1) PsA at baseline. Outcomes included ACR20, 50, and 70 responses at Weeks 2, 12, 24, and 48, and mean change in modified total Sharp score (DmTSS) between baseline and Weeks 24 and 48. Data from pts who received PBO or ADA during the first 24 weeks of ADEPT were analyzed separately. All pts were switched to ADA in an open-label extension after Week 24.

Results:

Data from 288 ADEPT pts were analyzed (ADA, N=145; PBO, N=143). Of these 288 pts, 172 pts (ADA, n=86; PBO, n=86) had moderate PsA and 116 pts (ADA, n=59; PBO, n=57) had severe PsA at baseline. At Weeks 12, 24, and 48, no differences were observed in ACR20 and ACR50 responses between pts with moderate vs. severe PsA at baseline. Conversely, at Weeks 24 and 48, a statistically significantly greater ACR70 response was observed in the ADA-treated pts with moderate PsA at baseline (p<0.05). Similarly, we observed a trend for a greater radiographic outcome at Week 48 in pts with moderate PsA at baseline in both treatment groups. Results of clinical and structural evaluations at Week 48 are presented in the table.

Clinical and Radiographic Responses to ADA and PBO for Pts With Moderate vs. Severe PsA

Outcome at Week 48Baseline DAS28 <5.1Baseline DAS28 >=5.1
ACR20, n (%)ADA77 (68.8)51 (68.6)
 PBO/ADA83 (54.2)55 (58.2)
ACR50, n (%)ADA77 (53.2)51 (51.0)
 PBO/ADA83 (39.8)55 (38.2)
ACR70, n (%)ADA77 (42.9)a51 (23.5)
 PBO/ADA83 (21.7)55 (23.6)
DmTSS, mean (SD) [n]ADA-0.1 (1.35) [69]+0.4 (2.66) [44]
 PBO/ADA+0.3 (3.52) [75]+1.7 (5.13) [50]
ap<0.05 compared with ADA-treated patients with severe PsA (DAS28>5.1) at baseline using Fisher's exact test.

Conclusion:

Treatment with ADA resulted in greater ACR70 response rates and in a trend for greater inhibition of radiographic progression for pts with moderate disease activity at baseline compared with patients with severe disease activity at baseline.

Reference

1.Mease, PJet al. Arthritis Rheum. 2005;52:3279–89.

To cite this abstract, please use the following information:
Mease, Philip, Kavanaugh, Arthur, Perdok, Renee, Kupper, Hartmut, Lavie, Frédéric; Are Clinical and Radiologic Outcomes the Same for Patients with Moderate Vs. Severe Disease Activity at Baseline in Patients with Psoriatic Arthritis?Post-Hoc Analysis of ADEPT [abstract]. Arthritis Rheum 2009;60 Suppl 10 :533
DOI: 10.1002/art.25615

Abstract Supplement

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