Trajectory of radiographic change over a decade: the effect of transition from conventional synthetic disease-modifying antirheumatic drugs to anti-tumour necrosis factor in patients with psoriatic arthritis

Allard, Andrew, Antony, Anna, Shaddick, Gavin ORCID: https://orcid.org/0000-0002-4117-4264, Jadon, Deepak R, Cavill, Charlotte, Robinson, Graham, Korendowych, Eleanor, McHugh, Neil and Tillett, William 2019. Trajectory of radiographic change over a decade: the effect of transition from conventional synthetic disease-modifying antirheumatic drugs to anti-tumour necrosis factor in patients with psoriatic arthritis. Rheumatology 58 (2) , pp. 269-273. 10.1093/rheumatology/key297

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Abstract

Objectives To describe the trajectory of radiographic progression among patients with PsA who transitioned from conventional synthetic DMARDs to anti-TNF-α inhibitors in routine care. Methods A retrospective sample of patients with PsA (ClASsification criteria for Psoriatic ARthritis) was taken from the Bath longitudinal cohort. All patients had radiographs of the hands and feet taken: 5 years before (T0), at the time of (T1) and 5 years after (T2) commencing anti-TNF treatment. Radiographs were scored blinded using the PsA-modified Sharp-van der Heijde score (mSvdHS) and for osteoproliferation (Psoriatic Arthritis Ratingen Score) by A.Allard, A.Antony and W.T. This sample size was calculated to ensure 90% power to determine the smallest detectable difference of the mSvdHS to a 5% significance level. Cumulative probability plots were used to determine the probability of radiographic progression pre- (T0–T1) and post- (T1–T2) anti-TNF treatment. Results Eighty-four radiographs from 28 patients were selected for inclusion. The median [interquartile range (IQR)] disease duration at baseline (T0) was 8.5 (0–19.5) years. The interval between T0–T1 and T1–T2 was 4.2 years (3.34–6.65) and 4.9 years (4.25–5.87), respectively. The median mSvdHS at baseline (T0) was 8.5 (IQR 1.75–27.5). The median (IQR) rate of change in mSvdHS per year reduced after commencing anti-TNF, from 2.1 (0.88–3.92) between T0–T1 to 1.0 (IQR 0.05–2.35) between T1–T2 (P = 0.012). Conclusion The trajectory of damage accumulation over a 10-year period in this observational clinical cohort is low overall. The rate of radiographic damage as measured by the mSvdHS slows following commencement of anti-TNF.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	?? VCO ??
Publisher:	Oxford University Press
ISSN:	1462-0324
Last Modified:	31 Jul 2024 16:00
URI:	https://orca.cardiff.ac.uk/id/eprint/170700

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