AB0953 Psaid-12 can be used to determine the anti-tnf treatment decision in the psoriatic arthritis registry
Authors: U. Kalyoncu, S. Kiraz, S. Apras Bilgen, O. Karadag, A. Akdogan, L. Kilic, A. Erden, B. Armagan, A. Sari, I. Ertenli
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Psoriatic Arthritis Impact of Disease (PsAID-12) score has 12 questions and each question has its own weight. PsAID-12 is developed to be used in daily practice. However, in the daily practice, there has been no information on the utilisation of determining the response of the biological DMARD treatment. <h3>Objectives</h3> The assessment of utilisation of PsAID-12 for PsA patients on determination of the efficiency and inefficiency of anti-TNF treatment in a biological registry. <h3>Methods</h3> In this study patients were taken from Hacettepe University biological database (HUR-BIO). Since January 2013 PsAID-12 score was built in HUR-BIO database. PsAID-12 score was known for 116 patients before starting off the first anti-TNF treatment and 88 patients whose PsAID-12 score was 4 and above were included in the enquiry. Overall, 70 PsA patients included to analysis. Demographic data before anti-TNF treatment of PsA patients were noted. The decision of continuation, stopping or switching to another anti-TNF drugs were performed by both clinicians and the patients agreement. According to baseline evaluation, decrease of 20 mm and above on pain-VAS score and PGA, improvement of 0.22 unit and above on HAQ-DI score, or decrease of 1.2 unit and above on DAS-28 score were considered favourable to the anti-TNF treatment. Stopping or switching the anti-TNF treatments due to inefficiency was definitely a negative response. Pain-VAS score being under 15 mm or below, global-VAS score being 20 mm and below, HAQ-DI score being 0.5 and below, DAS-28 score being 2.6 and below were determined as targeted goals. Changes were analysed comparing to baseline level in PsAID-12 score, in compliance with the favourable and unfavourable responses to Anti-TNF treatments. In determining the response of the treatment, standardised response mean (SRM) was used. <h3>Results</h3> Seventy (78.6% female) patients were analysed, mean age was 45.5 (12.0). Mean follow-up duration was 18.3 (12.6) months, and total of 213 clinical visits were performed, median 3<sup>1–8</sup> control visits were done. At baseline, the mean (SD) DAS-28 4.07 (1.22), HAQ-DI 0.86 (0.53), pain-VAS 6.9 (2.1), PGA-VAS 6.4 (1.7), and PsAID-12 6.6 (1.5) were as follows. Anti-TNF treatments were stopped due to inefficacy in 43/210 (20.5%) outpatient visit during the follow-up period. The results of anti-TNF stopped and continuing patients; Δ PsAID-12 were 0.38 (1.71), and 3.12 (2.14), respectively and PsAID-12 baseline/control visits 0.96 (0.29) vs 0.50 (0.33), respectively. Level of favourable response and achieving to goal according to ΔPsAID-12 and PsAID-12 Baseline/control visit were shown table 1. On the follow up visits, among measured parameters one of the highest SRM was detected in PsAID-12; PsAID-12 (1.10), DAS-28 (1.14), PGA (0.88), Pain (0.85), and HAQ-DI (0.51), respectively. <h3>Conclusions</h3> Having 3.5 unit or 50% decrease in the PsAID-12 score indicates a favourable response to anti-TNF treatment, 4 unit or 70% decrease indicates level of targeted response. PsAID-12 appears to be an effective composite index for retaining the response of the treatment in biological registry. <h3>Disclosure of Interest</h3> None declared