AB0925 Comparison of psoriatic arthritis therapeutic targets – psa-mda and dapsa remission/low disease activity in patients treated in the institute of rheumatology prague
Authors: J. Stolfa, L. Sedova, Z. Mares
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> According to the Czech Society of Rheumatology guidelines for therapy and monitoring of psoriatic arthritis from 2016(<sup>1</sup> which are based on the EULAR recommendations 2015(2) the target of the therapy is to attain either minimal disease activity (MDA)(3) or remission/low disease activity according to DAPSA(4). In fact, the majority of our patients have only mild skin disease and that's why DAPSA, which is more feasible to use could be sufficient as a target of therapy, even though these two indices assess the disease from different points of view (MDA being more comprehensive, including also entheses, skin and function and DAPSA only joint disease). <h3>Objectives</h3> To compare the ability of these two indices in the evaluation of the response to treatment. <h3>Methods</h3> We compared both indices from 206 visits in 32 patients with PsA from our database of 247 patients. At first we took the patients who complied with MDA criteria and looked at what percentage of them were in remission/low disease activity, moderate, or high activity respectively at the same time. Then, we took the paients, who did not comply with MDA criteria and again looked at the level of activity according to DAPSA. <h3>Results</h3> In the group of patients who fulfilled the MDA criteria (5/7), 99,5% were also in the state of remission or low disease activity according to DAPSA. In only 1 case the activity was assessed as moderate and no patient was in high disease activity state. In the group of patients who did not comply with MDA criteria, 42,6% of pats. were in mild disease activity state and only 57,4% of patients were in moderate, or high activity according to DAPSA – Tab. 1 <h3>Conclusions</h3> DAPSA correlates well with MDA in patients with mild skin disease and can be used in these patients instead of MDA. In patients who fail to respond to therapy according to MDA there can be a substantial proportion of patients with mild joint disease, due to more severe skin disease and/or presence of enthesitidies, which are nevertheless vaguely defined. <h3>References</h3> [1] Štolfa J, Vencovský, J, Pavelka K. Doporučené léčebné postupy pro psoriatickou artritidu. Česká revmatologie2016; 24(4):142–152 [2] Gossec L, Smolen JS, Ramiro S. et al., European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies 2015 update. Ann Rheum Dis2015;0:1–12. [3] Coates LC, Fransen J, Helliwell PS. Defining minimal disease activity in psoriatic arthritis: a proposed objective target for treatment. Ann Rheum Dis2010; 69: 48–53. [4] Schoels M, Aletaha D, Alasti F, et al. Disease activity in psoriatic arthritis (PsA): defining remission and treatment success using the DAPSA score. Ann Rheum Dis2015. <h3>Acknowledgements</h3> Supported by the Research program of the Ministry of health of Czech Republic: IGA MZ CR: No. 000 000 23 728 <h3>Disclosure of Interest</h3> None declared