In a clinical trial published in The Journal of Rheumatology, researchers evaluated the effect of apremilast treatment vs baseline disease activity in patients with psoriatic arthritis who were not previously treated with a disease-modifying antirheumatic drug (DMARD).
This study was a post-hoc analysis of the PALACE 4 randomized controlled study, which enrolled 175 patients who received apremilast 30 mg twice daily over 52 weeks. Changes from baseline disease to Week 52 were assessed using Clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA) treatment targets, including remission and low disease activity.
At baseline, 66.3% of patients had high disease activity and 31.4% had moderate activity. According to the researchers, around twice as many patients from the moderate baseline activity group achieved remission or low disease activity compared with those in the high baseline activity group (61.7% vs 28.2%).
Successful cDAPSA outcomes also were associated with decreased articular and extraarticular symptoms. Additionally, the authors reported that the subgroup of patients with 1 or more extraarticular psoriatic arthritis manifestations had similar rates of achieving cDAPSA targets.
The authors concluded that cDAPSA measures of baseline disease activity were able to functionally predict successful response to apremilast treatment in DMARD-naïve patients with psoriatic arthritis.
Reference: Mease PJ, Kavanaugh A, Ogdie A, et al. Baseline Disease Activity Predicts Achievement of cDAPSA Treatment Targets With Apremilast: Phase III Results in DMARD-naïve Patients With Psoriatic Arthritis. J Rheumatol. 2022;49(7):694-699. doi:10.3899/jrheum.210906