High incidence of disease recurrence after discontinuation of disease-modifying antirheumatic drug treatment in patients with psoriatic arthritis in remission

Annals of the Rheumatic Diseases
Elizabeth G AraujoGeorg Schett

Abstract

To investigate the possibility of drug-free remission in patients with psoriatic arthritis (PsA) in continuous remission. Prospective observational study in disease-modifying antirheumatic drug (DMARD)-treated PsA patients in continuous disease remission (no musculoskeletal symptoms, no or minimal skin/nail disease) for at least 6 months. Demographic, disease-specific and ultrasound parameters were assessed at baseline. DMARDs (traditional or biologic) were discontinued at the initial visit, and patients were followed for a maximum of 6 months for recurrence of disease. 26 patients (methotrexate monotherapy: N=14; tumour necrosis factor inhibitors: N=12) with a mean age of 55.2 years, absence of musculoskeletal symptoms and minimal skin disease (mean Psoriasis Area Severity Index (PASI): 0.21) were enrolled. Incidence of recurrence of disease was high (N=20, 76.9%) and occurred rapidly (74.50±51.72 days) after treatment discontinuation. Male PsA patients were significantly more likely to lose remission. Long disease duration, more severe skin involvement and the presence of synovial hypertrophy by ultrasonographic examination at baseline decreased the likelihood for drug-free remission. Reinitiation of DMARDs promptly restored ...Continue Reading

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Citations

Mar 9, 2017·The New England Journal of Medicine·Christopher T RitchlinDafna D Gladman
Jan 3, 2018·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Renato de StefanoLudovico de Stefano
May 4, 2017·The Journal of Rheumatology·Philip S HelliwellPhilip J Mease
May 29, 2018·Arthritis & Rheumatology·Philippe CarronFilip Van den Bosch
May 22, 2020·Annals of the Rheumatic Diseases·Laure GossecJosef S Smolen
Nov 20, 2016·Rheumatology·Juergen Braun
Jan 18, 2018·Expert Review of Clinical Immunology·Fabio Massimo PerrottaEnnio Lubrano
Sep 29, 2020·Frontiers in Medicine·Sayam R DubashHelena Marzo-Ortega
May 3, 2016·The Journal of Rheumatology·Anna R MoverleyPhilip S Helliwell
Oct 1, 2019·Annals of Dermatology·Byungsoo KimSiba P Raychaudhuri
Jun 3, 2021·Dermatologic Therapy·Xinya XuLeihong Flora Xiang

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