AB0741 ACHIEVEMENT OF CDAPSA LOW DISEASE ACTIVITY OR REMISSION IS ASSOCIATED WITH CONTROL OF ARTICULAR AND EXTRA-ARTICULAR MANIFESTATIONS OF ACTIVE PSORIATIC ARTHRITIS IN SUBJECTS TREATED WITH APREMILAST

Abstract

Background: Therapeutic targets for psoriatic arthritis (PsA) include the achievement of remission (REM) or low disease activity (LDA), measured by the Clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA [0‐154]), a composite of swollen and tender joints counts (SJC and TJC), Patient's Assessment of Pain (PAP) and Patient's Global Assessment of Disease Activity (PtGA). Objectives: We examined the trajectories for improvement in cDAPSA, its core components and PsA manifestations not measured by cDAPSA among subjects achieving cDAPSA REM or LDA by Week 52. Methods: Pooled analyses of the phase III PALACE 1, 2 and 3 studies were performed for subjects assigned to receive apremilast (APR) 30 mg twice daily at baseline (BL). Subjects with cDAPSA components available to calculate responses at Week 52 were included and grouped according to the cDAPSA categories reached at Week 52 (REM: ≤4; LDA: >4 to ≤13; moderate disease activity: >13 to ≤27; high disease activity: >27). We then traced their mean cDAPSA trajectory from BL to Week 52. Mean disease activity in core PsA domains were reported longitudinally by cDAPSA category reached at Week 52. Results: A total of 375 APR subjects were included in the analyses. Achievement of REM or LDA by Week 52 was associated with lower mean cDAPSA at BL, and these subjects had continuous improvements in disease activity from BL to Week 52 (Figure). Among subjects who achieved REM or LDA by Week 52, most were classified as having LDA (mean cDAPSA: 8.5) or moderate disease activity (mean cDAPSA: 16.6), respectively, at Week 16. Furthermore, subjects who achieved REM or LDA by Week 52 showed early improvement, with no/mild articular and extra‐articular disease activity by Week 52 with APR (Table). Conclusion: In the subgroup of subjects who achieved cDAPSA REM or LDA, early improvement was seen in disease activity by Week 16 and sustained to Week 52 with continued treatment. Subjects achieving cDAPSA REM or LDA exhibited no or mild disease activity in enthesitis, dactylitis, function and skin psoriasis by Week 52.