SAT0324 Certolizumab pegol provides sustained remission and minimal disease activity in patients with psoriatic arthritis over 4 years' treatment

Abstract

Background: Disease Activity Index for Psoriatic Arthritis (DAPSA)1 and the minimal disease activity (MDA) criteria2 are instruments recommended for evaluating disease activity in psoriatic arthritis (PsA). The RAPID-PsA trial (NCT01087788) has demonstrated the sustained efficacy of certolizumab pegol (CZP) across the spectrum of PsA symptoms.3,4 Objectives: To report the proportion of CZP-treated patients (pts) achieving DAPSA remission (REM), DAPSA low disease activity (LDA), MDA (fulfilling ≥5/7 MDA criteria), and very low disease activity (VLDA; fulfilling 7/7 MDA criteria) over 216 weeks (wks) in RAPID-PsA. Methods: RAPID-PsA was double-blind and placebo-controlled to Wk24, doseblind to Wk48, and open-label (OL) to Wk216. Pts had active PsA and had failed ≥1 disease modifying anti-rheumatic drug. Data for pts randomised to CZP at Wk0 (200 mg every 2 wks or 400 mg every 4 wks, following a 400 mg loading dose at Wks0, 2, 4), who continued their assigned dose in the OL period, are presented as observed case and with imputation (figure 1). Outcomes reported are DAPSA (the sum of tender and swollen joint counts [TJC 68; SJC 66], pt global and pain assessment [10 cm visual analogue scale], and C-reactive protein levels [mg/dL]), and pts achieving: 1) DAPSA LDA (DAPSA>4 and£14); 2) DAPSA REM (DAPSA£4); 3) MDA (fulfilling ≥5/7 MDA criteria); and 4) VLDA (fulfilling 7/7 MDA criteria), to Wk216. Pts withdrawing from the study between scheduled visits had their final observed assessment values assigned to the next scheduled visit timepoint. Results: Of 409 pts randomised; 273 received CZP from Wk0, of whom 248 (90.8%) completed Wk24, 237 (86.8%) completed Wk48, and 183 (67.0%) completed Wk216. The mean (SD) baseline DAPSA was 44.8 (22.9). Of pts completing Wk24, 29.7% (74/249) achieved LDA; 25.3% (63/249) REM; 38.2% (95/249) MDA; and 14.9% (37/249) VLDA. At Wk216, 31.9% (59/185) achieved LDA; 44.3% (82/185) REM; 57.8% (107/185) MDA; and 29.0% (58/183) VLDA (figure 1). Conclusions: A substantial proportion of pts who completed the 4 year study achieved disease inactivity targets:∼75% achieved DAPSA LDA or REM, almost 60% achieved MDA, and half of those also achieved VLDA (Figure Presented) .