Performance and Predictors of Minimal Disease Activity Response in Patients With Peripheral Spondyloarthritis Treated With Adalimumab

Laura C. Coates, Sonya Abraham, William Tillett, Philip J. Mease, Sofia Ramiro, Tianshuang Wu, Xin Wang, Aileen L. Pangan, In Ho Song

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Abstract

Objective: To examine the concurrent validity and discrimination of criteria for modified minimal disease activity (MDA) in peripheral spondyloarthritis (SpA) following filter principles of Outcome Measures in Rheumatology (OMERACT) and to determine predictors of modified MDA response. Methods: Four modified MDA versions were derived in the ABILITY-2 study using the Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index or the Leeds Enthesitis Index (LEI) while excluding psoriasis. To assess concurrent validity, modified MDA versions were correlated with Peripheral Spondyloarthritis Response Criteria (PSpARC) remission, Ankylosing Spondylitis Disease Activity Score showing inactive disease (ASDAS ID), and physician global assessment of disease activity. Treatment discrimination was assessed between adalimumab and placebo at week 12. Multiple logistic regression was used to determine baseline predictors of long-term modified MDA responses and sustained modified MDA. Results: The 4 modified MDA versions showed a stronger positive correlation with PSpARC remission (r tet > 0.95) versus ASDAS ID (r tet > 0.75) at week 12 and years 1–3 and were able to show discrimination (P < 0.001). Responsiveness was shown at week 12; significantly more patients receiving adalimumab versus placebo achieved all 4 versions of modified MDA. Approximately 40–60% of patients treated with adalimumab achieved modified MDA using the LEI or SPARCC enthesitis index at years 1–3. Achieving modified MDA response after 12 weeks of adalimumab treatment was a robust positive predictor of attaining long-term modified MDA through 3 years (odds ratio [OR] 11.38–27.13 for modified MDA using the LEI; OR 17.98–37.85 for modified MDA using the SPARCC enthesitis index). Conclusion: All 4 versions of modified MDA showed concurrent validity and discriminated well between adalimumab and placebo treatment groups. Early modified MDA response is a more consistent predictor of long-term modified MDA achievement than baseline characteristics. The 5 of 6 versions of modified MDA could be an appropriate treatment target in patients with peripheral SpA.

Original languageEnglish
Pages (from-to)259-267
Number of pages9
JournalArthritis Care & Research
Volume74
Issue number2
Early online date16 Sept 2020
DOIs
Publication statusPublished - 1 Feb 2022

Bibliographical note

Funding Information:
Supported by AbbVie and the National Institute for Health Research and Oxford Biomedical Research Centre. Dr. Coates' work was supported by the National Institute for Health Research (Clinician Scientist award).

Funding Information:
Dr. Coates has received consulting fees and/or speaking fees from Amgen, Bristol Myers Squibb, Celgene, Galapagos, Gilead, Eli Lilly and Company, Janssen, MSD, Pfizer, Prothena, Sun Pharma, UCB (less than $10,000 each), AbbVie, and Novartis (more than $10,000 each) and research grants from AbbVie, Celgene, Novartis, and Pfizer. Dr. Abraham has received consulting fees and/or speaking fees from AbbVie, Celgene, Novartis, Pfizer, and UCB (less than $10,000 each) and research grants from those companies. Dr. Tillett has received consulting fees and/or speaking fees from AbbVie, Celgene, Eli Lilly and Company, Janssen, Novartis, Pfizer, and UCB (less than $10,000 each) and research grants from those companies. Dr. Mease has received consulting fees and/or speaking fees from AbbVie, Bristol Myers Squibb, Boehringer Ingelheim, Celgene, Galapagos, Gilead, GlaxoSmithKline, Genentech, Merck, Sun Pharma, UCB (less than $10,000 each), Amgen, Janssen, Eli Lilly and Company, Novartis, and Pfizer (more than $10,000 each) and research grants from those companies. Dr. Ramiro has received consulting fees and/or speaking fees from AbbVie, Eli Lilly and Company, MSD, Novartis, Sanofi, and UCB (less than $10,000 each) and research grants from MSD. Drs. Wu, Wang, Pangan, and Song own stock or stock options in AbbVie. No other disclosures relevant to this article were reported.

Publisher Copyright:
© 2020 The Authors. Arthritis Care & Research published by Wiley Periodicals LLC on behalf of American College of Rheumatology.

ASJC Scopus subject areas

  • Rheumatology

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