Treat-to-Target Approach Improves Outcome for Some New Psoriatic Arthritis Patients

While tight control of inflammation in a prespecified target is standard in the treatment of rheumatoid arthritis, the treat-to-target approach could soon be utilized to serve adults with early psoriatic arthritis (PsA) following promising results in a recent study.

In an assessment published in The Lancet on February 26, 2014, researchers recruited 206 PsA patients with a median age of 45 years over a 4-year span. This group comprised 101 patients who were randomized to tight control and 105 patients who received standard care. Over the course of the 48-week study, 12 patients withdrew and 12 were lost to follow-up.

The study saw 55 of 89 patients (61.8%) in the tight control group exhibit a 20% improvement rate in their joint symptoms as defined by the American College of Rheumatology (ACR20), while 37 of 83 patients (44.6%) receiving standard care achieved ACR20.

However, patients in the tight control group exhibited a high rate of symptoms caused by the treatment. Adverse events (AEs) were reported in 97% of patients in tight control, versus 77.1% of patients in standard control.

A total of 33 serious AEs were reported in 20 patients, with 25 events in 14 patients who were on tight control, and 8 events in 6 patients in standard care. Ten serious AEs were believed to be related to drug therapy, with 8 AEs in the tight control group and 2 in standard care. Despite the high percentage of AEs, researchers reported no unexpected serious AEs or deaths.