ABSTRACT
BACKGROUND:
Psoriatic arthritis (PsA) is a chronic inflammatory
disease that
affects multiple
joints. It is associated with
psoriasis and treated with synthetic and
biologic drugs.
OBJECTIVE:
The objective of this study was to assess the outcomes of
patients who received
biologic therapy with
tumor necrosis factor (TNF) inhibitors in terms of
effectiveness,
safety, functionality, and
quality of life. DESIGN AND
SETTING:
A prospective
observational study was performed at a single center in Belo Horizonte,
Brazil.
METHODS:
Patients with PsA
who received their first
TNF inhibitor treatment were followed up for 12 months.
Disease activity was measured using the
Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Clinical
Disease Activity Index (CDAI). Functionality was measured using the
Health Questionnaire Assessment (HAQ), and
quality of life was evaluated using the European
Quality of Life Five Dimensions (EQ-5D). Multiple
linear regression was used to identify predictors of the clinical response at 12 months.
RESULTS:
A total of 143
patients treated with
adalimumab or
etanercept were evaluated. Most of the clinical
measures were significantly improved at 12 months. However, 31%-51% of the
patients did not achieve good clinical control. No differences were observed between
adalimumab and
etanercept, except for poor functionality at 12 months among
patients treated with
etanercept. The main predictors of a worse clinical response were
female sex,
etanercept use, poor functionality, or lower
quality of life at baseline. The main adverse reactions were
alopecia,
headache,
injection site reaction,
sinusitis, flu,
dyslipidemia, and
infections.
CONCLUSION:
TNF inhibitor therapy was effective and safe. However, despite improvements in clinical
measures, most
patients did not achieve satisfactory control of the
disease.