The American College of Rheumatology/National Psoriasis Foundation guideline for Psoriatic Arthritis recommend a treat-to-target strategy with the target being low disease activity using an established disease activity measure¹. We assessed disease activity using RAPID3, a validated patient-reported composite measure of disease activity. Although RAPID3 was designed for use in rheumatoid arthritis, it has been found useful in many rheumatic diseases including psoriatic arthritis and has been shown to have significant correlation with psoriatic disease activity score. Patients with newly diagnosed psoriatic arthritis started on a biologic agent (anti-tumor necrosis factor inhibitors, CTLA4-Ig, anti-IL-17 and anti-IL-23 inhibitors) between 2017 and 2021 were reviewed. We considered success as a RAPID3 score of <2.3 (near remission and low severity). 441 psoriatic arthritis patients were started on a biologic agent during 2017-2021. Of these, 44.7% achieved a RAPID3 score of <2.3. The percentage of patients in remission or near remission has declined from a high in 2017 of 50.5% to 46.7% in 2021. Fewer patients completed RAPID3 assessments in 2021, a result of COVID-19 protocols designed to reduce the risk of transmission, thus results may not be reflective of the entire population. A significant number of patients remained in moderate or high activity based on RAPID3 scores indicating the need to monitor and apply treat-to-target strategies.
¹Singh JA, Guyatt G, Ogdie A, Glad man DD, Deal C, Deodhar A, Dubreuil M, Dunham J, Husni ME, Kenny S, KwanMorley J, Lin J, Marchetta P, Mease PJ, Merola JF, Miner J, Ritchlin CT, Siaton B, Smith BJ, Van Voorhees AS, Jonsson AH, Shah AA, Sullivan N, Turgunbaev M, Coates LC, Gottlieb A, Magrey M, Nowell WB, Orbai AM, Reddy SM, Scher JU, Siegel E, Siegel M, Walsh JA, Turner AS, Reston J. 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Rheumatol. 2019 Jan;71(1):5-32.