Very Low Disease Activity, DAPSA Remission, and Impact of Disease in a Spanish Population with Psoriatic Arthritis

February 4, 2019

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Publicated to:Journal Of Rheumatology. 46 (7): 710-715 - 2019-07-01 46(7), DOI: 10.3899/jrheum.180460

Authors: Queiro, Ruben; Canete, Juan D; Montilla, Carlos; Angel Abad, Miguel; Montoro, Maria; Gomez, Susana; Cabez, Ana; Torre Alonso, J C; Roman-Ivorra, J A; Sanz, J; Salvatierra, J; Calvo-Alen, J; Bermudez, A; Romero, M; Riesco, M; Cobeta, J C; Medina, F; Aragon, A; Garcia, M L; Urruticoechea, A; Gonzalez, C M; Judez, E; Gonzalez, B; Fernandez, P; Pantoja, L; Morla, R

Affiliations

Albacete, Spain - Author

Cádiz, Spain - Author

Complejo Hosp Jaen, Jaen, Spain - Author

Complejo hospitalario Jaén, Spain - Author

Department of Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Spain - Author

Department of Rheumatology, Hospital Universitario Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain - Author

Department of Rheumatology, Hospital Universitario de Salamanca, Salamanca, Spain - Author

Department of Rheumatology, Hospital Virgen del Puerto, Plasencia, Medical Department, Pfizer, Madrid, Spain - Author

Hosp Bierzo, Leon, Spain - Author

Hosp Can Misses, Ibiza, Spain - Author

Hosp Getafe, Madrid, Spain - Author

Hosp Juan Ramon Jimenez, Rheumatol, Huelva, Spain - Author

Hosp Monte Naranco, Oviedo, Spain - Author

Hosp Puerta Mar, Cadiz, Spain - Author

Hosp Royo Villanova, Zaragoza, Spain - Author

Hosp St Pau & Sta Tecla, Tarragona, Spain - Author

Hosp Univ Cent Asturias, Dept Rheumatol, Oviedo, Spain - Author

Hosp Univ Clin Barcelona, Dept Rheumatol, Barcelona, Spain - Author

Hosp Univ HU La Fe, Valencia, Spain - Author

Hosp Univ Salamanca, Dept Rheumatol, Salamanca, Spain - Author

Hosp Virgen Puerto, Dept Rheumatol, Plasencia, Spain - Author

Hospital Universitario (HU) La Fe, Valencia, Spain - Author

HU 12 de Octubre, Madrid, Spain - Author

HU 12 Octubre, Madrid, Spain - Author

HU Basurto, Bilbao, Spain - Author

HU Gregorio Maranon, Madrid, Spain - Author

HU Nta Sra Candelaria, Tenerife, Spain - Author

HU Nta. Sra de la Candelaria, Tenerife, Spain - Author

HU Puerta de Hierro, Madrid, Spain - Author

HU Puerta Hierro, Madrid, Spain - Author

HU San Cecilio, Granada, Spain - Author

HU Sierrallana, Torrelavega, Spain - Author

HU, Albacete, Spain - Author

Ibiza, Spain - Author

IDIBAPS, Barcelona, Spain - Author

Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain - Author

Leon, Spain - Author

Madrid, Spain - Author

Oviedo, Spain - Author

Pfizer, Med Dept, Madrid, Spain - Author

Rheumatology H. Juan Ramón Jiménez, Huelva, Spain - Author

Santa Lucia, Cartagena, Spain - Author

Tarragona, Spain - Author

Vall d'Hebron, Barcelona, Spain - Author

Virgen Arrixaca, Murcia, Spain - Author

Virgen de la Arrixaca, Murcia, Spain - Author

Zaragoza, Spain - Author

Abstract

To examine the grade of agreement between very low disease activity (VLDA) and Disease Activity Index for Psoriatic Arthritis (DAPSA) remission, as well as their association with the effect of the disease as assessed by the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire in patients with psoriatic arthritis in routine clinical practice.Posthoc analysis of data from a cross-sectional multicenter study. Patients were included who fulfilled the Classification for Psoriatic Arthritis (CASPAR) criteria with at least 1 year of disease duration and were treated with biological and/or conventional synthetic disease-modifying antirheumatic drugs according to routine clinical practice in Spain. Patients were considered in VLDA if they met 7/7 of the minimal disease activity criteria. DAPSA and clinical (c)DAPSA score ≤ 4 identified remissions.Of the 227 patients included in the original study, 26 (11.5%), 52 (22.9%), and 65 (28.6%) were in VLDA, DAPSA remission, and cDAPSA remission, respectively. There was a moderate agreement between VLDA and DAPSA remission (κ = 0.52) or cDAPSA remission (κ = 0.42). Patients with VLDA had less effect of the disease as measured by PsAID [mean total score (SD): VLDA 1.1 (1.2); DAPSA remission 1.3 (1.5); cDAPSA remission 1.7 (1.6)]. There was a moderate agreement between DAPSA remission or cDAPSA remission and PsAID < 4 (κ = 0.46 and κ = 0.58 respectively), while poor agreement (κ = 0.18) was found between VLDA and PsAID < 4.VLDA criteria seem to be more stringent for assessing a status of remission; however, DAPSA remission shows better correlation with a patient-acceptable symptoms state than VLDA does.

Keywords

Activity statesCriteriaDisease activityDisease activity criteriaPsoriatic arthritisQuality-of-lifeRemissionValidation

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The work has been published in the journal Journal Of Rheumatology due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2019, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category Rheumatology.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 5.43, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-17, the following number of citations:

WoS: 19
Scopus: 18
Europe PMC: 6

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This work has been carried out with international collaboration, specifically with researchers from: United States of America.

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