Early treatment of psoriatic arthritis is associated with improved patient-reported outcomes: findings from the etanercept PRESTA trial

Objective The present paper aims to investigate the effect of psoriatic arthritis (PsA) disease duration on the outcome of treatment with etanercept (ETN) in patients with PsA who also have moderate-to-severe psoriasis. Methods Patients from the PRESTA trial who received >= 1 ETN 50 mg once weekly (QW) dose and had >= 1 post-baseline value were evaluated. Baseline and after-treatment changes were compared between patients with PsA L52 years versus PsA >= 2 years in efficacy measures (physician global assessment [PGA] arthritis, swollen joint count and Psoriasis Area and Severity Index [PASI]) and patient reported outcomes (PROs; joint pain, arthritis activity, Euro-Qol [EQ-5D] utility and visual analogue score [VAS]) using linear regression analysis. Results Baseline efficacy measures were similar between the PsA.-5:2 years (n=103) and PsA >= 2 years (n=269) groups, with the exception of PGA arthritis (p=0.006). At week 24, improvements in efficacy measures were observed in both groups but were significantly greater for PGA arthritis in the PsA <= 2 years group (p=0.03). Quality of life (QoL), measured using PROs, was generally lower at baseline in patients with PsA >2 years. Clinically meaningful improvements were seen in QoL with ETN treatment in both groups, but the change from baseline scores at week 24 were significantly higher in PsA <= 2 years group for joint pain (p=0.007), arthritis activity (p=0.01), EQ-5D utility (p=0.046) and EQ-5D VAS (13=0.04) responses. Conclusion PsA patients responded to ETN 50 mg QW treatment irrespective of disease duration; however, patients with shorter PsA duration had greater improvements in arthritis scores and several PRO measures.