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Treating Enthesitis in Psoriatic Arthritis Patients

Jul 20, 2022 3:51 pm

A large prospective psoriatic arthritis (PsA) study examined the enthesitis outcomes when PsA patients received conventional (cDMARDs) or targeted disease-modifying antirheumatic drugs (tDMARDs) and showed an overall 86% response rates, regardless of the medication used.

A total of 1270 PsA patients were studied and half (49%) had enthesitis.  Treatments were grouped as: (1) no treatment or nonsteroidal antiinflammatory drugs (NSAIDs) only; (2) cDMARDs ± NSAIDs; and (3) tDMARDs ± cDMARDs/ NSAIDs. Enthesitis was assessed in 29 enthesis sites, using the Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Index, the Leeds Enthesitis Index, and the Maastricht Ankylosing Spondylitis Enthesitis Score. Complete resolution of enthesitis (no tender enthesis) at 12 months was the primary outcome. 

Among the 526 patients (mean age 49 years) the mean enthesitis score was 2.13.

Complete resolution of enthesitis was seen in 86%, after a mean of 8.73 months.  While treatment responses were not significantly different between groups, those on cDMARDs or tDMARDs (+ cDMARDs) had numerically higher odds of enthesitis resolution. Overall, enthesitis resolution was associated with lower joint activity (OR 0.97, 95% CI 0.95-0.99; P = 0.01) and male sex (OR 1.66, 95% CI 0.97-2.84; P = 0.06).

Future studies may address enthesitis outcomes using advanced imaging.


The author has no conflicts of interest to disclose related to this subject

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