Disease-modifying antirheumatic drug–free remission in psoriatic arthritis: is it attainable and sustainable? A large longitudinal study

• DOI: 10.1016/j.ard.2025.04.022
• Publication Date: 2025-05-16T11:24:05Z
• Authors: Selinde V.J. Snoe...; Marijn Vis; Gonul Hazal Koc; Jolanda J. Luime; Marc R. Kok; Ilja Tchetverikov; Karen Visser; Lindy-Anne Korswagen; Jessica Bijsterbosch; Maikel van Ooster...; Paul Baudoin; Jos H. van der Kaap; Annette H.M. van ...; Pascal H.P. de Jong
• Keywords: Antirheumatic drugs; Pharmacotherapy

According to current management guidelines for psoriatic arthritis (PsA) tapering of disease-modifying antirheumatic drugs (DMARDs) can be considered. However, limited data are available on complete DMARD cessation, also known as drug-free remission (DFR). Therefore, our aim was investigate whether DFR is achievable and sustainable in PsA evaluate possible predictors sustained (SDFR). From the Dutch southwest Early Psoriatic Arthritis cohort, all newly diagnosed patients with oligoarticular/polyarticular who were treated DMARDs included (n = 451). Prevalence (S)DFR flare rates (early late) described. defined absence clinical synovitis ≥3 months after while SDFR, a period >1 year used. late flares restarting treatment ≤1 respectively. Subsequently, true that is, SDFR without flaring explored. After median 5.1 years (IQR, 3.0-7.3 years), 22% had reached DFR, reaching 4.7% an early flare. Thus, achieved 14.4% PsA; 5.3% experienced flare, which occurred 1.7 1.4-2.8 years) cessation. Eventually, 9.1% SDFR. Low baseline Disease Activity Index never using biological or targeted synthetic independent At time Health Assessment Questionnaire similar general population (median, 0.12; IQR, 0-0.75). attainable 9% patients. subgroup high disease activity at require do not achieve To knowledge, this first study demonstrate chronicity potentially influenced proportion PsA.