Early Disease Activity or Clinical Response Predict Long‐Term Outcomes with Certolizumab Pegol in Axial Spondyloarthritis or Psoriatic Arthritis

Objective Early identification of patients unlikely to achieve good long-term disease control with anti-TNF therapy in axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) is important for physicians following treat-to-target recommendations. Here we assess associations between disease activity or clinical response during the first 12 weeks (wks) of treatment and attainment of treatment targets at Wk48 in axSpA and PsA patients receiving certolizumab pegol (CZP). Methods The relationship between disease activity or clinical response during the first 12 wks of treatment, and achievement of Wk48 targets (axSpA: ASDAS-CRP inactive disease or BASDAI <2 with normal CRP; PsA: minDA), was assessed post-hoc using RAPID-axSpA (NCT01087762) and RAPID-PsA (NCT01087788) trial data. Results A clear relationship between disease activity from Wk2 to Wk12 and achievement of Wk48 treatment targets was observed in both axSpA and PsA populations. In axSpA, Wk48 ASDAS inactive disease was achieved by 0% (0/21) of patients with ASDAS very high disease activity at Wk12, compared to 68% (34/50) of patients with Wk12 ASDAS inactive disease. For PsA, Wk48 minDA was achieved by 0% (0/26) of patients with DAS28(CRP) >5.1 at Wk12, compared to 73% (57/78) of patients with DAS28(CRP) <2.6. Similar results were observed regardless of disease activity measure used. Clinical response at Wk12 also predicted Wk48 outcomes, though to a lesser extent than disease activity. Conclusion Using disease activity and clinical response state during the first 12 wks of CZP treatment, it was possible to identify a subset of axSpA and PsA patients unlikely to achieve long-term treatment goals. This article is protected by copyright. All rights reserved.