BSR: Multiple benefits seen with intensive psoriatic arthritis therapy

But is the intensive approach cost-effective when compared to standard care? Data suggest that it is. Although the incremental cost-effectiveness ratio (ICER) initially exceeded the £20,000–£30,000 (about $31,000-$47,000) threshold used by the U.K. National Institute for Health and Care Excellence to judge if a new treatment is cost effective, allowing for certain factors enabled the ICER to be brought down to about £28,000 ($44,000), making it a cost-effective strategy.

PsA consists of five classical subtypes. The most common of these subtypes is polyarthritis (60% of patients), followed by oligoarthritis (30%). The remaining 10% of patients comprise those with arthritis mutilans, distal interphalangeal predominant disease, or spinal predominant disease. The clinical features of dactylitis and enthesitis are prevalent in about 40% and 50% of patients, respectively, and can occur in any subgroup.

Considering such heterogeneity in its presentation, the challenge now will be to determine if all clinical subgroups of PsA could benefit from treating to an MDA target with intensive management, or if one or other subgroups benefit more than another.

The TICOPA study was funded by Arthritis Research UK with support from Pfizer. Dr. Helliwell has received consulting fees from Pfizer.

Results of this study were published in the Lancet Sept. 30, 2015.

This article was updated October 6, 2015.