Baseline Characteristics and Alignment to Clinical Practice
Panelists discuss how the clinical trial populations, characterized by middle-aged males with elevated body mass index (BMI) and moderate disease burden, accurately reflect real-world patients with psoriatic arthritis seen in clinical practice, including those with oligoarticular disease.
The clinical trial populations demonstrated characteristics representative of real-world patients with psoriatic arthritis, consisting primarily of males in their 50s with predominantly White ethnicity and BMI approaching 30. Disease duration ranged from six to nearly 10 years, with significant psoriasis burden evidenced by at least 3% body surface area involvement and Psoriasis Area and Severity Index scores between 8 and 10, indicating moderate psoriasis severity. Approximately 70% of participants continued concurrent conventional synthetic disease-modifying antirheumatic drugs, primarily methotrexate, throughout the study duration, reflecting standard clinical practice patterns.
The elevated BMI observed in trial participants represents an important comorbidity commonly encountered in clinical practice. Dr. Mease emphasizes that obesity, particularly visceral fat burden, contributes additional proinflammatory stimulus that compounds the inherent inflammatory drive of psoriatic arthritis. This creates an uphill therapeutic battle where clinicians must address not only the clear-cut manifestations of skin and joint disease but also contend with obesity-related inflammatory enhancement that can complicate treatment responses and disease management.
The clinical trial data remain applicable to patients with less extensive disease presentations, including those with oligoarticular involvement presenting with only two to four tender or swollen joints. Research across multiple data sets confirms that even patients with limited joint involvement can experience a significant impact on patient-reported outcomes, including pain, function and fatigue. This validates the relevance of trial findings for the broader spectrum of patients with psoriatic arthritis encountered in clinical practice, ensuring that treatment decisions based on study data can be confidently applied to patients with varying disease severity and joint involvement patterns.
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