Prevalence and Predictors of Achieving Sustained Remission in Psoriatic Arthritis: A Swedish Nationwide Registry Study
Bibliographic record
Abstract
OBJECTIVE: To estimate the prevalence and predictors of sustained remission (SR) in patients with psoriatic arthritis (PsA) receiving biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in Sweden. METHODS: All patients with PsA initiating b/tsDMARDs and who were registered in the national Swedish Rheumatology Quality Register (SRQ) from April 1999 to December 2019 were included. Data on disease/treatment characteristics at first b/tsDMARD (baseline) initiation and all subsequent visits were extracted from the SRQ. Remission was defined as Disease Activity Score in 28 joints based on C-reactive protein (DAS28-CRP) ≤ 2.6, Disease Activity Index for Psoriatic Arthritis in 28 joints (DAPSA28) ≤ 4 or the physician global assessment of disease activity (PGA) on a scale of 0 to 4 (remission = 0), and SR when these criteria persisted during ≥ 2 consecutive visits for ≥ 6 months. Baseline predictors of SR were explored using logistic regression analysis. RESULTS: Data on 4669 patients with PsA with 48,773 visits were available. Eighty-one percent of patients achieved DAS28-CRP remission ever, and 54% achieved SR at least once. The corresponding percentages for DAPSA28 were 46% and 24% and for PGA were 69% and 38% for ever reaching remission and SR, respectively. Male sex was a positive predictor of reaching SR when measured by DAPSA28 and PGA but not by DAS28-CRP. Fewer swollen joints at baseline predicted SR according to all 3 remission criteria. CONCLUSION: A considerable proportion of patients with PsA receiving various b/tsDMARDs never achieved remission, and approximately half never achieved SR in this Swedish nationwide registry study. Fewer swollen joints at first b/tsDMARD initiation increases the likelihood of SR, regardless of remission criteria used. There was still a sex difference when measured with DAPSA28 and PGA, with men being more likely to reach SR.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".