Comparing Imaging-Based and Conventional Treat-to-Target Strategies for Psoriatic Arthritis Over 24 Months

What this Trial Is About

Researchers are investigating whether a treat-to-target strategy that includes structured imaging assessments improves patient outcomes in psoriatic arthritis compared to a conventional treat-to-target approach. The study focuses on sustained remission, defined as very low disease activity at 16, 20, and 24 months. This two-arm, parallel-group study randomizes patients to either conventional clinical assessments or additional imaging assessments using ultrasound and MRI to guide treatment decisions. Participants receive treatment following European recommendations, with the conventional arm targeting disease activity based on clinical measures such as DAPSA remission, enthesitis, and psoriasis body surface area. The imaging-informed arm adds ultrasound assessments of joints, tendons, and entheses at every visit, plus MRI of the spine and sacroiliac joints at baseline and one year. Imaging results influence treatment progression, including advancing to biologic disease-modifying drugs if inflammation is detected. During the 24-month follow-up, patients undergo clinical and imaging assessments, including joint counts, enthesitis indices, and skin evaluations. Researchers measure disease activity, inflammation, health-related quality of life, and adverse events throughout the study. The primary outcome is sustained remission, while secondary outcomes include various disease activity scores and safety monitoring. The study aims to provide insights into the benefits of incorporating imaging in psoriatic arthritis management.

Imaging Treat-to-target Strategy vs Conventional Treat-to-target Strategy in Psoriatic Arthritis