IN a breakthrough study that could reshape long-term treatment strategies for psoriatic arthritis (PsA), researchers have found that a small but significant proportion of patients can achieve and maintain remission without the continued use of disease-modifying antirheumatic drugs (DMARDs). The findings offer promising evidence for DMARD-free remission in patients with oligoarticular or polyarticular PsA.
Using data from the Dutch southwest Early Psoriatic Arthritis cohort, the study followed 451 newly diagnosed patients who had been treated with DMARDs. After a median follow-up of 5.1 years, 22 percent of patients reached DMARD-free remission, defined as being free of clinical synovitis for at least three months after stopping treatment. However, only 14.4 percent sustained this remission for more than one year. Eventually, just 9.1 percent of patients achieved what researchers termed “true sustained DMARD-free remission”, that is, remission lasting more than a year without experiencing any disease flare.
The study also explored predictors of this rare but important outcome. Patients with low baseline Disease Activity Index in Psoriatic Arthritis scores and those who had never used biologic or targeted synthetic DMARDs were more likely to reach true sustained remission. Moreover, their functional health—measured by the Health Assessment Questionnaire, was comparable to that of the general population at the time of remission, with a median score of 0.12.
Despite the modest proportion, the researchers note that this is the first study to suggest that chronicity in PsA may be modifiable for a subset of patients. Importantly, those with high disease activity or who required biologic therapies did not achieve sustained remission, emphasizing the need for stratified, personalized treatment approaches in PsA care.
Reference:
Snoeck Henkemans SVJ et al. Disease-modifying antirheumatic drug-free remission in psoriatic arthritis: is it attainable and sustainable? A large longitudinal study. Ann Rheum Dis. 2025;S0003-4967(25)00948-3.
