A REAL-WORLD study of the treat-to-target (T2T) approach in psoriatic arthritis (PsA) suggests it can be successfully implemented in routine care, with many patients achieving key clinical targets by week 48. The results, presented at EULAR 2025, come from the MONITOR-PsA cohort, one of the largest prospective studies of its kind in the UK.
The study followed 234 patients across multiple UK rheumatology centres who were newly diagnosed with active PsA and had not previously received disease-modifying anti-rheumatic drugs (DMARDs) for their joint disease. Patients followed a step-up T2T strategy beginning with methotrexate, escalating to conventional synthetic DMARDs and biologics as needed, based on disease activity every 12 weeks.
By 48 weeks, over a third of patients (37%) achieved a ‘good’ response according to the PsA Disease Activity Score (PASDAS), and another third achieved a ‘moderate’ response. Nearly half (47.6%) met the criteria for minimal disease activity (MDA), and 32.7% achieved DAPSA remission. Patient-reported outcomes were also encouraging, with almost 70% reaching an acceptable symptom state according to the Psoriatic Arthritis Impact of Disease (PSAID) measure.
No structural damage progression was observed during the study period, and patients with an oligoarticular disease pattern generally fared better in terms of achieving disease control and fewer signs of radiographic progression.
These results mirror those of the earlier TICOPA trial but in a more pragmatic clinical setting, supporting wider implementation of T2T strategies in PsA.
Reference
Letarouilly JG et al. Real-World Treat-to-Target Strategy in Psoriatic Arthritis: 48-week Results from the MONITOR-PsA Cohort. Abstract: POS0106. EULAR Congress, 11-14th June, 2025.
