OBJECTIVE: Because 66/68 joint counts are not always performed in routine care, we aimed to determine which of the modified 28-joint disease activity index for psoriatic arthritis (DAPSA28) or 28-joint disease activity score with C-reactive protein (DAS28-CRP) should be preferred for monitoring disease activity in psoriatic arthritis (PsA) when the original DAPSA (66/68 joints) is not available. METHODS: Prospectively collected real-world data of European bionaive patients with PsA initiating a first tumor necrosis factor inhibitor were pooled. Remission and response status were evaluated at 6 months by remission (DAPSA ≤ 4, DAPSA28 ≤ 4, and DAS28-CRP < 2.6), response (75% improvement for DAPSA and DAPSA28), and combined EULAR good/moderate responses for DAS28-CRP. Logistic regression analyses on multiple imputed data were used to identify baseline predictors. RESULTS: Remission and response cohorts included 3,159 and 1,866 patients, respectively. The 6-month proportions achieving remission/response were DAPSA (27%/44%), DAPSA28 (28%/44%), and DAS28-CRP (59%/80%). Of 14 possible baseline predictors, 11 predicted both DAPSA and DAPSA28 remission (8 of which also predicted their response, indicated by "*"): longer disease duration*, male sex*, and higher CRP* were positive, whereas older age*, higher body mass index*, patient fatigue*, and global, physician global, health assessment questionnaire score*, and tender and swollen* joint counts were negative predictors. Eight and five of these predicted DAS28-CRP remission and response, respectively. CONCLUSION: In patients with PsA, DAPSA28 should be preferred over DAS28-CRP as a substitute for DAPSA when 66/68 joint counts are not available because of the large overlap in remission and response status and in predictors between DAPSA and DAPSA28.

Aarhus University Hospital and Aarhus Universitet Aarhus Denmark

Diakonhjemmet Hospital Oslo Norway

General University Hospital Gregorio Maranon and Complutense University of Madrid Madrid Spain

Geneva University Hospitals Geneva Switzerland

Helsinki University Central Hospital Helsinki Finland

Hospital de Santa Maria and Centro Academico de Medicina de Lisboa Lisbon Portugal

Inselspital University Hospital Bern Bern Switzerland

Institute of Rheumatology and Charles University 1st Faculty of Medicine Prague the Czech Republic

Karolinksa Institutet Stockholm Sweden

Landspitali National University Hospital of Iceland and University of Iceland Reykjavik Iceland

Rigshospitalet Glostrup Denmark

Rigshospitalet Glostrup Denmark and University of Copenhagen Copenhagen Denmark

Rigshospitalet Glostrup Denmark Diakonhjemmet Hospital Oslo Norway and Sørlandet Sykehus HF Kristiansand Norway

Skåne University Hospital Lund Sweden

TC Demiroglu Bilim University Istanbul Turkey

The DANBIO Registry Glostrup Denmark and University of Copenhagen Copenhagen Denmark

University Medical Centre Ljubljana and University of Ljubljana Ljubljana Slovenia

University of Aberdeen Aberdeen Scotland

University of Bari Bari Italy

University of Medicine and Pharmacy Carol Davila Bucharest Romania

University of Porto and Centro Hospitalar Universitário de São João Porto Portugal

University of Turku and Turku University Hospital Turku Finland

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