Spondyloarthritis & psoriatic arthritis
Composite outcome measures that successfully differentiate active treatments from placebo in psoriatic arthritis trials: a GRAPPA-OMERACT systematic review and network meta-analysis
Authors' conclusion
ACR20, MDA, and PASDAS demonstrated greater discriminant capacity than DAPSA.
Study context
- Population
- Randomised controlled trials (RCTs) comparing b- or tsDMARDs with placebo in psoriatic arthritis (PsA) reporting ≥2 of 7 shortlisted composite outcome measures24 trials (43 randomised comparisons)
- Comparison
- Discriminant capacity of composite outcome measures (ACR, CPDAI, DAPSA, MDA, PASDAS, 3- and 4-VAS) for b- or tsDMARDs vs placebo
- Outcome
- Discriminant capacity (OR) of composite outcome measures between active treatment and placebo
Methodological detailsmultivariate meta-analysis, GRAPPA-OMERACT, CPDAI rarely reported; no RCTs reported 3-VAS and 4-VAS
- Multivariate meta-analysis
- GRAPPA-OMERACT
- CPDAI rarely reported; no RCTs reported 3-VAS and 4-VAS
Pooled result
As reported in the abstract
Discriminant properties, main network meta-analysis
Odds ratio (95% CI)
DAPSAvs ACR20favouring ACR20
0.80(0.66–0.97)
DAPSAvs MDAfavouring MDA
0.71(0.57–0.87)
PASDASvs DAPSAfavouring PASDAS
1.35(1.10–1.66)
Further pooled results
| Outcome | Values |
|---|---|
| Discrimination active vs placebo, multivariate meta-analysis | MDA OR (95% CI) 5.06; 4.20-6.09 · ACR20 OR (95% CI) 4.01; 3.41-4.73 · PASDAS OR (95% CI) 3.70; 3.00-4.56 · DAPSA OR (95% CI) 3.02; 2.44-3.75 · CPDAI OR (95% CI) 1.86; 0.95-3.64 |
Sensitivity analyses
- Consistent numerical advantages for MDA and PASDAS
Exploratory analyses, ACR70
- ACR70 more discriminant than ACR20 and DAPSA but not ACR50, MDA and PASDAS
- Exploratory
Original publication
Composite outcome measures that successfully differentiate active treatments from placebo in psoriatic arthritis trials: a GRAPPA-OMERACT systematic review and network meta-analysis. Ann Rheum Dis. Published 5 June 2026. doi:10.
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