Philip J. Mease, MD: New Assessment Tool for Psoriatic Arthritis Patients


In this discussion with Dr. Mease at ACR 2023, he covers findings on an assessment tool known as the PsA-5Ts for patients with psoriatic arthritis.

During this interview with the HCPLive editorial team, Philip J. Mease, MD, spoke on research into the validity of the PsA-5Ts domains (PsA-5T-Ds), during which data from three phase 3 studies on guselkumab were assessed.

Mease is known for his work as a clinical professor at the University of Washington School of Medicine and director of rheumatology research at the Swedish Medical Center in Seattle. The data on the PsA-5Ts assessment tool discussed here had been presented at the 2023 American College of Rheumatology (ACR) Convergence in San Diego.

“I was the senior author on this study,” Mease explained. “And what was being done here was assessing a new tool that has the name, PsA-5T-D, sort of a slightly complex acronym, but the T stands for thermometer, and the D stands for domain. What we're looking at is 5 different domains of psoriatic arthritis: pain, fatigue, physical function, skin problems, and depression. What the clinician and patient that they're interviewing in the clinic are being asked is on a 0 - 10 scale, how are you in each of those domains, ranging from 0 not at all affected by pain to 10, horrible, terrible pain and fatigue.”

Mease added that this assessment was the same with skin disease, with function, and with depression.

“Then what they did, in order to validate whether this was a useful and reliable instrument, was to take the data from several phase 3 trials, DISCOVER 1 and 2, which were studies of guselkumab in bio-naive and a mixed population, as well as the COSMOS trial, which was all patients who have previously been treated with a biologic therapy. And they use different measures. For example, the pain measure that was used in the in the clinical trial, and matching it up doing a conversion to matching it up with a 0 - 10 scale on pain, looking at the FACIT-Fatigue score, which was measured in in these clinical trials, and then matching that up with a 0 - 10 fatigue measure that was part of the PSA-5 thermometers scale.”

Mease explained that for depression, they used question number 28 from the SF 36, which is ‘Have you felt downhearted and depressed?’ and then for physical function, they used the HAQ score and matched this up to the 0 - 10.

“What was shown was that there was a high degree of correlation between this particular scale and the achievement of these various mean changes in these measures in a clinical trial,” he said. “And then just using the 5T scale alone, they were able to show the same degree of discrimination between the guselkumab treatment arm. So the studies and placebo showed that over time, there were substantive improvements.”

Mease noted that this tells him that it could be useful to use this tool in clinic, adding that he hopes that both in a clinical setting and also in clinical trials, this tool will be implemented.

To find out more about this data, view the full video above or ACR 2023 conference coverage.

Mease is a paid consultant for Janssen and was not compensated for media work. The quotes used in this description were edited for clarity.

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