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Humira showed lowest number needed to treat vs. MTX, Otezla in patients with PsA
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Patients with psoriatic arthritis treated with Humira had the lowest number needed to treat compared with those treated with methotrexate or Otezla. Humira also cost significantly less than Otezla, but significantly more than methotrexate, according to results from an analysis of clinical trials by Vibeke Strand, MD, and colleagues.
Researchers reviewed the published literature to extract response rates from clinical trials in which approved biologics, methotrexate (MTX) and Otezla (apremilast, Celgene) were studied. Trials selected for inclusion in the study had to involve methotrexate-naïve patients with psoriatic arthritis (PsA) and have a placebo arm.
Vibeke Strand
The researchers identified three prior clinical trials: the Methotrexate in Psoriatic Arthritis (MIPA) trial for methotrexate; the Psoriatic Arthritis Long-term Assessment of Clinical Efficacy 4 (PALACE 4) for apremilast; and a subpopulation of the ADEPT phase 3 trial, which compared Humira (adalimumab, AbbVie) with placebo in patients who were not treated with MTX during the study period.
The reported clinical outcome was American College of Rheumatology 20 (ACR20) score at week 16 in the ADEPT and PALACE 4 trials and at week 24 in the MIPA trial. Week 24 results were assumed to be similar to week 16 results.
At week 16, the number needed to treat with MTX was 8.31, compared with 6.69 for apremilast and 2.63 for adalimumab, according to the researchers. The costs of treatment per ACR20 responder with MTX was $3,622, $45,808 with apremilast and $26,316 for treatment with adalimumab. – by Shirley Pulawski
Reference:
Strand V, et al. Paper #1555. Presented at: American College of Rheumatology Annual Meeting. Nov. 14-19, 2014; Boston.
Disclosures: Strand is a consultant for AbbVie, Afferent, Amgen, Biogen Idec, Bioventus, BMS, Carbylan, Celgene, Celltrion, CORRONA, Crescendo, Genentech/Roche, GSK, Hospira, Iroko, Janssen, Lilly, Merck, Novartis, Pfizer, Regeneron, Sanofi, SKK, Takeda, UCB and Vertex. Please see the full study for a list of all other authors’ relevant financial disclosures.