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Patients with PsA, spondylitis may benefit from Stelara

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Patients with psoriatic arthritis and concurrent spondylitis showed improvement in disease activity scores and symptoms, in addition to slowed radiographic progression, while receiving Stelara for 2 years, according to recently presented research.

A group of 186 patients with psoriatic arthritis (PsA) were randomly assigned to receive 45 mg or 90 mg Stelara (ustekinumab, Janssen) or placebo at weeks 0, 4 and 12. At week 16, patients who showed a 5% improvement or less in swollen and tender joints were the randomly assigned to a blinded early escape dose increase or continued at 90 mg. At week 24, patients who received placebo were given ustekinumab at 45 mg or 90 mg. All patients received doses every 12 weeks through week 88 and were assessed for efficacy at week 100 and for safety at week 108. Concurrent use of methotrexate was permitted but not required.

At baseline, patients had a mean age of 45.6 years, with a mean disease duration of 6.3 years. Additionally, 26% were HLA-B27-positive. Baseline mean combined swollen and tender joint count was 14.3, mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was 6.5 and mean Health Assessment Questionnaire-Disability Index (HAD-DI) score was 1.3.

At week 24, patients treated with 45 mg or 90 mg ustekinumab showed improvements in structural damage, dactylitis, enthesitis, HAQ-DI scores and a range of American College of Rheumatology (ACR) 20%, 50% and 70% improvements compared with patients who received placebo. In patients with 3% or greater body surface area involvement and spondylitis and peripheral arthritis at baseline, the Psoriasis Area Severity Index (PASI) 75% response was maintained through week 100, according to the researchers.

The number of adverse events in patients who received ustekinumab were comparable to patients who received placebo, the researchers reported. – by Shirley Pulawski

Reference:

Kavanaugh A, et al. Paper #OP0174. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.

Disclosures: Kavanaugh reports receiving grant or research support from AbbVie, Amgen, Janssen and UCB. Please see the full study for a list of all other authors’ relevant financial disclosures.