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Minimal disease activity predicted outcomes with golimumab for patients with PsA
Patients with psoriatic arthritis who met minimal disease activity with golimumab treatment at three or four consecutive visits were more likely to have better long-term outcomes and less radiographic progression than patients who did not meet minimal disease activity criteria, according to recently published research.
A group of 405 patients with psoriatic arthritis were enrolled in the GO-REVEAL trial. Patients had poor response to conventional treatments and had active psoriatic arthritis defined by at least three swollen and three tender joints, and the presence of at least one plaque psoriasis lesion 2 cm or larger in surface area.
The phase 3 trial was a randomized, double-blind trial with a placebo-controlled study through week 24, followed by an open-label extension for up to 5 years. Patients were randomized to receive blinded subcutaneous injections of either placebo, 50 mg golimumab or 100 mg golimumab every 4 weeks. Dose escalation was available for patients with an improvement of less than 10% at week 16, and all patients who received placebo were switched to 50 mg golimumab. By week 252, 126 patients discontinued the study, primarily due to adverse events or inadequate response.
A significantly greater response and achievement of minimal disease activity was observed in patients who received golimumab compared to placebo at week 14 and week 24, with no effect observed from baseline use of methotrexate.
Regardless of the initial treatment, patients who achieved minimal disease activity at three and four or more consecutive time points had significantly less radiographic progression and better functional outcomes at 5 years compared with patients who did not reach minimal disease activity criteria. However, achievement of minimal disease activity did not necessarily affect changes in skin involvement at week 256 in patients with 3% or greater body surface area affected at baseline. – by Shirley Pulawski
Disclosure s : The research was supported by Janssen Research and Development and Merck/Schering-Plough. Please see the full study for a list of all authors’ relevant financial disclosures.