Ustekinumab, TNF inhibitors exhibit comparable 3-year persistence in psoriatic arthritis
Click Here to Manage Email Alerts
Ustekinumab and TNF inhibitors demonstrate comparably persistent effects at 3 years in patients with psoriatic arthritis, but with fewer adverse events in those receiving ustekinumab, according to data.
“The ultimate goal of PsA therapy is to achieve the lowest possible disease activity, defined by composite measures such as the clinical Disease Activity Index for PSA (cDAPSA) and minimal disease activity/very low disease activity (MDA/VLDA),” Laure Gossec, MD, PhD, of Sorbonne University and Pitié-Salpêtrière Hospital, in Paris, and colleagues wrote in the Annals of the Rheumatic Diseases. “Treatment persistence is of critical importance for optimization of symptom remission and functional capacity and to help reduce health care costs.”
To investigate the persistence and effectiveness of ustekinumab (Stelara, Janssen) vs. a TNF inhibitor a in real-world setting among patients with PsA, Gossec and colleagues conducted PsABio, a prospective, observational study. The study specifically followed adults with PsA who received ustekinumab or a TNF inhibitor as a first- to third-line treatment.
The researchers assessed patients’ treatment persistence and effectiveness — defined as achieving clinical Disease Activity for PsA (cDAPSA) low disease activity or remission, and minimal or very low disease activity — every 6 months. Safety outcomes included all adverse events stemming from treatment. The study ran 3 years per patient, and follow-up visits were executed twice yearly.
The analysis included 895 patients, with 439 receiving ustekinumab and 456 in the TNF inhibitor group. According to the researchers, the percentage of patients continuing their initial treatment of ustekinumab or TNF inhibitors at 3 years was similar, at 49.9% and 47.8%, respectively.
Among the entire cohort, 58.6% of patients receiving ustekinumab achieved cDAPSA low disease activity and 31.4% achieved disease remission. In patients receiving a TNF inhibitor, 69.8% achieved cDAPSA low disease activity and 45% achieved remission. Additionally, although both therapies demonstrated favorable safety profiles over 3 years, fewer adverse events occurred in the ustekinumab group.
“In conclusion, 3-year results from the PsABio study demonstrated that, supporting our previous observations, ustekinumab and TNFi in general performed as effective and well tolerated first-line to third-line biological treatments for PsA in real-world clinical practice, demonstrating safety over a year,” Gossec and colleagues wrote.
“Adjusting for imbalances of outcome-modifying baseline characteristics, such as line of treatment, extent of skin involvement and monotherapy, resulted in identification of subgroups with a higher probability of long-term drug persistence and lower rates of [adverse events] with ustekinumab,” they added. “In line with our study results, patients with high levels of skin involvement, and in whom [methotrexate] use is contraindicated, may be attractive candidates for treatment with ustekinumab rather than TNFi.”
Collapse
Click Here to Manage Email Alerts