Guselkumab, a targeted inhibitor of interleukin-23, has emerged as a promising therapy for psoriatic arthritis, offering hope for improved patient outcomes.
A prospective multicenter study aimed to shed light on the effectiveness of using guselkumab for psoriatic arthritis (PsA) management by analyzing the experiences of PsA patients over 6 months. The study also looked at the drug retention rate (DRR) of guselkumab, exploring how comorbidities and specific patient clinical profiles influence treatment outcomes over an 18-month prospective follow-up period.
The comprehensive approach strived to illuminate the nuances of managing PsA with guselkumab in everyday clinical practice. The study’s results are published in the journal Rhemuatology and Therapy.
The Methods Used
Disease Activity Index for Psoriatic Arthritis (DAPSA) scores were calculated at baseline and after 3 and 6 months of therapy. Tender and swollen joints, C-reactive protein (CRP) levels, and values for the Leeds Enthesitis Index and Bath Ankylosing Spondylitis Disease Activity Index were analyzed. Additionally, the cumulative drug retention rate (DRR) was assessed.
Results of Patients Treated With Guselkumab
Among 111 PsA patients treated with guselkumab (mean age 56.8 ± 9.9, 20.7% male), the cohort predominantly presented with active, long-standing PsA, with a median disease duration of 6 years (55.9% had a disease duration of ≥5 years). Over half (55%) had comorbidities. Nearly four-fifths (78.4%) had previously received biologic disease-modifying anti-rheumatic drugs (bDMARDs), and 60.4% were being treated concomitantly with conventional synthetic DMARDs (csDMARDS).
After 6 months, a notable decrease in DAPSA scores was recorded (β − 15.47, p = 0.001, 95% confidence interval (CI) − 23.15 to − 9.79), with 39.6% of participants achieving a DAPSA score of ≤ 14.
At the end of the cumulative follow-up period, 71.2% were continuing with guselkumab treatment, while 24.3% had discontinued due to lack of efficacy, leading to an estimated 18-month DRR of 66.7% and an average treatment duration of 9.8 ± 4.1 months. The DRR did not significantly vary with disease duration, the presence of comorbidities, obesity, concurrent use of csDMARDs, or prior bDMARD therapy.
Real-World Effectiveness of Guselkumab
The study demonstrated the 6-month real-world effectiveness of guselkumab in treating PsA patients with a history of active, long-standing disease, previous bDMARD therapy, and comorbidities. The relatively high DRR over 18 months was not influenced by disease duration, comorbidities, obesity, or previous bDMARD treatment.
Source:
Ruscitti, P., Cataldi, G., Gentile, M., Dionisi, A., Volpe, P., Finucci, A., Verardi, L., Di Muzio, C., Italiano, N., Celletti, E., Penta, M., Di Cola, I., Marrelli, A., Alfonsi, A., Monache, F. D., Cipollone, F., Gabini, M., & Cipriani, P. (2024). The Evaluation of Effectiveness and Safety of Guselkumab in Patients with Psoriatic Arthritis in a Prospective Multicentre “Real-Life” Cohort Study. Rheumatology and Therapy (Print). https://doi.org/10.1007/s40744-024-00649-2
