Τίτλος:
Effectiveness of IL-12/23 inhibition (ustekinumab) versus tumour necrosis factor inhibition in psoriatic arthritis: Observational PsABio study results
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objectives To evaluate 6-month effectiveness of ustekinumab versus tumour necrosis factor inhibitor (TNFi), analysing predictors of low disease activity (LDA)/remission. Methods PsABio is a prospective, observational cohort study of patients with psoriatic arthritis (PsA) at 92 sites in eight European countries, who received first-line to third-line ustekinumab or a TNFi. Comparative achievement at 6 months of clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA) LDA/remission, and minimal disease activity (MDA)/very LDA using propensity score (PS)-adjusted multivariate logistic regression was assessed. Results In the final analysis set of 868 participants with 6-month follow-up data (ustekinumab, n=426; TNFi, n=442), with long-standing disease and a high mean cDAPSA score (31.0 vs 29.8, respectively), proportions of patients in ustekinumab/TNFi treatment groups achieving cDAPSA LDA at 6 months were 45.7%/50.7%. cDAPSA remission was achieved in 14.9%/19.2%, and MDA in 26.4%/30.8% of patients. PS-adjusted odds ratios (OR; 95% confidence interval (CI)) of reaching cDAPSA LDA and MDA were 0.73 (0.46 to 1.15) and 0.87 (0.61 to 1.25) with ustekinumab versus TNFi, indicating no significant difference. High baseline body mass index or high cDAPSA were associated with a lower chance (OR (95% CI)) of reaching cDAPSA LDA with TNFi (0.94 (0.89 to 0.99) and 0.64 (0.52 to 0.79), respectively). Predictive factors were similar to previously published evidence, with cDAPSA and 12-item Psoriatic Arthritis Impact of Disease scores and chronic widespread pain at baseline appearing as new risk factors for unfavourable outcome. Safety data were similar between groups. Conclusion Treatment targets were reached similarly after 6 months of treatment with ustekinumab and TNFi. © Author(s) (or their employer(s)) 2021.
Συγγραφείς:
Smolen, J.S.
Siebert, S.
Korotaeva, T.V.
Selmi, C.
Bergmans, P.
Gremese, E.
Joven-Ibáñez, B.
Katsifis, G.
Noël, W.
Nurmohamed, M.T.
Richette, P.
Sfikakis, P.P.
De Vlam, K.
Theander, E.
Gossec, L.
Περιοδικό:
Annals of the Rheumatic Diseases
Εκδότης:
BMJ Publishing Group
Λέξεις-κλειδιά:
antirheumatic agent; interleukin 12; interleukin 23; tumor necrosis factor inhibitor; ustekinumab, adult; cohort analysis; comparative study; female; human; male; middle aged; pathophysiology; prospective study; psoriatic arthritis; treatment outcome, Adult; Antirheumatic Agents; Arthritis, Psoriatic; Cohort Studies; Female; Humans; Interleukin-12; Interleukin-23; Male; Middle Aged; Prospective Studies; Treatment Outcome; Tumor Necrosis Factor Inhibitors; Ustekinumab
DOI:
10.1136/annrheumdis-2021-220263
