Intravenous Golimumab Effective for Preventing Radiographic Progression in Psoriatic Arthritis

According to data from a randomized controlled trial published in The Journal of Rheumatology, intravenous golimumab performed significantly better than placebo in inhibiting radiographic progression in active psoriatic arthritis (PsA).

The GO-VIBRANT trial randomly assigned patients with active PsA to receive either intravenous placebo (n=239) or intravenous golimumab 2 mg/kg (n=241) at 0, 4, 12, and 20 weeks. Radiographic progression was evaluated as change from baseline to 24 weeks in PsA-modified total Sharp/van der Heijde scores. Single radiographs of the hands and feet were obtained at baseline and 24 weeks and read by 2 independent investigators who were blinded to patient identity, treatment group, and assessment point. In addition to change from baseline in total PsA-modified Sharp/van der Heijde score, investigators also captured the proportions of patients exceeding smallest detectable change or >0 or 0.5 in Sharp/van der Heijde scores.

Patients randomly assigned to receive intravenous golimumab exhibited significantly less radiographic progression compared with placebo-treated patients, with mean changes from baseline to 24 weeks in Sharp/van der Heijde scores of −0.36 and 1.95, respectively (P <.001). Results obtained from the radiographic readers demonstrated good agreement, with intraclass correlation coefficients of 0.93 and 0.92 for Sharp/van der Heijde total scores at baseline and 24 weeks, respectively. Golimumab also better inhibited radiographic progression in subgroup analyses based on baseline demographics, disease characteristics, and concomitant therapy, including methotrexate use.

Eight percent of patients in the golimumab group exceeded the smallest detectable change in Sharp/van der Heijde total score at 24 weeks compared with 27.0% in the placebo group (P <.001). In addition, 28.3% and 18.6% of golimumab-treated patients exceeded a >0 and >0.5 change from baseline, respectively, in total Sharp/van der Heijde score compared with 57.0% and 41.8% of placebo-treated patients (both P <.001). Results were also consistent for component erosion and joint space narrowing scores and in hands and feet. Golimumab also demonstrated inhibition of radiographic progression regardless of clinical response.

Intravenous golimumab performed significantly better than placebo in inhibiting radiographic progression of structural damage in PsA. Further research should examine the effects of long-term golimumab treatment in improving the quality of life of patients with PsA.

Reference

Kavanaugh A, Husni ME, Harrison DD, et al. Radiographic progression inhibition with intravenous golimumab in psoriatic arthritis: week 24 results of a phase III, randomized, double-blind, placebo-controlled trial [published online February 1, 2019]. J Rheumatol. doi: 10.3899/jrheum.180681