Ustekinumab or TNF Inhibitor Treatment May Improve PsA Patient Reported Outcomes

Patient-reported outcomes (PROs) improved following 3-year ustekinumab or tumor necrosis factor (TNF) inhibitor treatment among patients with psoriatic arthritis (PsA), according to results of a prospective, observational study published in Arthritis Research & Therapy.

The PsABio study included patients with PsA who were prescribed first- to third-line ustekinumab or a TNF inhibitor and remained on the drug for 3 years. Investigators aimed to evaluate the real-world effects of these drugs on PROs and their association with PsA effectiveness endpoints over 3 years.

Patient reported outcomes were assessed using the EuroQol-5 dimensions health state visual analogue scale (EQ-5D VAS), 12-item Psoriatic Arthritis Impact of Disease questionnaire (PsAID-12; range 0–10), and the Work Productivity and Activity Impairment for Psoriatic Arthritis questionnaire (WPAI).

Results were expressed as a percentage for each domain, and the association between PROs and WPAI with effectiveness endpoints, clinical disease activity index for psoriatic arthritis (cDAPSA), low disease activity (LDA)/remission, minimal disease activity (MDA), and very low disease activity (VLDA) were analyzed.

A total of 437 patients were included in the analysis. Mean patient age was 49.1 years; 47.8% of patients were women.

Following 3 years of treatment with either ustekinumab or TNF inhibitors, both groups showed similar improvements in EQ-5D VAS. The mean change from baseline was 11.0 for the ustekinumab group and 18.9 for the TNF inhibitor group.

Similarly, both groups also showed improvements in the PsAID-12 after 3 years. The mean change from baseline was -2.9 for the ustekinumab group -3.5 for the TNF inhibitor group.

Patients treated with TNF inhibitors had lower work productivity at baseline vs those treated with ustekinumab. The mean productivity reduction was 58.8 for the TNF inhibitor group and 43.3 for the ustekinumab group.

Patients who received TNF inhibitor treatment demonstrated a more significant improvement in their work productivity vs those who received ustekinumab treatment, after 3 years. This resulted in similar levels of overall work productivity between both groups. The mean improvement was 44.5% for the TNF inhibitor group and 24.9% for the ustekinumab group. A similar trend was observed for activity impairment.

Patients who reached effectiveness endpoints, such as cDAPSA LDA/remission, MDA, and VLDA, in both treatment groups demonstrated more significant improvements in PROs and WPAI compared with those who did not attain these endpoints.

The study was limited by its nonrandomized nature.

The study authors concluded, “Patients achieving effectiveness endpoints had improved PROs, independent of treatment group. These findings may be useful for physicians in aiding treatment decisions in clinical practice.”

Disclosure: One of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.