Frederic Lavie, MD, PhD: cDAPSA Demonstrates Efficacy in Monitoring Disease Activity in PsA

Post hoc analyses of the DISCOVER-1 and DISCOVER-2 trials demonstrated the promising effects of guselkumab, a fully human interleukin (IL)-23p19-subunit inhibitor, on the Clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA) among a cohort of patients with moderate to high active psoriatic arthritis (PsA).

In an interview with HCPLive, Frederic Lavie, MD, PhD, head of Global Medical Affairs Rheumatology at the Janssen Pharmaceutical Companies of Johnson & Johnson, said the team of investigators sought to validate the composite score that could measure disease activity in these patients in a more simplified approach than what is currently used in clinical trials.

“The difference between clinical trials and real life is that most of the time the physicians don't have the time to assess all the single joints and to do all the measures that are associated with the composite score that enables us to demonstrate the efficacy of the drugs in the setting of a clinical trial,” Lavie explained. “So, we desperately need to find composite scores that can be used and validated in clinical trials, but also can be used in clinical practice.”

In the study presented at the 2024 European Congress of Rheumatology (EULAR) conference, bio-naïve patients received either guselkumab 100 mg at week 0, week 4, and every 8 weeks (Q8W); guselkumab 100 mg at week 0, week 4, and every 4 weeks (Q4W), or placebo with a crossover to guselkumab 100 mg Q4W starting at week 24. Eligible patients had moderate (>13 - ≤27) or high (>27) levels of joint disease activity at baseline.

Investigators compared the cDAPSA response and the state of low disease activity or remission—a score <13—in patients treated with guselkumab compared with placebo. They also analyzed the number of patients who were in low disease activity and remission at week 24 and those who reached remission at week 52 and week 100. Additionally, the team assessed if early response was able to predict a reduction in radiographic progression using cDAPSA results.

Results showed that using this simple tool, providers can accurately measure the level of disease activity in patients and that evaluation can predict whether the patient will have radiographic progression.

“I think that moving forward, the cDAPSA will become more and more important,” Lavie explained. “And this is why at Janssen we wanted to look into our data and see if we could help the scientific community make progress with this tool. It will become more and more important, as we enter in the era of treat-to-target, to have tools that enable the physicians to closely monitor the disease activity of the patients without spending too much time in the clinic looking at the different endpoints.”

The transcript was edited for clarity.

Disclosures: Lavie is the head of Global Medical Affairs Rheumatology at Janssen.