Real-World Study Confirms Similar Efficacy of Guselkumab and IL-17i for PsA

Laure Gossec, MD, PhD

Credit: Sorbonne University

New findings from an observational study found that patients with psoriatic arthritis (PsA) receiving guselkumab or IL-17 inhibitor (IL-17i) treatment had comparable real-world efficacy, potentially helping to inform physician treatment choices.¹

These findings, from the PsABIOnd study, were presented at the American College of Rheumatology (ACR) Convergence 2024, held November 14-19 in Washington, DC, by Laure Gossec, MD, PhD, Professor of Rheumatology, Pitié-Salpêtrière Hospital and Sorbonne University - Pierre et Marie Curie Campus, Paris, France.

“We now have many drugs available for the treatment of PsA. We have 6 different modes of action now available to us on top of conventional synthetic DMARDs, and we have data from randomized control trials showing that each of these drugs works better than placebo, but we are lacking large comparative, head to head trials of 1 drug against another, in particular for modes of action which have appeared after the TNF inhibitors,” Gossec told HCPLive® during the meeting.

The PsABIOnd study included 360 patients receiving guselkumab and 326 receiving IL-17i as of January 8, 2024.2At baseline, participants receiving guselkumab and IL-17i had a mean age of 52.0 and 53.6 years, and 63.1%/63.8% pts had previously received ≥1 targeted drug, respectively.¹

Gossec and colleagues found that treatment persistence was high at 6 months, with 94.2% (n = 339) of the guselkumab group and 93.3% (n = 304) of the IL-17i group remaining on initial treatments at 6 months (PS-adjusted hazard ratio of GUS vs IL-17i stop/switch, 0.87 [95% CI, 0.47-1.61]).¹

Similar rates of efficacy were seen at 6 months, with 39.7% (95% CI, 32.2-47.3) of the guselkumab group and 34.3% (95% CI, 27.3-41.7) of the IL-17i group achieving cDAPSA LDA/REM. Similarly, DAPSA LDA/REM was achieved by 38.0% of the guselkumab group (95% CI, 30.0-46.5) compared with 38.9% (95% CI, 31.1-47.2) of the IL-17i group, psoriasis body surface area <3% was achieved by 34.9% (95% CI, 29.7%-40.1) of the guselkumab group and 31.5% (95% CI, 26.1-36.9)of the IL-17i group, minimal disease activity by 24.0% (95% CI, 19.4-29.0) of the guselkuimab group and 28.6% (95% CI, 23.4-34.2) of the IL-17i group, resolution of enthesitis by Leeds Enthesitis Index by 45.1% (95% CI, 37.6-52.8) of the guselkumab group and 48.5% (95% CI, 40.8-56.3) of the IL-17i group, and dactylitis resolution by 60.3% (95% CI, 47.2-72.4) of the guselkumab groupand 65.6% (95% CI, 52.7-77.1) of the IL-17i group.¹

“We really need to insist on the importance of shared decision making in PSA, because it's a disease where the patient burden is really high, not only because of the disease itself, the skin involvement, but also the comorbidities. And we really need to make the best choice for our patients,” Gossec said.

REFERENCES

1. Gossec L, Sharaf M, Baraliakos X, et al. Guselkumab and IL-17 Inhibitors Show Comparable Treatment Persistence and Effectiveness in Psoriatic Arthritis: 6-month Interim Results of the PsABIOnd Observational Cohort Study. Presented at: ACR Convergence 2024; November 14-19; Washington, DC. Abstract 1464

2. Siebert S, Behrens F, Lubrano E, et al. PsABIOnd Study and eDaily Substudy Design: Long-Term Effectiveness and Safety of Guselkumab and IL-17 Inhibitors in Routine Clinical Practice in Patients with Psoriatic Arthritis. Rheumatol Ther. 2023;10(2):489-505. doi:10.1007/s40744-022-00518-w