Comparative early effectiveness across 14 PsA drugs and 5 classes of PsA treatment: 3-month results from the PRO-SPIRIT study.

IF 5.1 2区 医学 Q1 RHEUMATOLOGY
Lars Erik Kristensen, Khai Jing Ng, Marcus Ngantcha, Jacques Morel, Ennio Lubrano, William Tillett, Rieke Alten, Vinod Chandran, Àngels Martinez Ferrer, Baojin Zhu, Dominika Kennedy, Thorsten Holzkämper, Nicola Gullick, Andris Kronbergs, Walid Fakhouri, Inmaculada de la Torre, Dennis G McGonagle
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Abstract

Background: The psoriatic arthritis (PsA) Observational Study of Persistence of Treatment (PRO-SPIRIT) assesses effectiveness and persistence of real-world PsA treatments. Ixekizumab (IXE) is an interleukin (IL)-17A inhibitor (i) (IL-17Ai), approved for the treatment of adult PsA.

Methods: The aim of this predefined interim analysis was to report baseline characteristics along with early (3-month) descriptive and comparative real-world effectiveness in patients with PsA prescribed with advanced treatment including IL-17Ai; IXE or secukinumab (SEC), IL-12/23i, IL-23i, tumour necrosis factor (TNFi) or Janus kinase (JAKi).

Results: 1192 patients across 6 countries were analysed. At baseline, patients receiving IXE had longer disease duration and higher previous biological/targeted-synthetic disease-modifying antirheumatic drugs experience than patients starting TNFi and SEC 150, and less concomitant conventional-synthetic DMARD use than TNFi and JAKi. Comparative analyses at 3 months showed that: (a) versus TNFi, IXE exhibited similar improvement in clinical Disease Activity in PsA (cDAPSA) but significantly greater improvement in body surface area affected by psoriasis (BSA) and global assessments (physician GA, patient GA (PatGA)); (b) versus IL-12/23i and IL-23i (pooled), IXE showed significantly greater improvement in cDAPSA and PatGA; (c) IXE was as fast as JAKi in improving joint disease activity. Ad hoc analysis indicated that more patients with active psoriasis (BSA ≥3%) achieved minimal disease activity with IXE than JAKi or IL-12/23i. The responses to SEC varied by dosage.

Conclusions: This study confirms the rapid 3-month effectiveness of IXE on joint disease activity-as fast as TNFi and JAKi (cDAPSA), and exceeding IL-12/23i and IL-23i-along with clear benefits to skin.

14 种 PsA 药物和 5 类 PsA 治疗的早期疗效比较:PRO-SPIRIT研究的3个月结果。
背景:银屑病关节炎(PsA)持续治疗观察研究(PRO-SPIRIT)评估了实际PsA治疗的有效性和持续性。Ixekizumab(IXE)是一种白细胞介素(IL)-17A抑制剂(IL-17Ai),已被批准用于治疗成人PsA:这项预先确定的中期分析旨在报告PsA患者的基线特征、早期(3个月)描述性和实际疗效比较,包括IL-17Ai、IXE或secukinumab (SEC)、IL-12/23i、IL-23i、肿瘤坏死因子(TNFi)或Janus激酶(JAKi):对6个国家的1192名患者进行了分析。基线时,与开始使用TNFi和SEC 150的患者相比,接受IXE治疗的患者病程更长,既往使用生物/靶向合成修饰性抗风湿药物的经历更多,同时使用传统合成DMARD的次数也少于TNFi和JAKi。3 个月的比较分析表明(a) 与 TNFi 相比,IXE 对 PsA 临床疾病活动性(cDAPSA)的改善相似,但对银屑病体表面积(BSA)和总体评估(医生 GA、患者 GA(PatGA))的改善明显更大;(b) 与 IL-12/23i 和 IL-23i(联合)相比,IXE 对 cDAPSA 和 PatGA 的改善明显更大;(c) IXE 在改善关节疾病活动性方面的速度与 JAKi 不相上下。特别分析表明,与JAKi或IL-12/23i相比,更多的活动性银屑病患者(BSA≥3%)使用IXE后疾病活动性达到最小。对SEC的反应因剂量而异:本研究证实了 IXE 对关节病活动的 3 个月快速疗效--与 TNFi 和 JAKi(cDAPSA)一样快,超过了 IL-12/23i 和 IL-23i,同时对皮肤也有明显的益处。
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来源期刊
RMD Open
RMD Open RHEUMATOLOGY-
CiteScore
7.30
自引率
6.50%
发文量
205
审稿时长
14 weeks
期刊介绍: RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.
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